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. 2003 Oct;143(4):463-9.
doi: 10.1067/S0022-3476(03)00442-6.

Validation of a new biomarker of fetal exposure to alcohol

Cynthia F Bearer  1 , Joseph L Jacobson, Sandra W Jacobson, Dana Barr, Julie Croxford, Christopher D Molteno, Denis L Viljoen, Anna-Susan Marais, Lisa M Chiodo, Andrew S Cwik
Affiliations

Validation of a new biomarker of fetal exposure to alcohol

Cynthia F Bearer et al. J Pediatr. 2003 Oct.

Abstract

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.

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Figures

Fig 1
Fig 1
Relation of drinks per occasion during pregnancy to ethyl oleate concentration (dry weight basis) in meconium. One ounce equals two standard drinks.
Fig 2
Fig 2
Receiver operating characteristic curve assessing the sensitivity and specificity of ethyl oleate concentrations in meconium for identifying women who ingested at least 1.5 oz AADD per day during pregnancy.
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