Observational studyJournal of perinatology : official journal of the California Perinatal Association2026
Prospective observational study quantifying maternal-fetal fentanyl transmission in epidural analgesia infusion using umbilical cord blood and neonatal meconium.
Observational study in Journal of perinatology : official journal of the California Perinatal Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo determine whether fetal exposure to maternal epidural fentanyl can result in a positive meconium drug test. STUDY
designQuantitative evaluation of fentanyl levels in cord blood and meconium of infants ≥37 weeks whose mothers received epidural analgesia was performed using High Performance Liquid Chromatography-tandem Mass Spectrometry. The association between dose and duration of maternal epidural and fentanyl levels in cord blood and meconium was evaluated.
resultsIn 298 mother-infant dyads, median duration of fentanyl epidural was 6.8 hours. There was a strong positive correlation between epidural duration and fentanyl levels in meconium (Spearman rho = 0.70, 95%CI [0.64-0.76]), p < 0.001). Positive predictive value for fentanyl detection in meconium >0.05 ng/g for epidural exposure of >4 hours was 93.9%.
conclusionThere is a strong positive correlation between maternal epidural duration and fentanyl in meconium. Providers can anticipate a positive meconium drug screen for fentanyl in the setting of a maternal epidural.
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