Interpreting Toxicology Results in Perinatal and Newborn Specimens: Urine, Meconium, and Umbilical Cord.

Neonatal toxicology is used as a substitute for comprehensive prenatal substance use history to assess the short-term and long-term complications the newborn may encounter. Neonatal urine, meconium, and umbilical cord tissue look at different windows of development and can be sampled independently, or together, to determine exposure risk of the newborn. Immunoassay-based presumptive testing followed by mass spectrometry-based definitive testing is the traditional testing algorithm. Given the limits of sensitivity of the traditional algorithm and the increased complexity of substances, direct mass spectrometry testing is becoming more preferred.