Detection of opioids in umbilical cord lysates: an antibody-based rapid screening approach.

TitleDetection of opioids in umbilical cord lysates: an antibody-based rapid screening approach.
Publication TypeJournal Article
Year of Publication2018
AuthorsKnight SJ, Smith AD, Wright TE, Collier AC
JournalToxicol Mech Methods
Date Published07/2018

In pregnancy, opioids may be used medically and also misused. We hypothesized that the umbilical cord (UC) could be a good screening tool for determining opioid exposure and improving medical care. One hundred and one UC, each with 50 associated ICD9/ICD10 codes were used. Using predictive pharmacokinetic analysis we determined that opioids could be detected since last ingestion prior to birth. The UC were lysed and screened using ELISA detecting multiple opioids and their metabolites. Statistical comparisons to obstetric and neonatal outcomes were performed. Although the commercial ELISA was less sensitive in UC than blood or urine, there was perfect method selectivity as compared to a subset of cords designated positive or negative by clinical diagnostics, so our results are accurate and reliable. Absolute quantitation was not possible because the antibody cross reacts with multiple compounds, but "low" or "high" levels of exposure were assigned. Prevalence of opioids was 11%, which reduced to 7% when caesarean-section births were eliminated. For non-caesarean-section infants adjusted for preterm birth, advanced maternal age and smoking (independent risk factors), opioids were significantly associated with intra-uterine growth restriction (pā€‰=ā€‰0.017) and admission to neonatal intensive care (pā€‰=ā€‰0.002). UC can be collected non-invasively and rapidly providing a reliable tools for semi-quantitative opioid screening using ELISA. Moreover, as UC are usually discarded collection presents few technical or safety concerns for staff or patients. Further development of this methodology may provide a rapid, non-invasive clinical screening tool to identify NAS and/or opioid use in late pregnancy.

Alternate JournalToxicol. Mech. Methods
PubMed ID30064290
PubMed Central IDPMC6355377
Grant ListG12 MD007601 / MD / NIMHD NIH HHS / United States
U54 MD007601 / MD / NIMHD NIH HHS / United States