Document Detail

Umbilical cord monitoring of in utero drug exposure to buprenorphine and correlation with maternal dose and neonatal outcomes.
MedLine Citation:
PMID:  21819795     Owner:  NLM     Status:  MEDLINE    
Buprenorphine is under investigation in the U.S. as pharmacotherapy for opioid-dependent pregnant women. Buprenorphine and metabolites were quantified in umbilical cord specimens from women receiving daily buprenorphine doses. Correlations between maternal buprenorphine dose, buprenorphine and metabolite umbilical cord concentrations, and neonatal outcomes were investigated, as well as the ability to identify heroin and cocaine relapse during pregnancy. Umbilical cord concentrations were compared to those of matched umbilical cord plasma and meconium. Buprenorphine metabolites were detected in all cords, but buprenorphine itself was absent. Concentration ranges were 1.2-5.1 ng/g norbuprenorphine, 1.7-4.2 ng/g buprenorphine-glucuronide, and 8.3-23 ng/g norbuprenorphine-glucuronide. Cord concentrations were similar to those in plasma, and lower (16-210-fold), although statistically correlated, than those in meconium. Significant positive correlations were observed for buprenorphine-glucuronide concentrations in umbilical cord and mean maternal BUP daily dose throughout pregnancy and third trimester, but buprenorphine biomarker concentrations did not predict neonatal outcomes. Opiate concentrations were lower (200-fold) in umbilical cord than in meconium, and when cocaine was present in meconium, it was not identified in cord. Umbilical cord can serve as an alternative matrix for identifying prenatal drug-exposure, but is much less sensitive than meconium. Buprenorphine provided a controlled drug administration model for evaluating drug disposition in the maternal-fetal dyad.
Marta Concheiro; Hendreé E Jones; Rolley E Johnson; Robin Choo; Diaa M Shakleya; Marilyn A Huestis
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, N.I.H., Intramural    
Journal Detail:
Title:  Journal of analytical toxicology     Volume:  34     ISSN:  1945-2403     ISO Abbreviation:  J Anal Toxicol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2011-08-08     Completed Date:  2011-12-06     Revised Date:  2011-12-15    
Medline Journal Info:
Nlm Unique ID:  7705085     Medline TA:  J Anal Toxicol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  498-505     Citation Subset:  IM    
Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland 21224, USA.
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MeSH Terms
Analgesics, Opioid / blood,  pharmacokinetics*
Apgar Score
Birth Weight
Buprenorphine / blood,  pharmacokinetics*
Dose-Response Relationship, Drug
Drug Monitoring / methods
Fetal Blood
Gestational Age
Infant, Newborn / blood
Length of Stay
Maternal Exposure
Meconium / chemistry,  metabolism
Opiate Substitution Treatment*
Grant Support
Reg. No./Substance:
0/Analgesics, Opioid; 52485-79-7/Buprenorphine

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