Maternal Risk Factors Associated with Positive Infant Drug Toxicology

Abstract Background: Identifying substance use disorder (SUD) during pregnancy is challenging as there is no general consensus on which pregnant women should be tested for SUD during pregnancy. Recent studies have shown that a criteria-based approach may be essential for toxicological testing. Objective: To identify maternal and neonatal risk factors associated with positive neonatal drug toxicology results. Design/Methods: A retrospective chart review of mothers and their delivered infants from 2016 to 2022 at Montefiore St. Luke's Cornwall Hospital, Newburgh, NY. Urine, umbilical cord, and meconium were analyzed for toxicological testing. Results: Of the 5488 deliveries, 10.2% of mothers had risk factors, and 5.4% of dyads had positive toxicology results. Mothers with recent substance use disorder (SUD), including SUD on medication-associated treatment (MAT), infants with withdrawal signs, small for gestational age (SGA), and exposure to sexually transmitted infections (STD) had positive toxicology results. Conclusion: Insufficient prenatal care, the most common indication for toxicology testing, was not associated with positive toxicology results.