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Prediction Model of Simpson et al for Positive Neonatal Meconium and Urine Drug Tests

Description

Simpson et al reported a prediction model for a positive neonatal drug test using meconium or urine. Certain findings can help reduce the number of unnecessary laboratory drug tests. The authors are from Children's Mercy Kansas City, University of Missouri-Kansas City School of Medicine and Inova Fairfax Hospital for Children.


Patient selection: neonate

 

Drug testing is typically performed on both urine and meconium.

 

Findings associated with a positive drug test on a neonate:

(1) positive maternal urine drug test

(2) maternal history of drug use during pregnancy

(3) 0 or 1 prenatal visit

(4) history of remote substance use

 

The presence of 1 or more of these findings has a sensitivity of 94% and specificity of 69%.

 

If the maternal urine drug test is negative, then neonatal urine drug test will be negative. If the maternal urine drug test is normal, then testing neonatal urine is very low yield.

 

If drug testing is not performed, then samples of meconium and urine should be saved in the event of neonatal abstinence or other reason to suspect maternal drug use.

 


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