Ordering Recommendation

Use to detect and document fetal exposure to kratom during approximately the last trimester of a full-term pregnancy.

Mnemonic

KRA QQQ CD

Methodology

Qualitative Liquid Chromatography-Tandem Mass Spectrometry

Performed

Wednesday

Reported

8-9 days

New York DOH Approval Status

Specimens from New York clients will be sent out to a New York DOH approved laboratory, if possible.

Specimen Required

Patient Preparation
Collect

Umbilical cord (at least 8 inches, approximately the width of a sheet of paper)

Specimen Preparation

Drain and discard any blood. Rinse the exterior of the cord segment with normal saline or water. Pat the cord dry and transport at least 8 inches of umbilical cord in a routine urine collection cup or Security Kit for Meconium/Umbilical Drug Detection (ARUP supply #51548) available online through eSupply using ARUP Connect? or by contacting ARUP Client Services at 800-522-2787. (Min: 6 inches)

Storage/Transport Temperature

Refrigerated

Unacceptable Conditions

Cords soaking in blood or other fluid. Formalin fixed. Tissue that is obviously decomposed.

Remarks
Stability

Ambient: 1 week; Refrigerated: 3 weeks; Frozen: 1 year

Reference Interval

Test Number
Components
Reference Interval
  Mitragynine, Cord, Qual
Cutoff Concentrations (ng/g)
0.08

  Speciociliatine, Cord, Qual
Cutoff Concentrations (ng/g)
0.08

Interpretive Data

Methodology: Qualitative Liquid Chromatography-Tandem Mass Spectrometry

This test is designed to detect and document exposure to alkaloids found in kratom, an herbal product derived from the Mitragyna speciosa tree or related plants, that occurred during approximately the last trimester of a full-term pregnancy. While mitragynine is considered the primary pharmacologically active alkaloid, speciociliatine is also widely detected in umbilical cord tissue. Regular use of or exposure to kratom can lead to dependency, and abstinence may contribute to signs and symptoms of drug withdrawal. Alternative testing is available to detect other drug exposures. The pattern and frequency of kratom used by the mother cannot be determined by this test. A negative result does not exclude the possibility that a mother used kratom during pregnancy. Detection of kratom alkaloids in umbilical cord tissue depends on extent of maternal use, as well as stability, unique characteristics of alkaloid deposition in umbilical cord tissue, and the performance of the analytical method. Detection of kratom alkaloids in umbilical cord tissue does not insinuate impairment and may not affect outcomes for the infant. Interpretive questions should be directed to the laboratory.

This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the U.S. Food and Drug Administration. This test was performed in a CLIA-certified laboratory and is intended for clinical purposes.

Compliance Category

Laboratory Developed Test (LDT)

Note

Absolute minimum: 6 inches.

Hotline History

N/A

CPT Codes

80323 (Alt code: G0480)

Components

Component Test Code* Component Chart Name LOINC
3005875 Mitragynine, Cord, Qual
3005876 Speciociliatine, Cord, Qual
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.

Aliases

Kratom, Umbilical Cord, Qual