Newborn Drug Testing

 

Timely detection of in utero drug exposure is critical for effective detection and management of intoxication, withdrawal syndrome, and long-term needs (social and medical) for exposed neonates. Two modes of testing are available: umbilical cord tissue and meconium.

Chain-of-custody may not be required:

Umbilical cord and meconium drug tests are performed to support clinical and social management decisions, and do not usually require chain-of-custody.

If chain-of-custody is required, ARUP can provide a specimen tracking form to help authenticate the specimen collection and transport process, if desired. Contact ARUP Client Services for more information.

Meconium

Meconium is the traditional specimen to detect and document maternal drug use during pregnancy, approximately the last trimester of a full-term birth. ARUP’s neonatal drug testing in meconium is a qualitative immunoassay screen for nine drug classes. Specimens testing positive for one or more drugs are reflexed to highly sensitive and specific mass spectrometry technology for confirmation.

Drugs and Drug Metabolites Reported

Opioids	Stimulants	Sedatives/Hypnotics	Other
buprenorphine norbuprenorphine methadone methadone metabolite (EDDP) heroin metabolite (6-acetylmorphine) morphine codeine hydromorphone hydrocodone oxycodone oxymorphone	methamphetamine amphetamine MDA MDEA (Eve) MDMA (Ecstasy) cocaine cocaine metabolites: benzoylecgonine m-hydroxybenzoylecgonine cocaethylene	alprazolam a-hydroxyalprazolam butalbital clonazepam 7-amino clonazepam diazepam nordiazepam oxazepam temazepam lorazepam midazolam phenobarbital	cannabis (THC) metabolite phencyclidine (PCP)

Umbilical Cord Tissue

Umbilical cord tissue is a relatively new specimen to detect and document maternal drug use during pregnancy, approximately the last trimester of a full term birth. ARUP’s neonatal drug testing in umbilical cord tissue is based on highly sensitive and specific qualitative liquid chromatography and tandem mass spectrometry (LC-MS/MS) .

For additional information regarding testing strategies, refer to our Laboratory Test Directory.

• Enhanced report
• Umbilical Cord Collection Video

Drugs and Drug Metabolites Reported in Drug Detection Panel, Umbilical Cord Tissue, Qualitative (2006621)

Opioids	Stimulants	Sedatives/Hypnotics	Other
​buprenorphine norbuprenorphine methadone methadone metabolite (EDDP) heroin metabolite (6-acetylmorphine) morphine codeine dihydrocodeine hydrocodone norhydrocodone hydromorphone oxycodone noroxycodone oxymorphone noroxymorphone tramadol n-desmethyl tramadol o-desmethyl-tramadol tapentadol meperidine fentanyl propoxyphene naloxone​	methamphetamine amphetamine MDMA (Ecstasy) cocaine cocaine metabolites: benzoylecgonine m-hydroxybenzoylecgonine cocaethylene phentermine	7-amino clonazepam a-hydroxyalprazolam a-hydroxymidazolam alprazolam butalbital clonazepam diazepam lorazepam midazolam nordiazepam oxazepam phenobarbital temazepam zolpidem	phencyclidine (PCP) gabapentin

Additional Resources

• Umbilical Cord Tissue Collection and Testing
  A digital version of trifold focused on umbilical cord collection and testing to determine what drugs babies have been exposed to in utero.
• ARUP Consult: Newborn Drug Testing
  ARUP offers testing of two specimen types for newborn drug testing – umbilical cord tissue and meconium.
• ARUP Consult: Clinical Toxicology Testing
  Clinical toxicology in the laboratory sphere deals with the identification of chemicals, drugs, or toxins.
• Newborn Drug Testing Brochure
  Discusses features and benefits of newborn drug testing.
• Drug Cut-off Limits for Meconium and Umbilical Cord
  Drug test table for meconium and umbilical cord tissue.
• Drug Detection Panel, Umbilical Cord Tissue, Qualitative
  Detects and documents maternal drug use during approximately the last trimester of a full term birth.
• Umbilical Cord Collection Instructions
  Provides overview of umbilical cord tissue collection for drug testing at ARUP.
• Monitoring Pain Management Medications in Pregnancy and the Neonate
  Presented by: Gwen McMillin, PhD - Medical Director, Toxicology and Pharmacogenetics, ARUP Laboratories 2017.
• Umbilical Cord Collection Video
  ARUP Laboratories, Published on Feb 26, 2018. Umbilical cord collection instructions for abused drug testing in newborns.
• If Baby Could Talk: Laboratory Detection of Prenatal Drug Exposure
  Presented by Gwen McMillin, PhD. Meconium and umbilical cord can detect drug-exposed newborns.
• Spotlight on Testing: Drug Testing with Umbilical Cord Tissue
  Presented by Gwen McMillin, PhD