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.
Bearer
Cynthia F
CF
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
Jacobson
Joseph L
JL
Jacobson
Sandra W
SW
Barr
Dana
D
Croxford
Julie
J
Molteno
Christopher D
CD
Viljoen
Denis L
DL
Marais
Anna-Susan
AS
Chiodo
Lisa M
LM
Cwik
Andrew S
AS
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