The prenatal detection of significant alcohol exposure with maternal blood markers.
OBJECTIVE
To examine the efficacy of a combination of 4 blood markers of alcohol use in detecting alcohol-abusing pregnant women.


METHODS
Two new markers of alcohol use, whole blood-associated acetaldehyde and carbohydrate-deficient transferrin, and 2 traditional markers of alcohol use, gamma-glutamyl transpeptidase and mean red blood cell volume, were measured in the blood of pregnant women. Each woman was interviewed about alcohol and drug use, medical and obstetric histories, and nutrition. Each infant was examined by a clinician who was blinded to exposure status.


RESULTS
All of the women who reported drinking an average of 1 or more ounces of absolute alcohol per day had at least 1 positive blood marker. The infants of mothers with 2 or more positive markers had significantly smaller birth weights, lengths, and head circumferences than the infants with negative maternal screens. The presence of 2 or more positive markers was more predictive of infant outcome than any self-reporting measure.


CONCLUSIONS
These markers, which detect more at-risk pregnant women than self-reporting methods, could lead to better efforts at detection and prevention of alcohol-induced fetal damage.
Stoler
J M
JM
Genetics and Teratology Unit, Pediatric Service, Massachusetts General Hospital, Boston 02114, USA.
Huntington
K S
KS
Peterson
C M
CM
Peterson
K P
KP
Daniel
P
P
Aboagye
K K
KK
Lieberman
E
E
Ryan
L
L
Holmes
L B
LB
D000079:Acetaldehyde / Q000097:blood; D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D001724:Birth Weight; D001827:Body Height; D004909:Erythrocyte Indices; D000431:Ethanol / Q000009:adverse effects / Q000506:poisoning*; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000175:diagnosis* / Q000517:prevention & control; D006257:Head / Q000033:anatomy & histology; D006801:Humans; D007231:Infant, Newborn; D008487:Medical History Taking; D009747:Nutritional Physiological Phenomena; D011237:Predictive Value of Tests; D011247:Pregnancy / Q000097:blood*; D011256:Pregnancy Outcome; D011296:Prenatal Diagnosis; D011297:Prenatal Exposure Delayed Effects; D017584:Reproductive History; D016037:Single-Blind Method; D019966:Substance-Related Disorders / Q000097:blood; D014168:Transferrin / Q000032:analysis; D005723:gamma-Glutamyltransferase / Q000097:blood
D015415:Biomarkers; D014168:Transferrin; D000431:Ethanol; D005723:gamma-Glutamyltransferase; D000079:Acetaldehyde