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Validation of a new biomarker of fetal exposure to alcohol

2003; Elsevier BV; Volume: 143; Issue: 4 Linguagem: Inglês

10.1067/s0022-3476(03)00442-6

1097-6833

Cynthia F. Bearer, Joseph L. Jacobson, Sandra W. Jacobson, Dana Boyd Barr, Julie Croxford, Christopher D. Molteno, Denis Viljoen, Anna-Susan Marais, Lisa M. Chiodo, Andrew S. Cwik,

Gestational Diabetes Research and Management

Objective To test the sensitivity and specificity of fatty acid ethyl esters (FAEEs) extracted from meconium to identify alcohol-using pregnant women with a sensitive and specific methodology, gas chromatography-tandem mass spectroscopy (GC/MS/MS). Study design Twenty-seven samples of meconium were obtained from infants from the mixed race community in Cape Town, South Africa, who were enrolled in a longitudinal neurobehavioral study. Maternal alcohol use was reported prospectively during pregnancy. FAEEs were isolated from meconium and quantitated by GC/MS/MS. Results Ethyl oleate was the FAEE that correlated most strongly with maternal self-reported drinking, especially with the average ounces of absolute alcohol ingested per drinking day. Ethyl oleate was most strongly related to drinking in the second and third trimesters (Pearson r = .55 and .40, respectively). At a threshold of 1.5 average ounces of absolute alcohol ingested per drinking day, the area under the receiving operator characteristic curve was .92 (95% confidence interval, 0.74–0.97). Using a cut-off value of 32 ng/g, sensitivity was 84.2% and specificity was 83.3%. Conclusions Ethyl oleate concentration in meconium assayed by GC/MS/MS provides a highly sensitive and specific indicator of maternal alcohol use during pregnancy.