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. 2025 Apr;45(4):454-457.
doi: 10.1038/s41372-024-02075-2. Epub 2024 Jul 28.

Using umbilical cord tissue to identify prenatal ethanol exposure and co-exposure to other commonly misused substances

Joseph Jones  1 , Donna Coy  2 , Dominique Gidron  2 , Shanthi Hariharan  2 , Mary Jones  2 , Niranjan Patel  2 , Amy Racines  2 , Sarah Toma  2 , Guida Brown  3
Affiliations

Using umbilical cord tissue to identify prenatal ethanol exposure and co-exposure to other commonly misused substances

Joseph Jones et al. J Perinatol. 2025 Apr.

Abstract

Objective: Substance misuse during pregnancy can result in a variety of poor pregnancy outcomes. Objective data reporting the prevalence of neonates born with ethanol metabolites (evidence of prenatal ethanol exposure) in their fluids or tissues are limited.

Study design: A secondary analysis of umbilical cord tissue specimens received for routine toxicological analysis was conducted. Prevalences of ethyl glucuronide (EtG), a long-term direct ethanol biomarker, were determined using a new laboratory tool, LDTD-MSMS. Additionally, other commonly misused substances were determined using routine procedures.

Results: Of 12,995 specimens, 238 (1.8%) specimens contained EtG. Concentrations of EtG ranged from 5 ng/g to 6679 ng/g (median 47 ng/mg; IQR: 16 ng/g, 203 ng/g). Of those 238 EtG-positive specimens, nearly 58% (N = 138) contained additional substances or metabolites.

Conclusion: Self-report of substance use during pregnancy is under-reported. We have demonstrated co-exposure of substances with ethanol is higher than previous reports.

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Conflict of interest statement

Competing interests: The authors of this manuscript are employed by United States Drug Testing Laboratories or are a paid consultant (GB) of United States Drug Testing Laboratories. Ethics approval: The study qualified as IRB Exempt Research because we studied de-identified biological specimen results with no access to human subject information, and because the identity of the human subjects could not readily be ascertained directly or through identifiers linked to the subjects.

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