Matrices biológicas y biomarcadores de exposición fetal a drogas de abuso durante el tercer trimestre de la gestación

Abstract

Introduction Substances of abuse consumption in Western countries has become a public health problem. These substances are also consumed by pregnant women, affecting the foetus and the newborn, especially vulnerables. Since the eighties, presence and eventual disposal of a substance of abuse and its correlation with clinical and/or subjective effects has been evaluated by analysis of plasma or urine. However, determinations in biological matrices other than blood and urine are very interesting. Non-invasiveness in sample collection and obtention of more information back in time make biological matrices such as placenta, meconium and hair, attractive to assess chronic exposure to drugs of abuse during pregnancy and chilhood. Methodology Review of the methodology used for the detection of drugs of abuse consumption during pregnancy, specifically of the different biomarkers of alcohol in alternative matrices, as they have a large exposure window and are easier to obtain. Microscopic and macroscopic study of changes in placental morphology in women using substances of abuse during pregnancy, detected through an objective marker of foetal exposure during the third trimester in an alternative matrix (meconium). Determination of exposure to substances of abuse by another alternative third trimester matrix (maternal hair). Results Three articles have been published related to the topic. A review on biomarkers of alcohol during pregnancy that demonstrates the utility of biomarkers in alternative matrices. A morphological study on the changes in the placenta of substances of abuse using mothers. No macroscopic changes were observed, but some alterations in placental vasculature at the microscopic level were found. Finally, a study on the determination of substances of abuse in maternal hair was made, demonstrating the usefulness of this alternative matrix for detecting drugs of abuse in the third trimester and confirming under-reporting by mothers. Discussion and conclusions In this thesis we demonstrated the usefulness of the detection of substances of abuse in the third trimester of pregnancy using biomarkers in alternative matrices. Similarly, we found changes in the placenta, which can also be used as a third trimester matrix, which could help us to understand the causes of harmful effects of substance use on the newborn, although further studies are needed. In conclusion, in order to detect exposure to substances of abuse during the third trimester of pregnancy, the use of different alternative matrices (meconium, hair, placenta) to minimize the invasiveness of collecting samples and to obtain information about chronic consumption compared to the matrices used traditionally (blood and urine) is recommended.

Date of Award	22 Jan 2013
Original language	Spanish
Supervisor	Oscar Garcia Algar (Director) & B. Friguls (Director)