• Login
    View Item 
    •   UMB Digital Archive
    • School, Graduate
    • Theses and Dissertations All Schools
    • View Item
    •   UMB Digital Archive
    • School, Graduate
    • Theses and Dissertations All Schools
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Browse

    All of UMB Digital ArchiveCommunitiesPublication DateAuthorsTitlesSubjectsThis CollectionPublication DateAuthorsTitlesSubjects

    My Account

    LoginRegister

    Statistics

    Display statistics

    Biomarkers of prenatal drug and tobacco exposure and predictors of neonatal outcome

    • CSV
    • RefMan
    • EndNote
    • BibTex
    • RefWorks
    Author
    Gray, Teresa
    Advisor
    Levine, Barry, 1957-
    Huestis, Marilyn
    Date
    2010
    Type
    dissertation
    
    Metadata
    Show full item record
    Abstract
    Meconium, the first neonatal feces, is considered the "gold standard" for detecting prenatal drug exposure; however, several questions remain unanswered, including the efficacy of meconium testing compared to maternal self-report, drug detection windows, appropriate analytes of interest, maternal dose-meconium concentration relationships and prediction of adverse infant outcomes by meconium quantitative and/or qualitative results. Several analytical methodologies, offering significant improvements over existing procedures, were developed and validated to quantify drug and tobacco biomarkers in meconium. Toxicological results of meconium specimens obtained through national and international collaborations were compared to maternal self-report and biological testing results, and neonatal outcome parameters. Contrary to previous investigations of prenatal cocaine and opioid use, maternal self-report was more important than meconium testing for identifying prenatal cannabis and methamphetamine exposure. Meconium was previously assumed to reflect second and third trimester use, but objective evidence from maternal urinalysis throughout gestation suggest that the actual drug detection window spans only the third trimester. Novel biomarkers of tobacco, methamphetamine and cannabis were identified in meconium, improving the identification of affected infants. Furthermore, cleaving glucuronide conjugates was necessary to maximize drug-exposure detection for cannabinoids, but not tobacco biomarkers. Meconium concentrations observed in meconium were not related to maternal dose, but tobacco biomarker concentrations greater than 10 ng/g differentiated active smokers from passive or non-exposed women. Higher biomarker concentrations in meconium did not predict more severe neonatal outcome. Yet, the presence of a tobacco or cannabis biomarker in meconium was associated with fetal growth deficits. Also, opioid-positive meconium in methadone-exposed neonates indicated increased risk of prematurity and longer hospital stays. These data reinforce the need to evaluate the disposition of drug classes in meconium individually. Also, if maternal drug use in the first or second trimester is suspected, another means of objectively identifying exposure is necessary. Quantitative analyses in meconium may not be necessary, as no concentration effects were observed, but all assays employed for meconium testing should adhere to clinical and forensic standards of quality assurance.
    Description
    University of Maryland, Baltimore. Toxicology. Ph.D. 2010
    Keyword
    prenatal
    Drugs
    Meconium
    Pharmaceutical Preparations
    Tobacco
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/871
    Collections
    Theses and Dissertations All Schools
    Theses and Dissertations School of Medicine

    entitlement

     
    DSpace software (copyright © 2002 - 2022)  DuraSpace
    Quick Guide | Policies | Contact Us | UMB Health Sciences & Human Services Library
    Open Repository is a service operated by 
    Atmire NV
     

    Export search results

    The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download. To export the items, click on the button corresponding with the preferred download format.

    By default, clicking on the export buttons will result in a download of the allowed maximum amount of items.

    To select a subset of the search results, click "Selective Export" button and make a selection of the items you want to export. The amount of items that can be exported at once is similarly restricted as the full export.

    After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format.