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Analysis of umbilical cord tissue as an indicator of in utero exposure to toxic adulterating substances

In utero drug exposure is a significant public health threat to the well-being and normal development of the neonate. Recently, testing of umbilical cord tissue (UCT) has been employed to measure illicit drug exposure, as drugs used by the mother during the third trimester may be retained in the UCT...

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Autores principales: Midthun, Kari M., Nelson, Brandon N., Strathmann, Frederick G., Browne, Thom, Logan, Barry K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10070803/
https://www.ncbi.nlm.nih.gov/pubmed/37025298
http://dx.doi.org/10.3389/fped.2023.1127020
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author Midthun, Kari M.
Nelson, Brandon N.
Strathmann, Frederick G.
Browne, Thom
Logan, Barry K.
author_facet Midthun, Kari M.
Nelson, Brandon N.
Strathmann, Frederick G.
Browne, Thom
Logan, Barry K.
author_sort Midthun, Kari M.
collection PubMed
description In utero drug exposure is a significant public health threat to the well-being and normal development of the neonate. Recently, testing of umbilical cord tissue (UCT) has been employed to measure illicit drug exposure, as drugs used by the mother during the third trimester may be retained in the UCT. Focus has also been given to potential adverse health effects among drug users, resulting from exposure to pharmacologically active adulterants and cutting agents in the street drug supply. The in utero effects of these substances have not been well studied in humans, nor has their presence been demonstrated as a means for assessing adverse health effects in the neonate. Here, we describe the application of a novel test method to analyze UCT for the presence of more than 20 common adulterating/cutting substances via LC/Q-TOF. In total, 300 de-identified UCT samples were analyzed–all had previously tested positive for cocaine or opiates. Generally, the positivity rates of individual compounds were similar between the Cocaine and Opiates Subgroups, apart from levamisole, xylazine, dipyrone (metabolites), and promethazine. Many of the adulterants used in the street drug supply do have legitimate medicinal/therapeutic uses, including several of the compounds most frequently detected in this study. Caffeine and lidocaine were the most frequently identified compounds both individually (>70% each) and in combination with each other. Alternatively, levamisole, an adulterant with no legitimate therapeutic use, was present in 12% of cases. Importantly, this data demonstrates that the detection of traditional drugs of abuse may serve as indicators of potential in utero exposure to toxic adulterating substances during gestation. While there is cause for concern with respect to any unintentional drug exposure, illicit drug use during pregnancy, including uncontrolled dosing, poly-adulterant consumption, and the interactions of these drug mixtures, produces a significant public health threat to the neonate which warrants further study.
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spelling pubmed-100708032023-04-05 Analysis of umbilical cord tissue as an indicator of in utero exposure to toxic adulterating substances Midthun, Kari M. Nelson, Brandon N. Strathmann, Frederick G. Browne, Thom Logan, Barry K. Front Pediatr Pediatrics In utero drug exposure is a significant public health threat to the well-being and normal development of the neonate. Recently, testing of umbilical cord tissue (UCT) has been employed to measure illicit drug exposure, as drugs used by the mother during the third trimester may be retained in the UCT. Focus has also been given to potential adverse health effects among drug users, resulting from exposure to pharmacologically active adulterants and cutting agents in the street drug supply. The in utero effects of these substances have not been well studied in humans, nor has their presence been demonstrated as a means for assessing adverse health effects in the neonate. Here, we describe the application of a novel test method to analyze UCT for the presence of more than 20 common adulterating/cutting substances via LC/Q-TOF. In total, 300 de-identified UCT samples were analyzed–all had previously tested positive for cocaine or opiates. Generally, the positivity rates of individual compounds were similar between the Cocaine and Opiates Subgroups, apart from levamisole, xylazine, dipyrone (metabolites), and promethazine. Many of the adulterants used in the street drug supply do have legitimate medicinal/therapeutic uses, including several of the compounds most frequently detected in this study. Caffeine and lidocaine were the most frequently identified compounds both individually (>70% each) and in combination with each other. Alternatively, levamisole, an adulterant with no legitimate therapeutic use, was present in 12% of cases. Importantly, this data demonstrates that the detection of traditional drugs of abuse may serve as indicators of potential in utero exposure to toxic adulterating substances during gestation. While there is cause for concern with respect to any unintentional drug exposure, illicit drug use during pregnancy, including uncontrolled dosing, poly-adulterant consumption, and the interactions of these drug mixtures, produces a significant public health threat to the neonate which warrants further study. Frontiers Media S.A. 2023-03-21 /pmc/articles/PMC10070803/ /pubmed/37025298 http://dx.doi.org/10.3389/fped.2023.1127020 Text en © 2023 Midthun, Nelson, Strathmann, Browne and Logan. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Midthun, Kari M.
Nelson, Brandon N.
Strathmann, Frederick G.
Browne, Thom
Logan, Barry K.
Analysis of umbilical cord tissue as an indicator of in utero exposure to toxic adulterating substances
title Analysis of umbilical cord tissue as an indicator of in utero exposure to toxic adulterating substances
title_full Analysis of umbilical cord tissue as an indicator of in utero exposure to toxic adulterating substances
title_fullStr Analysis of umbilical cord tissue as an indicator of in utero exposure to toxic adulterating substances
title_full_unstemmed Analysis of umbilical cord tissue as an indicator of in utero exposure to toxic adulterating substances
title_short Analysis of umbilical cord tissue as an indicator of in utero exposure to toxic adulterating substances
title_sort analysis of umbilical cord tissue as an indicator of in utero exposure to toxic adulterating substances
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10070803/
https://www.ncbi.nlm.nih.gov/pubmed/37025298
http://dx.doi.org/10.3389/fped.2023.1127020
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