Skip to main content
SMFM 2025 Pregnancy Meeting Main banner
Final Program


Program Book
Icon Legend
Presentation Icons
Additional registration fee required
Additional registration fee required
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Poster Icons
Additional registration fee required
Additional registration fee required
Faculty have requested this content not be shared on social media
Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Back

Poster Session 2

(396) Accuracy of Point of Care Urine Drug Screen Testing in Pregnancies Complicated by Opioid Use

Thursday, January 30, 2025
4:00 PM – 6:00 PM  
Objective: To evaluate the accuracy of point of care (POC) versus the gold standard quantitative urine drug screen in a comprehensive perinatal substance treatment program. 

Study Design: This study was from a longitudinal cohort of women receiving prenatal care through a comprehensive perinatal substance use treatment program between 2014 and 2024. We assessed participants who had both a POC and a quantitative urine drug screen (UDS) result during the same prenatal visit. Postpartum visits were excluded.

Results: Data was available for 2079 samples collected for a POC analysis and a quantitative drug screen, and the results were compared. We looked specifically at the accuracy of identifying opioids as most of our patients are on medication for opioid use disorder (MOUD). A true positive was defined as the POC matching the gold standard urine quantitative result. 78.2% (76.3, 79.9%) of the time the POC test yielded results matching the quantitative assessment. 21.8% of the time the POC was positive for an opiate when the quantitative was negative either for an opiate or for that specific opiate. The test yielded a positive predictive value of 79.5% (78.7, 80.2%) and a negative predictive value of 64.9% (58.2, 71.0%). 

Conclusion: POC is not an accurate tool for use in pregnancy when evaluating compliance with MOUD. False positive and false negative results can adversely affect decisions that impact the patient and fetus. This can result in loss of trust in the medical system, decreased likelihood to engage in care, and poorer outcomes. More accurate quantitative tests should be utilized for evaluating compliance with treatment.