ESPOSIZIONE PRENATALE E PEDIATRICA A SOSTANZE STUPEFACENTI INDAGATA MEDIANTE ANALISI DEL CAPELLO: ASPETTI EPIDEMIOLOGICI, MEDICO LEGALI E SPUNTI PER LA PROGRAMMAZIONE SANITARIA

The high prevalence of drug use in Europe and worldwide makes prenatal and paediatric exposure an emerging public health problem. Such exposure can occur through multiple modalities, the probability of which varies in relation to the age and psychomotor development of the child, and can entail consequences in the short and long term. Exposure to drugs of abuse is investigated, even in children and adolescents, by analysis of biological matrices (blood, urine, hair). Despite the importance of this topic, the data available are limited and this affects the possibility of clearly delineating the extent of the phenomenon and defining the possible need for prevention and health planning interventions. In this context, this work aims to deepen the topic of children exposure to drugs of abuse both through the review of the literature on the topic and on the basis of the experience gained at the University-Hospital of Padova (Italy). To this end, a review of the literature on pediatric exposure to drugs of abuse investigated through hair analysis was performed, using the Pubmed and Scopus databases. An analysis of the cases underwent toxicological analysis at the Legal Medicine and Toxicology Unit of the University Hospital of Padova (Italy) in the period 2023-2025 was also performed, selecting the cases in which hair analysis was performed in subjects aged 0-18 years. The literature review allowed the inclusion of 76 articles for the in-depth study of the topic, of which 38 observational studies, 24 case reports and case series about one/two substances, 11 commentaries and 3 literature reviews. The analysis of University-Hospital cases instead included 397 children from 2023 to 2025. Overall, the most frequently detected substance was cocaine (121 positives), followed by THC (107 positives). The highest concentrations of cocaine were found in children under one year of age. The present work confirmed the importance of the topic of exposure to drugs of abuse in the pediatric population and provided alarming data about the spread of cocaine exposure in the reference area. In light of the results, the importance of careful monitoring and the search for prevention measures is underlined, including more comprehensive information for pregnant women and their partners.