Background 50–100 babies are born per year to drug using mothers in Leeds. Local guidelines state maternal or neonatal urine toxicology (UT) should be sent if the mother is known to use illicit substances (with the mother’s verbal consent).
A local audit was conducted alongside a national survey of the use of UT in drug exposed newborn infants.
Methodology Survey: Representatives from all UK neonatal networks were asked about their use and local indications for UT.
Audit The case notes of infants born to drug using women in 2012 were reviewed. UT results for infants during this period were obtained from biochemistry.
Survey 32 health professionals responded in total representing 19 of the 24 UK networks. 22% sent maternal UT and 28% sent UT from the baby.
Audit 49 cases were reviewed. Maternal toxicology results were documented in 2 cases. 30 infant urine samples were received by the laboratory. 25 cases had documentation of urine being sent. 19 had documented consent. UT results identified more concerning drug use than that reported in 5/19 cases. 31 cases had discharge planning documented and urine results documented in 13/31 cases.
Discussion/Conclusions National practice is variable with the majority of units discontinuing testing. Locally, despite sending UT, documentation is poor and testing does not alter management.
There is a need for accurate, quick and reliable testing for infants, where drug exposure is known or suspected. The use of bedside meconium testing is being piloted locally and may provide an alternative to UT.
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