Mean cell volume and gamma-glutamyl transferase are superior to carbohydrate-deficient transferrin and hemoglobin-acetaldehyde adducts in the follow-up of pregnant women with alcohol abuse.
OBJECTIVE
To compare the usefulness of carbohydrate-deficient transferrin (CDT), the ratio of CDT to total transferrin, and hemoglobin-acetaldehyde adducts with mean cell volume (MCV) and gamma-glutamyl transferase (GGT) in the follow-up of alcohol abuse during pregnancy.


METHODS
Forty-four pregnant drug and alcohol abusing female patients attending a special outpatient clinic were followed from the 8th to 24th gestational week onwards. A population of sixty-two healthy pregnant women was recruited to assess the effect of gestation on the markers.


RESULTS
Eight of thirteen heavy drinking (> or =8 drinks/week) patients delivered infants with fetal alcohol effects (FAE). MCV and GGT were higher among heavy drinking patients than in moderately drinking (<8 drinks/week) patients (92+/-4 vs 90+/-3 fl and 31+/-34 vs 16+/-10 U/ L, respectively), and in patients delivering infants with FAE compared with patients delivering healthy infants (95+/-3 vs 90+/-3 fl and 34+/-26 vs 15+/-10 U/L, respectively). Hemoglobin-acetaldehyde adducts, CDT, and the ratio of CDT to total transferrin were neither associated with the reported level of alcohol consumption nor with the occurrence of FAE. In the receiver operating characteristics analysis MCV was found to be superior to CDT and the adducts, and GGT superior to the adducts, in identifying heavy drinking and in predicting FAE. In the control population, both CDT and total transferrin were found to rise during pregnancy, whereas the ratio of CDT to total transferrin was found to decline. The upper reference range of 33 U/L for CDT was considerably higher than that of non-pregnant women (26 U/L).


CONCLUSIONS
MCV and GGT appear to be the most efficient laboratory markers for detecting excessive alcohol consumption and the adverse effects of alcohol on the fetus.
Sarkola
T
T
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland.
Eriksson
C J
CJ
Niemelä
O
O
Sillanaukee
P
P
Halmesmäki
E
E
D000079:Acetaldehyde / Q000097:blood / Q000737:chemistry; D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000097:blood; D019973:Alcohol-Related Disorders / Q000097:blood / Q000473:pathology*; D019540:Area Under Curve; D004909:Erythrocyte Indices; D000431:Ethanol / Q000652:urine; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000175:diagnosis; D005500:Follow-Up Studies; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis / Q000737:chemistry; D006801:Humans; D007231:Infant, Newborn; D017533:Marital Status; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000473:pathology*; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D011446:Prospective Studies; D012372:ROC Curve; D012907:Smoking; D014168:Transferrin / Q000031:analogs & derivatives / Q000032:analysis; D005723:gamma-Glutamyltransferase / Q000097:blood*
D006454:Hemoglobins; D014168:Transferrin; C056759:carbohydrate-deficient transferrin; D000431:Ethanol; D005723:gamma-Glutamyltransferase; D000079:Acetaldehyde