Analysis of umbilical cord samples offers forensic toxicologists a method for evaluating maternal drug intake patterns. These matrices may be an uncommon sample for many laboratories, but for those that are tasked with the challenge, solid phase extraction offers the most efficient methodology for the analysis of said compounds.

An estimated 5% of expectant mothers use illicit drugs during pregnancy. Drug use during pregnancy is associated with premature birth, low birth weight and cognitive or behavioral problems for the child. According to the Guttmacher Institute, prenatal substance use is considered to be child abuse in 24 states as well as the District of Columbia. In 23 states and in the District of Columbia, health care providers are obliged to report any suspected drug use during pregnancy, and it is required in seven states that newborns be tested for drug exposure if prenatal substance use is in fact suspected.

Meconium has been considered the gold standard for detecting prenatal drug exposure; however, it has some disadvantages. It could take a few days for meconium to pass in preterm infants which delays the testing, or it could be unavailable for testing if it is passed in utero. It can also be inadvertently disposed of with a diaper. Umbilical cord is an alternative specimen to meconium for drug testing and is gaining in popularity due to its advantages. Umbilical cord is readily available in every birth, has sufficient quantity, and has a 90–99% concordance rate in drug detection compared with meconium. 

In recent paper authored by Amy Alexander et al., in Journal of Analytical Toxicology (doi: 10.1093/jat/bky009), UCT’s flagship sorbent Clean Screen®DAU (CSDAU020) was employed to analyze samples of umbilical cord taken from two monozygotic twins. It was found that the umbilical cord from newborn #1 was positive for hydromorphone only (1.06 ng/g), and the umbilical cord from newborn #2 was positive for hydromorphone (0.81 ng/g) and benzoylecgonine (5.41 ng/g).

Maternal administration of hydromorphone during labor resulted in similar concentrations of the analyte in umbilical cords of both twins. The significant differences in the concentration of benzoylecgonine in the twins may suggest that cocaine use by the mother occurred over a longer period of time.

This study shows that when forensic toxicologists are faced with the most challenging of matrices such as meconium or umbilical cord for drug testing, they require the most efficient of extraction sorbents and UCT’s flagship sorbent Clean Screen® is their first choice. For more information about   Clean Screen® sorbents, methods and applications please visit https://sampleprep.unitedchem.com/products/spe/clinical-forensic/clean-screen-dau