CYP2B6, ABCB1 and OPRM1 profile in a stillborn affected by chronic methadone intoxication

  • Eva MontanariEmail author
  • Maria Paola Bonasoni
  • Federica Alessandrini
  • Raffaele Frazzi
  • Federico Mocchegiani
  • Francesco Paolo Busardò
  • Raffaele Giorgetti
  • Adriano Tagliabracci
Letter to the Editor

Dear Editor,

The indirect effect of maternal drug exposure on the fetus may include serious consequences such as neonatal abstinence syndrome or, more rarely, intrauterine fetal death (IUFD).

Kalin [1] reported the incidence of fetal drug exposure in 39 of 58 fetal/neonatal deaths among a total of 23,400 general fatalities; notably, only 39 of the cases provided toxicological analyses. Toxicological analyses showed positive results in 22 of 39 cases (17/39 had negative toxicological results). In only 2/22 cases, IUFD was attributed to drug intoxication, as high levels of methamphetamine (1200–1500 ng/mL) were detected in fetal blood. In the other 20 cases, drug was detected in such a small amount that it was considered an occasional finding; the main causes of death were placental abruption/prematurity/stillbirth in 13 cases, maternal drug abuse associated with fetal asphyxia in two cases, chorioamnionitis in one case, drowning in one case, car accident in one case and undetermined in...


Compliance with ethical standards

Conflict of interest

The authors have no financial or other relations that could lead to a conflict of interest.

Ethical approval

In Italy, there is no legislation that forbids the use of human tissues collected during an autopsy, provided that the samples are made anonymous and linked exclusively to codes. We followed this privacy-guaranteed principle. The mother was not traceable, and it was not possible to obtain her consent.


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Copyright information

© Japanese Association of Forensic Toxicology 2019

Authors and Affiliations

  • Eva Montanari
    • 1
    Email author
  • Maria Paola Bonasoni
    • 2
  • Federica Alessandrini
    • 1
  • Raffaele Frazzi
    • 3
  • Federico Mocchegiani
    • 4
  • Francesco Paolo Busardò
    • 1
  • Raffaele Giorgetti
    • 1
  • Adriano Tagliabracci
    • 1
  1. 1.Section of Legal Medicine, Department of Excellence of Biomedical Sciences and Public HealthPolytechnic University of MarcheAnconaItaly
  2. 2.Pathology UnitAzienda Unità Sanitaria Locale-IRCCS di Reggio EmiliaReggio EmiliaItaly
  3. 3.Laboratory of Translational ResearchAzienda Unità Sanitaria Locale-IRCCS di Reggio EmiliaReggio EmiliaItaly
  4. 4.Hepatopancreatobiliary and Transplantation Surgery Unit, Experimental and Clinical Medicine DepartmentPolytechnic University of MarcheAnconaItaly

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