Rates of substance and polysubstance use through universal maternal testing at the time of delivery.

OBJECTIVE: To report substance and polysubstance use at the time of delivery. STUDY DESIGN: A cross-sectional study was performed on mothers consented for universal drug testing (99%) during hospital admission at six delivery hospitals in Cincinnati, Ohio. Mass spectrometry urinalysis detected positivity rates of 46 substances. Rates of positive drug tests for individual and common co-occurring substances measured were reported. RESULTS: 2531 maternal samples were tested (88%) and 33% contained cotinine, 11.3% THC, 7.2% opioids, 3.8% cocaine, and 1.9% methamphetamines. Polysubstance use prevalence was as high as 15%. Among mothers testing positive for methadone or buprenorphine, 93% also tested positive for cotinine and 39% tested positive for a third substance in addition to cotinine. CONCLUSIONS: Substance use at delivery is more prevalent than previously reported. Many mothers testing positive for opioids also test positive for other substances, which may increase overdose risk and exacerbate neonatal opioid withdrawal syndrome (NOWS).

Regional comparison of self-reported late pregnancy cigarette smoking to mass spectrometry analysis.

OBJECTIVE: To report a more accurate prevalence estimate of late pregnancy nicotine exposures. STUDY DESIGN: A cross-sectional study during a 2-month period in 2019. Participants were women delivering in any of the six county maternity hospitals who consented to universal drug testing at the time of delivery as part of routine hospital admission. RESULTS: Of 2531 tested samples, 18.7% tested positive for high levels of cotinine indicating primary smoking or other primary use of tobacco products. Together, 33.0% of the study population tested positive for nicotine exposure during late pregnancy compared to vital records which reported 8.2% cigarette smoking during the third trimester of pregnancy and 10.5% cigarette smoking at any time during pregnancy through maternal self-report. CONCLUSION: Captured vital birth smoking measures vastly underreport actual primary exposures to nicotine products. Vital birth data also fail to capture secondhand exposures which constitute a significant proportion of the population.

Carbon and nitrogen pools and mobile fractions in surface soils across a mangrove saltmarsh ecotone.

In the subtropics, climate change is pushing woody mangrove forests into herbaceous saltmarshes, altering soil carbon (C) and nitrogen (N) pools, with implications for coastal wetland productivity and C and N exports. We quantified total C and N pools, and mobile fractions including extractable mineral N, extractable organic C and N, and active (aerobically mineralizable) C and N, in surface soils (top 7.6 cm) of adjacent mangrove (primarily Avicennia germinans) and saltmarsh (Juncus roemerianus) vegetation zones in tidal wetlands of west-central Florida (USA). We tested whether surface-soil accumulations of C, N, and their potentially mobile fractions are greater in mangrove than in saltmarsh owing to greater accumulations in the mangrove zone of soil organic matter (SOM) and fine mineral particles (C- and N-retaining soil constituents). Extractable organic fractions were 39-45% more concentrated in mangrove than in saltmarsh surface soil, and they scaled steeply and positively with SOM and fine mineral particle (silt + clay) concentrations, which themselves were likewise greater in mangrove soil. Elevation may drive this linkage. Mangrove locations were generally at lower elevations, which tended to have greater fine particle content in the surface soil. Active C and extractable mineral N were marginally (p < 0.1) greater in mangrove soil, while active N, total N, and total C showed no statistical differences between zones. Extractable organic C and N fractions composed greater shares of total C and N pools in mangrove than in saltmarsh surface soils, which is meaningful for ecosystem function, as persistent leaching of this fraction can perpetuate nutrient limitation. The active (mineralizable) C and N fractions we observed constituted a relatively small component of total C and N pools, suggesting that mangrove surface soils may export less C and N than would be expected from their large total C and N pools.