Validation of a new biomarker of fetal exposure to alcohol.
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.
Department of Pediatrics and Neurosciences, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, 11100 Euclid Avenue, Suite 3100, Cleveland, OH 44106-6010, USA. cfb3@po.cwru.edu
Cynthia F
CF
Bearer
Joseph L
JL
Jacobson
Sandra W
SW
Jacobson
Dana
D
Barr
Julie
J
Croxford
Christopher D
CD
Molteno
Denis L
DL
Viljoen
Anna-Susan
AS
Marais
Lisa M
LM
Chiodo
Andrew S
AS
Cwik
D000328:Adult; D000428:Alcohol Drinking; D015415:Biomarkers; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D008431:Maternal-Fetal Exchange; D008470:Meconium / Q000737:chemistry*; D009829:Oleic Acids / Q000032:analysis*; D011247:Pregnancy; D012372:ROC Curve; D012680:Sensitivity and Specificity
D015415:Biomarkers; D009829:Oleic Acids; C033180:ethyl oleate