RESUMO
This review aims to bring together the works on pesticide analysis in alternative biological matrices, such as hair, breast milk, meconium, and placenta. Much is known about the harmful effects of the use and indirect consumption of pesticides; however, the assessment of long-term contamination is still unclear. In this sense, the use of hair as an alternative biological matrix has some advantages, such as segmentation, which makes it possible to assess the presence of xenobiotics to which individuals have been exposed over the years, and possibly relate this exposure to symptoms or diseases that may affect them. Complementarily, the other matrices discussed are able to provide information about the exposure of mothers and newborn children, who may have been indistinctly exposed to pesticides while in the womb. Through the analysis of studies already performed, it can be observed that organochlorine pesticides (OCPs) are the most likely to be found within the biological matrices discussed here, due to the lipophilic characteristics of these compounds. For the other classes, biotransformation products are more easily detected.
Assuntos
Hidrocarbonetos Clorados , Praguicidas , Recém-Nascido , Gravidez , Feminino , Humanos , Praguicidas/toxicidade , Praguicidas/análise , Mecônio/química , Placenta/química , Hidrocarbonetos Clorados/análise , Cabelo/química , Monitoramento AmbientalRESUMO
Background/Objective: As a developing country, Brazil presents a wide range of environmental risks that can constitute hazards to child health. The country also presents different socio-economic-cultural conditions that could be responsible for determining different vulnerability and susceptibility levels for the population, which can potentiate the effects of the environmental pollutants. The Rio Birth Cohort Study (PIPA project) is a prospective maternal-infant health study, hosted in the city of Rio de Janeiro (Southeastern Brazil), designed to investigate separate and combined effects of environmental chemical pollutants, as well as the interactions between these exposures and sociocultural environment and epigenetic patterns. This paper presents the learned lessons and strategies to address the shortcomings detected from this pilot study. Methods: The study population will be all children born at the Federal University of Rio de Janeiro Maternity Hospital from July 1st, 2020 to June 30th, 2021. The estimated population is of 2,500 children. The study will collect social, demographic, and health information from pregnant women and their children up to four years of age. Biological samples from both mothers and newborns will be collected to assess metal, pesticide and plasticizer exposure. All newborns will have their landmarks of physical, neurological, psychological, and cognitive development recorded at specific ages. Findings: A pilot study was carried out between September 2017 and August 2018, totaling 142 enrolled pregnant women, leading to 135 (95%) births and the collection of umbilical cord (126-93%,) and mother (139-98%) blood samples, as well as both mother (142-100%) and newborn (54-40%) urine samples and newborn meconium samples (117-86.7%). Conclusions: The study proposes a comprehensive assessment of pre- and postnatal exposure to environmental chemicals at multiple time points in a population living in a highly urbanized developing country. As far as we know, this is the only birth cohort in Brazil specifically designed for this purpose.
Assuntos
Desenvolvimento Infantil , Exposição Ambiental/estatística & dados numéricos , Poluentes Ambientais/análise , Exposição à Violência/estatística & dados numéricos , Exposição Materna/estatística & dados numéricos , Adolescente , Adulto , Arsênio , Brasil , Cádmio , Pré-Escolar , Estudos de Coortes , Poluentes Ambientais/sangue , Poluentes Ambientais/urina , Epigênese Genética , Feminino , Sangue Fetal/química , Humanos , Lactente , Recém-Nascido , Chumbo , Masculino , Mecônio/química , Mercúrio , Metais/sangue , Metais/urina , Praguicidas/sangue , Praguicidas/urina , Projetos Piloto , Plastificantes/análise , Gravidez , Meio Social , Urinálise , Adulto JovemRESUMO
In a retrospective study of 501 neonates with potential in utero substance exposure, the drug detection performance of a commercially available umbilical cord tissue toxicology test was evaluated against a commercially available gold standard meconium toxicology test. Drugs detected in paired meconium and umbilical cord tissue samples were often discordant.
Assuntos
Drogas Ilícitas/análise , Troca Materno-Fetal/fisiologia , Mecônio/química , Efeitos Tardios da Exposição Pré-Natal/diagnóstico , Detecção do Abuso de Substâncias/métodos , Cordão Umbilical/química , Feminino , Seguimentos , Humanos , Drogas Ilícitas/toxicidade , Recém-Nascido , Masculino , Mecônio/citologia , Gravidez , Efeitos Tardios da Exposição Pré-Natal/metabolismo , Estudos Retrospectivos , Cordão Umbilical/citologiaRESUMO
Cannabis misuse during pregnancy is associated with severe impacts on the mother and baby health, such as newborn low birth weight, growth restriction, pre-term birth, neurobehavioral and developmental deficits. In most of the cases, drug abuse is omitted or denied by the mothers. Thus, toxicological analyzes using maternal-fetal matrices takes place as a suitable tool to assess drug use. Herein, meconium was the chosen matrix to evaluate cannabis exposure through identification and quantification of 11-nor-Δ9-tetrahydrocannabinol-9-carboxylic (THCCOOH). Accelerated solvent extraction (ASE) was applied for sample preparation technique to simultaneously extract and hydrolyze conjugated THCCOOH from meconium, followed by a solid-phase extraction (SPE) procedure. The method was developed and validated for gas chromatography-mass spectrometry (GC-MS), reaching hydrolysis efficiency of 98%. Limits of detection (LOD) and quantification (LOQ) were, respectively, 5 and 10â¯ng/g. The range of linearity was LOQ to 500â¯ng/g. Inter and intra-batch coefficients of variation were <8.4% for all concentration levels. Accuracy was in 101.7-108.9% range. Recovery was on average 60.3%. Carryover effect was not observed. The procedure was applied in six meconium samples from babies whose mothers were drug users and showed satisfactory performance to confirm fetal cannabis exposure.
Assuntos
Dronabinol/análogos & derivados , Cromatografia Gasosa-Espectrometria de Massas/métodos , Mecônio/química , Dronabinol/análise , Dronabinol/química , Dronabinol/isolamento & purificação , Dronabinol/metabolismo , Feminino , Glucuronídeos , Humanos , Hidrólise , Recém-Nascido , Modelos Lineares , Abuso de Maconha/metabolismo , Gravidez , Complicações na Gravidez/metabolismo , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
El consumo de alcohol durante la gestación está asociado con un amplio espectro de efectos adversos conocidos como trastornos del espectro alcohólico fetal (TEAF). Así es como a través del dosaje de los esteres etílicos de ácidos grasos (FAEEs) en meconio, como biomarcadores de exposición prenatal al consumo de etanol, nos brinda una herramienta importantísima en el screening de los recién nacidos, facilitando la confi rmación del diagnóstico y la intervención clínica adecuada en los individuos afectados por esta problemática con una mejora en las expectativas y calidad de vida. El síndrome alcohólico fetal (SAF) representa el clásico síndrome y la manifestación más grave inducido por el alcohol de forma repetida durante el embarazo. Dado el carácter heterogéneo de las alteraciones clínicas presentes en los recién nacidos expuestos a etanol, la mayoría de los cuales no son específi cos, conlleva a un diagnóstico del TEAF extremadamente difícil.
Alcohol consumption during pregnancy is associated with a wide range of adverse effects known as fetal alcohol spectrum disorders (FASDs). Through the measurement of Fatty Acid Ethyl Esters (FAEEs) in meconium, as biomarkers of prenatal alcohol exposure, we have a very important tool in the screening of newborns, facilitating the confi rmation of diagnosis and adequate clinical intervention in individuals affected by this problem with improvements in life quality and expectancy. Fetal Alcohol Syndrome (FAS) represents the classic syndrome and the most serious condition is caused by repetitive alcohol consumption during pregnancy. Due to the heterogeneous characteristics of clinical alterations of newborns exposed to ethanol, most of which are not specifi c, diagnosis of FASDs is extremely diffi cult.
O consumo de álcool durante a gravidez é associado a um amplo espectro de efeitos adversos conhecidos, tais como transtornos do espectro do alcoolismo fetal (TEAF). É assim como através da dosagem dos ésteres etílicos de ácidos graxos (FAEEs) em mecô- nio, como biomarcadores de exposição pré-natal ao consumo de etanol, fornece uma ferramenta importantíssima na triagem de recém-nascidos, aprimorando a confi rmação do diagnóstico e a intervenção clínica adequada em indivíduos afectados por este problema com uma melhoria das expectativas e qualidade de vida. Síndrome alcoólica fetal (FAS) representa a síndrome clássica e a mais grave manifestação induzida frequentemente pelo álcool durante a gravidez. Dada a heterogeneidade das alterações clínicas em recémnascidos expostos ao etanol, a maioria das quais são não-específi cas, esta situação gera um diagnóstico de TEAF extremamente difícil.
Assuntos
Humanos , Masculino , Feminino , Gravidez , Complicações na Gravidez/prevenção & controle , Mecônio , Mecônio/química , Transtornos do Espectro Alcoólico Fetal , Transtornos do Espectro Alcoólico Fetal/mortalidade , Transtornos do Espectro Alcoólico Fetal/prevenção & controleRESUMO
OBJECTIVES: To determine whether antiretroviral (ARV) medications can be detected in meconium from second or third trimester, labor and delivery (L&D), or postnatal exposures. STUDY DESIGN: Twenty ARV medications were quantified by liquid chromatography-tandem mass spectrometry in 598 meconium samples from uninfected infants born to pregnant women with HIV enrolled in the Pediatric HIV/AIDS Cohort Study. RESULTS: ARV detection in meconium following third trimester exposure was 85.7%-94.4% for all ARVs except stavudine (0%, n = 2), likely because of low doses and a high limit for quantification. Of 107 samples with some second trimester only ARV exposures, meconium was positive for only lopinavir, tenofovir, or efavirenz in 11.8%-14.3% of exposed neonates; administration of these ARVs occurred between gestational weeks 25-28 in the positive samples. Days without lopinavir or tenofovir before delivery significantly correlated with decreasing concentrations of lopinavir and tenofovir in meconium. Tenofovir and lamivudine concentrations significantly correlated with increasing gestational age among infants with continuous second and third trimester exposure. Zidovudine given during L&D or for neonatal prophylaxis was detected in 95.1% and 94.6% of meconium samples, respectively. CONCLUSIONS: Changes in ARV treatments during pregnancy offered a unique opportunity to investigate ARV detection in meconium. ARVs in meconium primarily reflect third trimester ARV exposures, although 6 of 107 second trimester only exposures were detected. Zidovudine administration during L&D was detected in meconium indicating potential urine contamination or rapid incorporation into meconium. These data will improve interpretation of meconium drug test results.
Assuntos
Antirretrovirais/análise , Idade Gestacional , Infecções por HIV/tratamento farmacológico , Mecônio/química , Complicações Infecciosas na Gravidez/tratamento farmacológico , Efeitos Tardios da Exposição Pré-Natal , Cromatografia Líquida , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Gravidez , Terceiro Trimestre da Gravidez , Espectrometria de Massas em TandemRESUMO
OBJECTIVE: To examine associations between amounts of fatty acid ethyl esters (FAEEs) in meconium and cognitive development in school-aged children exposed to alcohol and drugs in utero. STUDY DESIGN: A secondary analysis of a prospective cohort of children, primarily African American and of low socioeconomic status, that was recruited at birth. FAEEs were quantified with gas chromatography via a flame ionization detector. Meconium was analyzed for FAEEs in 216 newborns; 191 of these infants were assessed for IQ at ages 9, 11, and 15 years with the Wechsler Intelligence Scales for Children-Fourth Edition. RESULTS: Longitudinal mixed model analyses indicated that, after we controlled for maternal and child covariates, greater concentrations of FAEEs (ethyl myristate, ethyl oleate, ethyl linoleate, and ethyl linolenate) were associated with lower Wechsler Intelligence Scales for Children-Fourth Edition Verbal Comprehension Index, Working Memory Index, and Full-Scale IQ scores. Associations of FAEEs with Verbal Comprehension Index, Working Memory Index, and Full-Scale IQ did not vary over time. No associations of FAEEs with Perceptual Reasoning and Processing Speed Indices were found. CONCLUSION: Elevated levels of FAEEs in meconium are potential markers for identifying newborns at risk for poor cognitive development related to prenatal alcohol exposure.
Assuntos
Desenvolvimento do Adolescente/fisiologia , Ácidos Araquidônicos/metabolismo , Desenvolvimento Infantil/fisiologia , Cognição/fisiologia , Ésteres/metabolismo , Ácidos Graxos/metabolismo , Mecônio/química , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/metabolismo , Biomarcadores/metabolismo , Criança , Feminino , Feto/metabolismo , Seguimentos , Humanos , Recém-Nascido , Masculino , Gravidez , Estudos Prospectivos , Adulto JovemRESUMO
Drug abuse by pregnant women is considered a serious public health problem worldwide. Meconium is the first excretion in newborns and has been used as an alternative matrix to evaluate in utero drug exposure. Solid phase extraction (SPE) is widely employed to prepare and clean up samples in the field of forensic analysis. Most SPE products require large volumes of solvent, which culminates in longer sample processing times and increased cost per sample. Disposable pipette extraction (DPX) tips have been used as an alternative to traditional SPE cartridges. They combine efficient and rapid extraction with reduced solvent consumption. The purpose of this study was to develop and validate a method to determine nicotine, cotinine, cocaine, benzoylecgonine, cocaethylene and methyl ester anhydroecgonine in meconium using DPX and gas chromatography-mass spectrometry (GC-MS). Validation results indicated that extraction efficiency ranged 50-98%, accuracy 92-106%, intra-assay precision 4-12% and inter-assay precision 6-12%. Linear calibration curves resulted in R(2) values >0.99, limits of detection ranged from 2.5 to 15 ng/g and the limit of quantitation from 10 to 20 ng/g. The DPX-GC-MS method was shown to selectively analyze trace concentrations of drugs in meconium samples. Finally, the developed and validated method was applied to 50 meconium samples.
Assuntos
Cocaína/análogos & derivados , Mecônio/química , Nicotina/análise , Calibragem , Cocaína/análise , Feminino , Cromatografia Gasosa-Espectrometria de Massas , Humanos , Recém-Nascido , Modelos Lineares , Gravidez , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Extração em Fase Sólida , Solventes/análise , Manejo de EspécimesRESUMO
OBJECTIVE: To assess relationships between marker concentrations of tobacco in meconium and weekly self-reported maternal cigarette consumption, and prediction of neonatal growth outcomes. STUDY DESIGN: Pregnant mothers (n = 119) from a longitudinal maternal smoking and infant neurobehavioral study (Behavior and Mood in Babies and Mothers [BAM BAM]) provided daily tobacco smoking histories. Nicotine, cotinine, and trans-3'-hydroxycotinine concentrations were quantified in 111 neonatal meconium specimens by liquid chromatography-tandem mass spectrometry. RESULTS: Median self-reported third trimester smoking was 5.9 cigarettes per day among smokers. Meconium samples from infants born to non-smokers (n = 42) were negative for tobacco markers, while specimens from self-reported smokers (n = 41) were positive for (median, range) nicotine (50.1 ng/g, 3.9-294), cotinine (73.9 ng/g, 6.4-329), and trans-3'-hydroxycotinine (124.5 ng/g, 10.2-478). Quitters (n = 28) self-reported stopping smoking at gestational weeks 2-39. Four meconium specimens from quitters were positive for tobacco biomarkers. Reduced birth weight, length, and head circumference significantly correlated with presence of meconium markers but not with individual or total marker concentrations. Among quitters and smokers, reduced infant birth weight, head circumference, and gestational age correlated with total and average daily cigarette consumption in the second and third trimesters. CONCLUSION: Smoking cessation or reduction during pregnancy improved neonatal outcomes. The window of detection for tobacco in meconium appears to be the third trimester; however, low exposure in this trimester failed to be detected. These results will aid physicians in educating women who are pregnant or thinking about becoming pregnant on the negative consequences of smoking during pregnancy. In addition, infants at risk can be identified at birth to assist early intervention efforts.
Assuntos
Cotinina/análogos & derivados , Cotinina/análise , Exposição Materna , Troca Materno-Fetal , Mecônio/química , Nicotiana/efeitos adversos , Efeitos Tardios da Exposição Pré-Natal/etiologia , Fumar/efeitos adversos , Adolescente , Adulto , Biomarcadores/análise , Cromatografia Líquida , Feminino , Humanos , Recém-Nascido , Estudos Longitudinais , Nicotina/análise , Gravidez , Efeitos Tardios da Exposição Pré-Natal/diagnóstico , Espectrometria de Massas em Tandem , Adulto JovemRESUMO
Adverse effects associated with smoking during pregnancy are well documented. Although self-report surveys on drug consumption during pregnancy have been improved with new interviewing techniques, underreporting is still a concern. Therefore, a series of biological markers and specimens to diagnose fetal exposure to tobacco have been studied. In the present study, an analytical method was developed to detect nicotine and cotinine (the main nicotine metabolite) in meconium samples. Accelerated solvent extraction (ASE) followed by solid-phase extraction (SPE) were used as sample preparation techniques. The analytes were detected by gas-chromatography with nitrogen-phosphorus detection. The limits of detection were 3.0 and 30 ng/g for cotinine and nicotine, respectively. The method showed good linearity (r(2) > 0.98) in the concentration range studied (LOQ-500 ng/g). The intraday precision, given by the RSD of the method, was less than 15% for cotinine and nicotine. The method proved to be fast, practical, and sensitive. Smaller volumes of organic solvents are necessary compared to other chromatographic methods published in the scientific literature. This is the first report in which ASE was used as sample preparation technique in methods to detect xenobiotics in meconium.
Assuntos
Cotinina/análise , Mecônio/química , Nicotina/análise , Feminino , Humanos , Recém-Nascido , Limite de Detecção , GravidezAssuntos
Transtornos Relacionados ao Uso de Cocaína/diagnóstico , Abuso de Maconha/diagnóstico , Mecônio/química , Detecção do Abuso de Substâncias/métodos , Adolescente , Adulto , Transtornos Relacionados ao Uso de Cocaína/epidemiologia , Ensaio de Imunoadsorção Enzimática , Feminino , Cromatografia Gasosa-Espectrometria de Massas , Hospitais Universitários , Humanos , Abuso de Maconha/epidemiologia , Gravidez , Complicações na Gravidez , Prevalência , Fatores Socioeconômicos , Trinidad e Tobago/epidemiologia , Adulto JovemRESUMO
OBJECTIVE: To test the hypothesis that the color of meconial fluid is associated with inflammatory biomarkers, by determining C-reactive protein (CRP) and Interleukin-6 (IL-6) in serum from the umbilical cord. METHODS: In this prospective study, the authors selected 30 newborns with meconium-stained amniotic fluid (MSAF): 14 with green/brown 656 R color and 16 with brown/cinnamon 654 R color, and 20 newborns which showed clear amniotic fluid without MSAF (non-MSAF); all newborns were from mothers without risk factors for neonatal sepsis. RESULTS: IL-6 concentration from umbilical cord blood, [median of 12.9 pg/mL (interquartile range {IQR} 8.7-31.0)] of MSAF-green/brown 656 R increased significantly (p < 0.05) when compared with IL-6 concentration, [median of 9.2 pg/mL (IQR 7.2-12.2)] of newborns with clear amniotic fluid and without meconium. CRP from MSAF-green/brown 656 R was median of 0.5 mg/mL (IQR 0.0-2.7), and median of 1.0 mg/mL (IQR 0.0-5.5) from clear amniotic fluid, without meconium. CONCLUSIONS: Significant association was found between MSAF-green/brown 656 R and increase in IL-6, with normal CRP values.
Assuntos
Proteína C-Reativa/análise , Sangue Fetal/imunologia , Interleucina-6/sangue , Mecônio/química , Líquido Amniótico , Biomarcadores/sangue , Estudos de Casos e Controles , Cor , Feminino , Humanos , Recém-Nascido , Masculino , Estudos ProspectivosRESUMO
OBJECTIVE: To identify the optimal measure of active and passive prenatal tobacco exposure to predict wheeze in early life. STUDY DESIGN: We conducted a birth cohort study of 398 mother-infant dyads enrolled during the second trimester of pregnancy and followed through age 2 years. We measured tobacco exposure with maternal report, serum cotinine level, and meconium cotinine level. We assessed wheeze with parent report every 6 months. We used a repeated measures logistic regression model. RESULTS: Of 367 children with respiratory data, 26% percent had parent reported active or passive prenatal maternal tobacco exposure, but cotinine was detected in 61% of mothers during pregnancy. Compared with children of mothers in the fifth percentile of tobacco exposure, children of mothers in the 95th percentile had increased odds of wheeze when exposure was measured with maternal serum cotinine level (adjusted OR, 2.6; 95% CI, 1.3-5.2; P < .006) versus meconium cotinine level (adjusted OR, 2.0; 95% CI, 1.0-4.0; P = .04) and total parent-reported exposure (adjusted OR, 1.7; 95% CI, 1.1-2.7; P = .01). CONCLUSIONS: Serum cotinine, a biomarker of tobacco exposure, was more strongly associated with wheeze than parent-reported exposure. Studies that rely on parent report of prenatal tobacco exposure may underestimate risk of wheeze.
Assuntos
Cotinina/análise , Pais , Sons Respiratórios/etiologia , Fumar/efeitos adversos , Poluição por Fumaça de Tabaco/efeitos adversos , Biomarcadores/análise , Pré-Escolar , Estudos de Coortes , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Masculino , Mecônio/química , Análise Multivariada , Gravidez , Efeitos Tardios da Exposição Pré-Natal , Autorrelato , Fumar/sangue , Poluição por Fumaça de Tabaco/análiseRESUMO
A number of fatty acid ethyl esters (FAEEs) have recently been detected in meconium samples. Several of these FAEEs have been evaluated as possible biomarkers for in utero ethanol exposure. In the present study, a method was optimized and validated for the simultaneous determination of eight FAEEs (ethyl laurate, ethyl myristate, ethyl palmitate, ethyl palmitoleate, ethyl stearate, ethyl oleate, ethyl linoleate and ethyl arachidonate) in meconium samples. FAEEs were extracted by headspace solid-phase microextraction. Analyte detection and quantification were carried out using GC-MS operated in chemical ionization mode. The corresponding D5-ethyl esters were synthesized and used as internal standards. The LOQ and LOD for each analyte were <150 and <100 ng/g, respectively. The method showed good linearity (r(2)>0.98) in the concentration range studied (LOQ-2000 ng/g). The intra- and interday imprecision, given by the RSD of the method, was lower than 15% for all FAEEs studied. The validated method was applied to 63 authentic specimens. FAEEs could be detected in alcohol-exposed newborns (>600 ng/g cumulative concentration). Interestingly, FAEEs could also be detected in some non-exposed newborns, although the concentrations were much lower than those measured in exposed cases.
Assuntos
Ésteres/análise , Ácidos Graxos/análise , Cromatografia Gasosa-Espectrometria de Massas/métodos , Mecônio/química , Microextração em Fase Sólida/métodos , Feminino , Transtornos do Espectro Alcoólico Fetal/diagnóstico , Humanos , Recém-Nascido , Limite de Detecção , Estrutura Molecular , Gravidez , Reprodutibilidade dos TestesRESUMO
Prenatal alcohol exposure can lead to a wide range of deficits known as fetal alcohol spectrum disorder. Epidemiologic studies regarding alcohol consumption in pregnancy have concentrated on North America, but recent reports have suggested that consumption is significant in many parts of the world. In Uruguay, alcohol consumption has changed into more risky and dangerous patterns and thus has a theoretical risk of having a high rate of prenatal alcohol exposure. This study characterizes the incidence of prenatal alcohol exposure in Montevideo, Uruguay, using a novel biomarker, fatty acid ethyl esters, in meconium as well as a survey to mothers. Nine hundred five meconium samples were collected from Hospital Pereira Rossell and Hospital de Clínicas in Montevideo, Uruguay. A maternal questionnaire was also completed. Meconium was analyzed for fatty acid ethyl esters using liquid-liquid and solid phase extraction with gas chromatography-flame ionization detection. Meconium was also analyzed for other drugs of abuse using enzyme-linked immunosorbent assay. Forty-four percent of meconium samples were above the positive cutoff for fatty acid ethyl esters and represent those newborns with risky prenatal exposure during the final two trimesters of pregnancy. Infants with prenatal alcohol exposure were more likely to have prenatal exposure to tobacco (odds ratio, 1.56; 95% confidence interval, 1.11-2.20) or any illicit drug (odds ratio, 2.29; 95% confidence interval, 0.98-5.31). Ethyl linoleate was a significant predictor of infant birth weight along with prenatal tobacco exposure, maternal body mass index, and infant sex. This study highlights a 44% incidence of prenatal alcohol exposure.
Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Etanol/toxicidade , Transtornos do Espectro Alcoólico Fetal/epidemiologia , Mecônio/química , Feminino , Humanos , Incidência , Recém-Nascido , Mecônio/metabolismo , Gravidez , Uruguai/epidemiologiaRESUMO
Se investigaron cocaína y marihuana en meconio de neonatos nacidos en la Maternidad Provincial de la Ciudad de Córdoba y se relacionaron los resultados con las semanas de gestación y los pesos al nacer. Las determinaciones se realizaron utilizando inmunoensayo y cromatografía gaseosa-espectrometría de masas. Se analizaron 48 muestras de meconio recolectadas durante un año (2007-2008). De los 48 meconios analizados, 17 correspondieron a neonatos masculinos y 31 a neonatos femeninos. Se procesaron en paralelo 15 muestras de meconio como controles normales (niños no expuestos a drogas) seleccionados por historia clínica y controles prenatales. De las 48 muestras de meconio 13 fueron positivas para cocaína y/o marihuana. El peso y las semanas degestación de los neonatos cuyas muestras fueron positivas se compararon frente a un grupo control normal, hallándose mayores diferencias estadísticamente significativas (α=0,05 p<0,0001) en relación a los pesos al nacer. Estos resultados, a pesar del reducido número de casos analizados, resaltan la importancia de la investigación de drogas de abuso en meconio, lo que permite confirmar el uso de drogas por parte de la madre durante el período gestacional temprano, y de ese modo interpretar las alteraciones (déficit de peso) observadas en el neonato al nacer, atribuibles al consumo de drogas durante la gestación.
We investigated cocaine and marijuana in meconium of newborns attended at the Hospital Materno Provincial of Córdoba City and the results were correlated with birthweight and weeks of pregnancy. The samples were analyzed using immunoassay (FPIA) and gas chromatography-mass spectrometry (GC-MS) for confirmation. Forty eight samples of meconium were collected during one year period (2007-2008). Of the 48 samples screened, 17 correspond to masculine sex and 31 to feminine. Fifteen samples of meconium from normal newborns (newborns not exposed to drugs) selected by maternal self report, pregnancy controls were processed as control group. The results obtained in 48 samples of meconium showed 13 cases tested positive for cocaine and/or marijuana. Birth weight and weeks of gestation of newborn with positive sample results were compared with a control group. A statistically significant difference (α= 0.05 - p<0.0001) was found in relation to birth weight. Although these results arise from a small number of samples, these data have relevance in public health and show the importance of the screening of drugs of abuse in meconium to confirm use in mothers during pregnancy and to interpret the alterations observed in the newborn after delivery as consequence of drug use in prenatal period.
Assuntos
Humanos , Masculino , Feminino , Gravidez , Recém-Nascido , Cannabis/metabolismo , Cocaína/análise , Cocaína/metabolismo , Complicações na Gravidez/diagnóstico , Feto , Troca Materno-Fetal , Mecônio/química , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Argentina , Cromatografia Gasosa-Espectrometria de Massas , Hospitais Públicos , Entorpecentes/análise , Entorpecentes/metabolismoRESUMO
Se investigaron cocaína y marihuana en meconio de neonatos nacidos en la Maternidad Provincial de la Ciudad de Córdoba y se relacionaron los resultados con las semanas de gestación y los pesos al nacer. Las determinaciones se realizaron utilizando inmunoensayo y cromatografía gaseosa-espectrometría de masas. Se analizaron 48 muestras de meconio recolectadas durante un año (2007-2008). De los 48 meconios analizados, 17 correspondieron a neonatos masculinos y 31 a neonatos femeninos. Se procesaron en paralelo 15 muestras de meconio como controles normales (niños no expuestos a drogas) seleccionados por historia clínica y controles prenatales. De las 48 muestras de meconio 13 fueron positivas para cocaína y/o marihuana. El peso y las semanas degestación de los neonatos cuyas muestras fueron positivas se compararon frente a un grupo control normal, hallándose mayores diferencias estadísticamente significativas (α=0,05 ¹ p<0,0001) en relación a los pesos al nacer. Estos resultados, a pesar del reducido número de casos analizados, resaltan la importancia de la investigación de drogas de abuso en meconio, lo que permite confirmar el uso de drogas por parte de la madre durante el período gestacional temprano, y de ese modo interpretar las alteraciones (déficit de peso) observadas en el neonato al nacer, atribuibles al consumo de drogas durante la gestación.(AU)
We investigated cocaine and marijuana in meconium of newborns attended at the Hospital Materno Provincial of Córdoba City and the results were correlated with birthweight and weeks of pregnancy. The samples were analyzed using immunoassay (FPIA) and gas chromatography-mass spectrometry (GC-MS) for confirmation. Forty eight samples of meconium were collected during one year period (2007-2008). Of the 48 samples screened, 17 correspond to masculine sex and 31 to feminine. Fifteen samples of meconium from normal newborns (newborns not exposed to drugs) selected by maternal self report, pregnancy controls were processed as control group. The results obtained in 48 samples of meconium showed 13 cases tested positive for cocaine and/or marijuana. Birth weight and weeks of gestation of newborn with positive sample results were compared with a control group. A statistically significant difference (α= 0.05 - p<0.0001) was found in relation to birth weight. Although these results arise from a small number of samples, these data have relevance in public health and show the importance of the screening of drugs of abuse in meconium to confirm use in mothers during pregnancy and to interpret the alterations observed in the newborn after delivery as consequence of drug use in prenatal period.(AU)
Assuntos
Humanos , Masculino , Feminino , Gravidez , Recém-Nascido , Cannabis/metabolismo , Cocaína/análise , Cocaína/metabolismo , Complicações na Gravidez/diagnóstico , Feto/efeitos dos fármacos , Troca Materno-Fetal , Mecônio/química , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Cromatografia Gasosa-Espectrometria de Massas , Hospitais Públicos , Entorpecentes/análise , Entorpecentes/metabolismo , ArgentinaRESUMO
OBJECTIVE: To determine the relationship between fatty acid ethyl esters (FAEE) in meconium and neurodevelopment in infants exposed to alcohol in utero at 6.5 months, 1 year, and 2 years of age. STUDY DESIGN: A secondary analysis of a prospective cohort of mothers at high risk and their infants recruited after admission to a labor and delivery unit. Mothers were screened for drug and alcohol use during pregnancy by clinical interview and urine screening. Meconium was analyzed for FAEE in 216 newborn infants. Outcome measures included the Bayley Scales of Infant Development Mental (MDI) and Psychomotor (PDI) Developmental Index scores in infants at 6.5 months, 1 year, and 2 years of age. RESULTS: After controlling for prenatal visits and maternal factors, increasing concentrations of FAEE were significantly associated with poorer mental and psychomotor development (beta +/- standard error) at all follow-up visits: ethyl myristate (MDI -2.46 +/- 1.24, P = .05; PDI -3.88 +/- 1.67, P = .02), ethyl oleate (MDI -1.94 +/- 0.65, P < .01; PDI -2.60 +/- 0.93, P < .01), ethyl linoleate (MDI -1.92 +/- 0.60, P < .01; PDI -2.28 +/- 0.84, P < .01), ethyl linolenate (MDI -1.99 +/- 0.74, P < .01; PDI -2.98 +/- 1.04, P < .01), and ethyl arachidonate (MDI -2.40 +/- 1.11, P = .03; PDI -3.32 +/- 1.51, P = .03). CONCLUSION: FAEE in meconium may be a marker for identifying newborns at risk for neurodevelopmental delay from alcohol exposure in utero.
Assuntos
Deficiências do Desenvolvimento/epidemiologia , Mecônio/química , Ácidos Araquidônicos/análise , Pré-Escolar , Seguimentos , Humanos , Lactente , Ácidos Linoleicos/análise , Ácidos Linolênicos/análise , Miristatos/análise , Ácidos Oleicos/análise , Ácidos Palmíticos/análise , Prognóstico , Estudos Prospectivos , Desempenho PsicomotorRESUMO
OBJECTIVE: To develop a laboratory marker to identify newborns exposed to alcohol. STUDY DESIGN: Meconium was collected from 30 infants from Jordan who were unexposed and from 248 Cleveland study infants of varying exposure status. Retrospective maternal alcohol histories were obtained. Fatty acid ethyl esters (FAEEs) were quantified with gas chromatography/flame ionization and compared between abstainers and non-abstainers to identify FAEEs of interest. The area under the receiver operating characteristic curve, sensitivity, specificity, and positive and negative predictive values were calculated by using definitions of drinking obtained from a graphical representation. RESULTS: Six of 7 FAEEs were significantly different between the non-abstainers and at least 1 of 2 of the abstaining groups. FAEEs best predicted drinks per drinking day, and ethyl linoleate had the greatest area under the curve (76%), with a sensitivity rate of 88%, a specificity rate of 64%, a positive predictive value of 9%, and a negative predictive value of 99%. No combination of FAEEs was better than a single ester for identifying drinkers. CONCLUSION: Ethyl linoleate in meconium is a useful biological marker for identifying infants not exposed in utero to high levels of alcohol in a high-risk, substance-abusing, clinic-based sample.