Neonatal hair analysis to reveal gestational exposure to drugs

Abstract

Maternal consumption of alcohol or of illicit or medicinal drugs during pregnancy exposes fetuses to severe health risks and may result in adverse mental, physical and psychological outcomes at birth. The assessment of in utero exposure is a public health concern and needs sensitive and specific methods. The identification of drugs or their biomarkers in either maternal or neonatal specimens is much more informative than are interview-based methods or self-reporting from mothers. Of the biological matrices available for this type of analysis, neonatal hair is one of the most important. Drugs or their metabolites that cross the placenta are incorporated into the growing fetal hair beginning at the12th week of gestation. Collection of neonatal hair at birth is therefore useful for retrospective assessment of exposure to drugs during the third trimester of gestation, through the identification and quantification of specific biomarkers. In this review, examples are discussed with respect to the documentation of in utero exposure to alcohol, cocaine, opiates, benzodiazepines, amphetamines and selective serotonin reuptake inhibitors.