Drugs warning issued to parents after newborns positive for cocaine had birth defect

Doctors at a Dublin maternity hospital have issued a drugs warning to parents after new born twin boys who tested positive for cocaine were each born with a birth defect.

The two babies had Hypospadias which is a birth defect in boys where the opening of the urethra- the tube that carries urine from the bladder to the outside of the body- is not located at the tip of the penis.

In a new paper entitled ‘Hypospadias and Cocaine Use in Pregnancy’ published in the Irish Medical Journal, the doctors warn parents of the dangers of drug use and the potential for birth anomalies.

On their arrival, they state the twins had Hypospadias and signs of respiratory distress, requiring non-invasive respiratory support mandating admission to the neonatal unit.

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While in the delivery suite, “the father presented as high alert, energetic and was talkative with a short attention span raising the suspicion that he was under the influence of an illicit substance”, they add.

Urine samples from the babies were requested due to the father’s behaviour and “both tested positive for cocaine metabolites in their urine”.

Both infants were referred to paediatric urology with a view to planned surgery for Hypospadias some time after their first birthday.

The doctors who authored the paper say there is a paucity of reporting regarding the association of cocaine use during pregnancy and urogenital anomalies, in particular Hypospadias.

They state Hypospadias is a common congenital anomaly and as the use of cocaine is increasing over time, there may be an under recognition of this association and a missed opportunity to identify a cause.

Hypospadias has an estimated incidence of 3-8 in 1,000 new born babies in Europe.

A review of the twin’s development at six weeks and three months at the hospital’s neonatal outpatient department found they were thriving.

The report states around 5 per cent to 10 per cent of women admit to illicit drug use during pregnancy while universal testing in high risk populations confirm cocaine use of between 10 per cent and 40 per cent.

They recommend a clinician should have a low threshold for testing the urine of an infant where there is concern about drug use. This should be done to ensure a psycho-social assessment and a referral to social services.

They add it is incumbent on the medical practitioner to counsel parents of the association between their drug use and the clinical findings in the hope of preventing drug use and modifying behaviour in subsequent pregnancies.