A case report on drug screening of Nail clippings to detect prenatal drug exposure

In a case of a sudden infant death syndrome-related death of a 3-month-old infant, nail clippings were positive for cocaine by gas chromatography-mass spectroscopy analysis that revealed a prenatal exposure to the drug substance. In utero exposure to drugs has been investigated using amniotic fluid, neonatal urine, meconium, and hair samples. Nail analysis offers some advantage over hair analysis because of its continuous growth and persistence after delivery. Nail material is easy to sample in suitable amounts. Currently, the cocaine finding cannot be related to the underlying cause of death. However, this observation indicates that nail analysis may be a new and valuable tool to screen newborns for intrauterine drug exposure. In addition, it can help collect information on the prevalence of possible embryotoxic effects and the link to postnatal manifestations of different dysfunctions in infants who are born by drug abusing mothers.