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Comparison of meconium and neonatal hair analysis for detection of gestational exposure to drugs of abuse

¹ The Motherisk Program, Division of Clinical Pharmacology and Toxicology, Hospital for Sick Children and University of Toronto, Toronto, Canada
² Department of Neonatology, Hadassah Medical Center and The Hebrew University, Jerusalem, Israel

Correspondence to:
Correspondence to:
Dr Koren, Director, Motherisk Program, Division of Clinical Pharmacology and Toxicology, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada;
gkoren{at}sickkids.ca

Background: Meconium and hair are two biological markers of in utero exposure to illicit drugs.

Objective: To compare the sensitivity of the two tests for different drugs.

Setting: Motherisk laboratory which tests in utero drug exposure in Toronto.

Methods: Cocaine, benzoylecgonine, opiates, cannabis, benzodiazepines, methadone, and barbiturates were measured in pairs of hair and meconium samples from the same neonates.

Results: Meconium was marginally more sensitive than neonatal hair for detection of cocaine and cannabis, possibly because it may detect second trimester exposure whereas hair grows only during the third trimester of pregnancy. There was a significant correlation between hair and meconium concentrations of cocaine, cannabis, and opiates.

Conclusion: In cases of clinical suspicion and a negative neonatal urine test, both meconium and hair are effective biological markers of in utero illicit drug exposure. Meconium may be more sensitive, but neonatal hair is available for three months whereas meconium is available for only one or two days. In contrast, the use of meconium, being a discarded material, is more acceptable to some parents than hair testing, which entails cutting scalp hair from the newborn.

Keywords: drug exposure; hair analysis; meconium analysis

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