背景:丹麦孕妇中缺乏客观验证的药物使用数据。我们估计了丹麦孕妇普通人群中包括酒精和尼古丁在内的物质使用的患病率。
方法:在这个匿名中,国家,横截面,描述性研究,2019年11月至2020年12月期间,孕妇被邀请在丹麦9家医院进行超声扫描。妇女提交了尿液样本并填写了调查表。用定性尿液试纸现场筛选尿液样本中包括酒精在内的15种物质,尼古丁,阿片类药物,安非他明,大麻,和苯二氮卓类药物.所有筛查阳性的尿液样本都接受了金标准的二次定量分析,液相色谱-串联质谱(LC-MS/MS)分析。将结果与问卷信息进行比较,以分析自我报告的有效性并检查可能的交叉反应。
结果:2154名受邀孕妇中,共有1903名(88.3%)参加。试纸阳性尿液样本的患病率为25.0%。其中44.0%为阳性,导致总确诊患病率为10.8%。尼古丁使用的患病率为10.1%-所有其他物质,<0.5%。尼古丁的使用在年轻孕妇中更为普遍,而其他物质的使用似乎在各年龄组均匀分布。使用尼古丁产品的自我报告较高(71.1%),但大麻和酒精摄入量较低(0%和33.3%,分别)。处方药解释了几乎所有的羟考酮病例,哌醋甲酯,和苯二氮卓类药物的使用。
结论:孕妇使用物质主要是尼古丁。试纸筛查涉及假阴性和假阳性的风险。除了酒精摄入和大麻的使用,试纸分析似乎没有提供比自我报告更多的信息.LC-MS/MS分析仍然是金标准,应该讨论试纸筛选的未来作用。
BACKGROUND: There is a paucity of objectively verified data on substance use among Danish pregnant women. We estimated the prevalence of substance use including alcohol and nicotine among the general population of Danish pregnant women.
METHODS: In this anonymous, national, cross-sectional, descriptive
study, pregnant women were invited when attending an ultrasound scan between November 2019 and December 2020 at nine Danish hospitals. Women submitted a urine sample and filled out a questionnaire. Urine samples were screened on-site with a qualitative urine dipstick for 15 substances including alcohol, nicotine, opioids, amphetamines, cannabis, and benzodiazepines. All screen-positive urine samples underwent secondary quantitative analyses with gold standard, liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis. Results were compared to questionnaire information to analyze the validity of self-reporting and to examine possible cross-reactions.
RESULTS: A total of 1903 of 2154 invited pregnant women participated (88.3%). The prevalence of dipstick-positive urine samples was 25.0%. 44.0% of these were confirmed positive, resulting in a total confirmed prevalence of 10.8%. The prevalence of nicotine use was 10.1%-and for all other substances, <0.5%. Nicotine use was more prevalent among younger pregnant women, while other substance use appeared evenly distributed over age groups. Self-reporting of use of nicotine products was high (71.1%), but low for cannabis and alcohol intake (0% and 33.3%, respectively). Prescription medication explained almost all cases of oxycodone, methylphenidate, and benzodiazepine use.
CONCLUSIONS: Substance use among pregnant women consisted mainly of nicotine. Dipstick screening involved risks of false negatives and false positives. Except for alcohol intake and cannabis use, dipstick analyses did not seem to provide further information than self-reporting. LC-MS/MS analyses remain gold standard, and future role of dipstick screenings should be discussed.