Assessment of tobacco, alcohol and cannabinoid metabolites in 645 meconium samples of newborns compared to maternal self-reports Sandrine Lamy a, b, c, d, e, f, g, h , Benjamin Hennart b , Estelle Houivet c , Sylvain Dulaurent d , Heloise Delavenne e , Jacques Benichou c , Delphine Allorge b, c, d, e, f , St  ephane Marret g , Florence Thibaut h, * , for the Perinatal network of Upper-Normandy a Department of Addictology, Ramsay- General de Sant e, SSR Petit Colmoulins, Harfleur, France b CHU Lille, Service de Toxicologie-G enopathies, F-59000 Lille, France c Department of Biostatistics, University Hospital Rouen, Centre d’Investigation Clinique et de Ressources Biologiques, INSERM CIC-CRB, 1404 Rouen, France d Laboratoire de Pharmacologie, Toxicologie et Pharmacovigilance, H^ opital Dupuytren, CHU de Limoges, France e Department of Psychiatry, Faculty of Medicine, Federal University of Minas Gerais, Brazil f Univ.Lille, EA 4483-IMPECS- IMPact de l’Environnement Chimique sur la Sant e humaine, F-59000 Lille, France g Department of Neonatal Medicine-Neuropediatrics, Rouen University Hospital and INSERM U 1245, Neovasc Team, Perinatal neurological handicap and Neuroprotection, Institute of Biomedical Research and Innovation, School of Medicine, Normandy University, France h University Hospital Cochin (site Tarnier), University Sorbonne Paris-Cit e (Paris V), Faculty of Medicine Paris Descartes, INSERM U894, Centre Psychiatry and Neurosciences, Paris, France article info Article history: Received 12 December 2016 Received in revised form 9 February 2017 Accepted 10 February 2017 Keywords: Pregnancy Biomarkers Psychoactive substances Meconium analysis Maternal self-reports Prenatal exposure abstract Prenatal psychoactive substance exposure has significant impact on neonatal health and child devel- opment and the development of reliable biomarkers is critical. Meconium presents several advantages for detecting prenatal exposure to psychoactive substances, as it is easy to collect and provides a broad time frame of exposure (third trimester). The aim of our study was to compare the prevalence of alcohol, tobacco and/or cannabis use during the third trimester of pregnancy (using maternal self-reports) with the results of meconium testing of their metabolites in newborns (cotinine, ethyl-glucuronide (EtG) and cannabinoid metabolites). Among all deliveries (993) that occurred in all maternities in Rouen (Normandy) during a defined time period (5 consecutive weeks in August, 2010 and August, 2011), 724 mothers were included and 645 meconium samples were collected. Maternal self-reports, using the Addiction Severity Index (5th edi- tion), and meconium samples were collected within 72 h of delivery. Cotinine detection appears highly correlated to maternal self-reports (Kappa value: 0.79; [95%CI: 0.73e0.85]). Moreover, detection in meconium seems more accurate in the prediction of neonatal consequences of prenatal tobacco exposure as compared to maternal self-reports. In contrast, we have found a lower concordance between maternal self-reports and meconium testing for EtG and cannabinoid metabolites (Kappa value: 0.13; [95%CI: 0.04e0.22] and: 0.30; [95%CI: 0.03e0.63], respectively); however the total number of EtG- and cannabinoid-positive meconium samples was small. Interestingly, meconium samples with the highest levels of EtG mainly corresponded to negative maternal self-reports. Fetal exposure to alcohol, tobacco or cannabis may also considerably differ as displayed in our pairs of dizygotic twins. Finally, a polyconsumption of these psychoactive substances was not frequently observed according to meconium testing. In conclusion, cotinine detection appears as a valuable meconium biomarker. EtG measurement in meconium samples seems interesting if there is any risk of high fetal exposure, whereas assessment of prenatal cannabis exposure, using meconium testing, needs to be improved. © 2017 Elsevier Ltd. All rights reserved. * Corresponding author. Service de Psychiatrie-Addictologie H^ opital Tarnier 89 rue d'assas, 75006 Paris, France. E-mail addresses: sandrine.lamy74@gmail.com (S. Lamy), benjamin.hennart@chru-lille.fr (B. Hennart), Estelle.Houivet@chu-rouen.fr (E. Houivet), sylvain.dulaurent@ unilim.fr (S. Dulaurent), heloise.delavenne@gmail.com (H. Delavenne), Jacques.Benichou@chu-rouen.fr (J. Benichou), delphine.allorge@chru-lille.fr, dallorge@univ-lille2.fr (D. Allorge), stephane.marret@chu-rouen.fr (S. Marret), florence.thibaut@aphp.fr (F. Thibaut). Contents lists available at ScienceDirect Journal of Psychiatric Research journal homepage: www.elsevier.com/locate/psychires http://dx.doi.org/10.1016/j.jpsychires.2017.02.012 0022-3956/© 2017 Elsevier Ltd. All rights reserved. Journal of Psychiatric Research 90 (2017) 86e93