Tobacco and Cannabis Use During Pregnancy.

OBJECTIVES: Nicotine (NIC) use during pregnancy can influence markers used in biochemical maternal serum screening. This study was designed to determine prevalence of disclosed tobacco smokers in our patient population and to compare disclosed tobacco smoking status with the presence of serum nicotine and a common tetrahydrocannabinol (THC) metabolite. METHODS: A deidentified dataset of disclosed smoking status for quadruple (Quad) screens was obtained. Residual serum submitted for Quad screens was obtained from frozen storage and analyzed for NIC and THC metabolites. RESULTS: Of specimens that had corresponding responses to the smoking history question on the patient history form, 7.2% (n = 1,783 of 24,611) specified that the patient was a tobacco smoker. Of the 271 specimens biochemically analyzed for NIC and THC metabolites, disclosed tobacco smokers had the highest prevalence of detectable NIC and THC metabolites. THC product use was most prevalent in patients categorized as probable tobacco smokers based on cotinine concentrations, as well as in younger patients. CONCLUSIONS: Prevalence and concentration of NIC and THC metabolites vary based on disclosed tobacco smoker status. Biochemical testing may increase sensitivity for the identification of NIC and THC status over self-reporting.

Evaluate the comparability of two automated liquid handling systems for clinical toxicology assays.

Automated liquid handling (ALH) platforms are increasingly implemented in clinical laboratories to improve analytical reproducibility and replace manual handling during sample analysis. In clinical toxicology laboratories, ALH platforms are primarily utilized to perform sample preparation and extraction prior to subsequent analysis by liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). When performing analysis with complex human biological matrices, verifying the performance characteristics of ALH platforms is required to ensure the assays' accuracy and reproducibility. Here, we evaluated and compared the analytical performances of Perkin Elmer JANUS® and Tecan Fluent® ALH systems in parallel, based on their performance in two toxicology assays designed to identify and quantify various opiates, semisynthetic opiates, and their metabolites. The comparability of the instrument platforms was evaluated by comparing assay analytical measuring range, total analytical imprecisions, and patient samples measurement when the ALH platforms are incorporated as part of the clinical assay's workflow. We have shown that both ALH platforms meet quality and performance criteria suitable for clinical toxicology assays. Nevertheless, the two platforms exhibit biases when measuring unknown patient samples. Such variations in their analytical performances may cause discrepancies when comparing results obtained from two different ALH platforms. In conclusion, it is important to consider how variations in ALH platform performances can affect patient results interpretation when implementing them in clinical laboratories.