Perinatal Drug Testing Lab
Meconium Drug Testing
USDTL was the first laboratory to commercially introduce meconium testing to the market in 1991 and has remained a pioneer in research and development in the newborn toxicology industry.
Maternal substance abuse continues to be a significant issue in the United States. The rate of current illicit drug use among pregnant women has been reported as:
ages 15 to 17 - 16.2 percent
ages 18 to 25 - 7.4 percent
ages 26 to 44 - 1.9 percent
Among pregnant women aged 15 to 44 who reported alcohol use: 10.8 percent reported current alcohol use, 3.7 percent reported binge drinking, and 1.0 percent reported heavy drinking with 10.1 percent of pregnant women reporting binge drinking during the first trimester.* Early identification of exposed newborns provides for early treatment and better results for the baby.
Meconium contains the amniotic fluid swallowed by the fetus in the last half of pregnancy and is released as the first stools after birth. Meconium is easier to collect than neonatal urine and provides a much longer window of exposure of up to 20 weeks. A sample of 3 grams (1 teaspoon) of meconium is needed for maximum sensitivity. USDTL will analyze smaller amounts, but with a reduction in sensitivity and/or the window of exposure. We recommend weighing the specimen on a jeweler's scale.
Click here to download the meconium collection instruction slides.
Click here to download the meconium drug panels.
Meconium collection for FAEE changed as of October 1, 2016. Please see the announcement for full details. Click Here
Click here to view the Meconium Resources page.
For information about umbilical cord tissue drug testing, please click here.
- 13 Panel
- 12 Panel
- 9 Panel
- 7 Panel
- 5 Panel
*Click the green and white plus sign beside each drug class to view the substances within each class.
Collect by transferring the meconium from the diaper liner to the collection container using the spatula provided. (If collection supplies are not available, a nonsterile, screw-top urine container and wooden tongue depressor may be used.)
By Phone: 1.800.235.2367
Business Hours (CST)
Monday 6am - 8pm
Tuesday 6am - 8pm
Wednesday 6am - 8pm
Thursday 6am - 8pm
Friday 6am - 8pm
Panel Name: MeconiumTesting
Panel Description: Meconium Testing Drug Panel
Collection Container: Leakproof Polypropylene
Collection Notes: Pool of Multiple Collections
Sample Amount: 3 grams (We recommend weighing the specimen on a jeweler's scale.)
Storage Conditions: Refrigerated
Transport Conditions: Ambient
Method: Initial screening test with confirmation of presumptive positives
Turn-Around Time: 1 day for negatives / 2-3 days for positives
- White Papers
Can Meconium Testing for FAEE be run in conjunction with testing for panels for illegal drugs?
Yes, Meconium Testing 5-, 7-, 9- and 12-drug panels can all be bundled with Meconium Testing for FAEE.
Can you test for alcohol exposure in meconium?
Yes, alcohol exposure can be tested individually or by adding the Meconium MAEE add-on to any of the Meconium Testing drug panels. The FAEE add-on screens for Fatty Acid Ethyl Ester, a direct ethanol biomarker, including exposure to ethanol (drinking alcohol). To report out a positive FAEE result, the laboratory must verify that the specimen was collected less than 18 hrs from the time of birth. If the final time of collection is greater than 18 hours from the time of birth, the specimen will be rejected for FAEE testing, and the following comment will be added to the specimen report: "Not suitable for FAEE testing due to delayed specimen collection."
Do doctors know about Meconium Testing for FAEE? Does USDTL have a means of informing doctors of this new test?
Yes and No. Many physicians know about the test from scientific publications and literature from USDTL. There are, however, many physicians that are not yet knowledgeable about the test and have never ordered it. If your local physicians do not have the necessary information to order the test, call Client Services at 1-800-235-2367 and the scientific information will be supplied.
Have meconium results been used in court cases?
Yes. Meconium results, when determined using two separate, validated laboratory procedures based on different scientific principles, are forensically defensible. Our laboratory procedures have been scrutinized by laboratory inspectors, and our test results have been upheld in court.
How are meconium results reported to the hospital?
How can DHS Methamphetamine specialists use information about Meconium Testing for FAEE to improve our protection of children?
Results from Meconium Testing for FAEE give DHS personnel direct information about newborns who have been exposed to high levels of Ethyl Alcohol. Approximately 3 percent of all newborns have been exposed to high levels of alcohol and these newborns’ meconium specimens have FAEE levels greater than 10,000 ng/gram. This “red flag” level represents only one quarter of the total number of alcohol exposed newborns. Three quarters of alcohol exposed newborns were exposed to small or moderate amounts of alcohol and represent lower risks of manifesting signs and symptoms of Fetal Alcohol Spectrum Disorder. The newborns with FAEE levels greater than 10,000 are at higher risk for Fetal Alcohol Spectrum Disorder, as well as a higher probability of living in a chaotic environment where abuse or neglect is more likely.
How does NIDA and the court system view the validity of Meconium Testing for FAEE?
NIDA (The National Institute on Drug Abuse) actually is NOT the institute that funded the original research for FAEE in meconium. It was the National Institute for Alcohol Abuse and Alcoholism (NIAAA) that provided USDTL with the grant funds to develop Meconium Testing for FAEE. This test has become the de facto standard for laboratory diagnosis of fetal alcohol exposure and is in routine use all over the United States and Canada. Courts have held that Meconium Testing for FAEE meets both the Fry and Daubert standards, and the results are admissible in adversarial proceedings.
How does using a forensic drug test help the child later in life?
There are several reasons detecting a substance exposed newborn is important. Early detection provides many more options than detection at a later stage in the child’s life, and
- Early detection of fetal alcohol syndrome (FAS) and fetal alcohol effect (FAE) allow newborns to be identified and enrolled into early intervention and community programs. New programs are showing dramatic improvements in children identified earlier in life.
- Detection of a exposed child can allow help, intervention and treatment to be offered to the mother, so that exposure during future pregnancies may be prevented.
- As programs, understanding, and treatments improve, substance exposure detection, at a very early stage, can only help the outcome of the child, mother and family.
How many days until I receive results?
Screen negative results will be transmitted to your secure fax on the same day on which the laboratory receives the sample. Screen positive results will be confirmed using a separate technique and reported 2-3 business days after specimen receipt.
How much meconium is needed for the test?
A minimum of 2 grams of meconium (a teaspoon) is normally required, although some tests, such as "confirmatory tests only" can be performed with less. However, for best results, we recommend collection of the entire passage of meconium until the milk stool appears.
If the quantity of drug or alcohol metabolite detected is high, could that be an indication that the donor (1) was consuming a large amount, (2) was using recently, or (3) was using frequently?
There are too many variables for anyone to know time of use, dosage, or frequency from the result(s) of a drug test. Reservoir matrices such as hair, fingernail, umbilical cord, and meconium continuously collect drug and alcohol biomarkers. This makes it difficult to determine specific details of use. Because the biomarker is collected over a period of time, the results represent total accumulation that cannot be pin-pointed to specific times/dates/dosages, etc.
Mother tested negative for chemicals on a saliva test, 8 days later, her baby was born and its meconium drug screen showed the presence of methamphetamine and amphetamine. What does this mean?
Please describe the new meconium test for alcohol.
Meconium Testing for FAEE is a test of the non-oxidative metabolites of ethanol called Fatty Acid Ethyl Esters. These metabolites are the chemical combination for endogenous fatty acids present in the blood of a fetus and Ethyl Alcohol. These new compounds, which only form when the fetus is exposed to Ethyl Alcohol, are deposited into the fetus’s meconium and can then be detected and quantified from the newborn’s meconium after delivery. The amount of the Fatty Acid Ethyl Esters found in the meconium is representative of the amount of Ethyl Alcohol the fetus was exposed to during the last half of the pregnancy.
What are the meconium sample storage requirements?
What information can you give on testing of meconium and why some experts state that it depends what part of the meconium is sent into labs as to what will test positive?
The single most important element of collecting meconium for drug and alcohol testing is obtaining the entire quantity of meconium that the newborn passes, being careful that it is not to mix in the milk stool. This is extremely important in order to obtain the maximum time window of exposure for the infant. Meconium is a HETEROGENOUS material and each portion passed reflects a different time of gestation. This is due to the extreme viscosity of the meconium mass and the lack of significant mixing in the fetal intestine. If only a portion of the total meconium is collected and sent for analysis, it may reflect a period of abstinence, and an exposed newborn may go undetected.
What is m-OH-BZE?
Lewis D, Moore C, Becker J, Leikin J. Prevalence of meta-hydroxybenzoylecgonine (m-OH-BZE) in meconium samples. Bulletin of the lnt.Ass.Forens Toxicol 1995;25(3):33-36
What is the relationship between alcohol consumed and FAEE levels?
Based on two research studies reported in peer-reviewed literature, the total FAEE levels in excess of 10,000 ng/g show significant ethanol exposure in the newborn. (Moore C, Jones J, Lewis D, Buchi K. Prevalence of fatty acid ethyl esters in meconium specimens. Clin Chem 2003;49(1):133-136)
What is the window of detection for meconium?
Why test for fetal alcohol exposure when there is no treatment available?
- Early diagnosis of fetal alcohol syndrome (FAS) and fetal alcohol effect (FAE) allow newborns to be identified and enrolled into early intervention and treatment programs. New programs are showing dramatic improvements in children identified earlier in life.
- Detection of an alcohol affected child can allow help, intervention and treatment to be offered to the mother, so that future FAS and FAE children may be prevented.
- When cocaine- and opiate-exposed newborns were first detected, there was no treatment. As programs, understanding and treatments improve, diagnosis at a very early stage can only help the outcome of the child, mother and family.
Why was one matrix positive and another negative on the same donor?
There are several explanations for this.
- Different sample matrices have different detection time frames. The result of any second collected specimen has no bearing on the validity of a first collected specimen. For example, a hair sample with a three month window of detection might test positive for a particular substance, while a urine sample from the same donor, with a 2-3 day window of detection, might test negative. In this case, the donor has used that substance within the past three months, but may not have used it within the most recent three days.
- The result of any second collected specimen has no bearing on the validity of a first collected specimen. Therefore, a negative result observed for the umbilical cord does not refute a positive result observed on the maternal urine specimen and the reverse is true as well. There are many legitimate reasons for discrepant urine and umbilical cord results.
- The urine specimen was a screen only result and was not confirmed using an appropriate mass spectrometric method. The screen only urine result is a clinically valid result, however, without an appropriate mass spectrometric confirmation, the urine result has no value in a forensic proceeding.
- Lastly, some placentas can prevent some compounds from reaching the fetus. There are documented cases of maternal ingestion without in utero exposure.