Identification and analysis of the major metabolites of cocaine in meconium

A gas chromatographic-mass spectrometric (GC-MS) method was used for the simultaneous analysis of cocaine and its metabolites (norcocaine, benzoylecgonine, norbenzoylecgonine, ecgonine methylester, cocaethylene, and the o-, m-, and p-hydroxy derivatives of cocaine and benzoylecgonine) in meconium specimens collected from newborns prenatally exposed to the drug in an effort to determine which of these metabolites are more relevant in the confirmation of immunoassay-positive specimens. Significant metabolites included benzoylecgonine and its m- and p-hydroxy derivatives. Reanalysis of immunoassay-positive meconium specimens that previously failed to confirm by GC-MS for benzoylecgonine revealed that the GC-MS confirmation rate could be substantially enhanced by inclusion of m- and p-hydroxybenzoylecgonine in the analysis along with benzoylecgonine. Several specimens were found to be positive for hydroxylated derivative(s) in the absence of benzoylecgonine itself.