Background Substance use during pregnancy is common, as is biological testing that is intended to help identify prenatal exposures. However, there is no standardized requirement for biological testing with either maternal or newborn specimens, nor is there standardization related to when testing occurs, how frequently testing occurs, what specimen(s) to test, what substances to test for, or how to perform testing. Content We review common specimen types tested to detect maternal and newborn substance exposure with a focus on urine, meconium, and umbilical cord tissue. We also review common analytical methods used to perform testing, including immunoassay, and mass spectrometry platforms. Considerations regarding the utilization of testing relative to the purpose of testing, the drug analyte(s) of interest, the specific testing employed, and the interpretation of results are emphasized to help guide decisions about clinical utilization of testing. We also highlight specific examples of unexpected results that can be used to guide interpretation and appropriate next steps. Summary There are strengths and limitations associated with all approaches to detecting substance exposure in pregnant persons as well as biological testing to evaluate a newborn with possible substance exposure. Standardization is needed to better inform decisions surrounding evaluation of substance exposures in pregnant people and newborns. If biological sampling is pursued, testing options and results must be reviewed in clinical context, acknowledging that false-positive and -negative results can and do occur.

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与检测新生儿物质暴露相关的实验室结果的生物学测试和解释

背景 怀孕期间使用药物很常见，旨在帮助识别产前暴露的生物测试也是如此。然而，对于孕产妇或新生儿标本的生物检测没有标准化要求，也没有与检测何时进行、检测频率如何、检测什么样本、检测什么物质或如何进行相关的标准化。测试。内容 我们回顾了用于检测孕产妇和新生儿物质暴露的常见样本类型，重点关注尿液、胎便和脐带组织。我们还回顾了用于执行测试的常见分析方法，包括免疫分析和质谱平台。强调关于测试的使用与测试目的、感兴趣的药物分析物、所采用的具体测试以及结果的解释有关的考虑，以帮助指导有关测试的临床使用的决策。我们还重点介绍了意外结果的具体示例，这些示例可用于指导解释和适当的后续步骤。摘要 检测孕妇物质暴露的所有方法以及评估可能接触物质的新生儿的生物测试都存在优点和局限性。需要标准化，以便更好地为有关评估孕妇和新生儿物质暴露的决策提供信息。如果进行生物采样，必须在临床背景下审查测试选项和结果，承认假阳性和假阴性结果可能而且确实会发生。