Biochemical markers of alcohol use in pregnant women.
OBJECTIVE
To describe the serious health consequences of alcohol (ethanol) use, especially as they relate to pregnancy and the development of fetal alcohol syndrome (FAS) and fetal alcohol effects (FAE). The classic markers of alcohol exposure, including blood/breath alcohol, gamma-glutamyl transferase (gammaGT), mean corpuscular volume (MCV), hemoglobin-associated acetaldehyde (HAA) and carbohydrate deficient transferrin (CDT), are valuable and their methods of analysis are reviewed.


CONCLUSIONS
Since both FAS and FAE represent two of the leading preventable causes of mental retardation and birth defects, identification of alcohol use early in pregnancy is important to avoid adverse fetal outcomes. Unfortunately, the diagnosis of FAS and FAE is usually made after birth, when alcohol damage has become irreversible and permanent. The clinical laboratory can help prevent this damage and make a valuable contribution in assessing prenatal alcohol use. The clinical utility of blood/breath alcohol, gammaGT, MCV, HAA and CDT in alcohol use identification, especially in pregnancy, is substantial. Although none of the markers singularly has adequate sensitivity and specificity for screening, their diagnostic utility increases when measured as a panel. This is especially true in detecting alcohol use in pregnancy where the presence of several positive markers was correlated with the presence of alcohol-related fetal effects.
Cook
Janine Denis
JD
Department of Medical and Research Technology, School of Medicine, University of Maryland, Baltimore, MD 21201-1082, USA. jcook002@umaryland.edu
D000079:Acetaldehyde / Q000097:blood; D000428:Alcohol Drinking / Q000009:adverse effects*; D000438:Alcohols / Q000378:metabolism; D015415:Biomarkers; D004909:Erythrocyte Indices; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000517:prevention & control*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007118:Immunoassay; D011247:Pregnancy; D011795:Surveys and Questionnaires; D013997:Time Factors; D014168:Transferrin / Q000031:analogs & derivatives* / Q000096:biosynthesis; D005723:gamma-Glutamyltransferase / Q000097:blood
D000438:Alcohols; D015415:Biomarkers; D006454:Hemoglobins; D014168:Transferrin; C056759:carbohydrate-deficient transferrin; D005723:gamma-Glutamyltransferase; D000079:Acetaldehyde