Biomarkers for detection of prenatal alcohol exposure: a critical review of fatty acid ethyl esters in meconium.
BACKGROUND
The objective of this study was a review of published studies utilizing measurement of fatty acid ethyl esters (FAEE) in meconium as biomarkers for prenatal alcohol exposure.


METHODS
We completed a literature search of PubMed using the terms meconium, fatty acid ethyl esters, biomarkers, and prenatal alcohol exposure. We included only peer reviewed studies utilizing analysis of meconium for the presence of FAEE in humans through the year 2007.


RESULTS
We found 10 articles reporting on original research examining the relationship of FAEE from meconium and prenatal alcohol exposure (PAE). The 10 articles used six different PAE assessment strategies and four different analytical techniques for determining FAEE endpoints. The articles included 2,221 subjects (range 4 to 725) with 455 (20.5%) subjects identified as exposed using the methods stated in the articles. FAEE levels above the studies' respective cutoffs were reported for 502 (22.6%) subjects.


CONCLUSIONS
The accurate identification of alcohol-exposed pregnancies represents a significant challenge in the development of FAEE detection cutoffs to maximize the sensitivity and specificity of the test. We present several options for the improvement of exposure assessment in future studies of FAEE as biomarkers for PAE.
Burd
Larry
L
North Dakota Fetal Alcohol Syndrome Center, Department of Pediatrics, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota 58203-9037, USA. laburd@medicine.nodak.edu
Hofer
Ryan
R
D015415:Biomarkers / Q000032:analysis*; D004952:Esters; D005227:Fatty Acids / Q000032:analysis*; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000175:diagnosis*; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D007231:Infant, Newborn; D008470:Meconium / Q000737:chemistry*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012680:Sensitivity and Specificity
D015415:Biomarkers; D004952:Esters; D005227:Fatty Acids