title: Rates of fetal alcohol exposure among newborns in a high-risk obstetric unit.
abstract: Meconium fatty acid ethyl esters (FAEEs) are sensitive and specific biomarkers for prenatal alcohol exposure (PAE) in pregnancy. We recently reported a 2.5% rate of FAEE positive meconium in a general population sample of infants born in the region of Grey-Bruce, Ontario. Women in this region with high-risk pregnancies are transferred to a tertiary care facility in London, Ontario. The objective of this study was to determine, in a population-based sample, whether high-risk pregnancies are associated with an increased risk of in utero alcohol exposure. Grey-Bruce residents transferred to the high-risk obstetric unit of St. Joseph's Health Care in London, Ontario were identified and consented to this anonymous prevalence study. Meconium was collected and analyzed for FAEE using gas chromatography with mass spectrometry. The prevalence of FAEE positive meconium was compared with the population-based prevalence in the Grey-Bruce. Fifty meconium specimens were collected from August 1, 2006 to July 31, 2007. Fifteen (30%) specimens tested positive for FAEE. The results indicate that infants born in the high-risk obstetric unit had a 12-fold higher risk of screening positive for second and third trimester alcohol exposure compared with infants born in the general population of Grey-Bruce (relative risk=12.04, 95% confidence interval=6.40-22.65, P<.0001). These results suggest that the high-risk pregnancies should be screened for PAE and followed-up for potential diagnosis of fetal alcohol spectrum disorder.
authors.affiliation: Division of Clinical Pharmacology & Toxicology, The Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8.
authors.forename: Y Ingrid
authors.initials: YI
authors.lastname: Goh
authors.forename: Janine R
authors.initials: JR
authors.lastname: Hutson
authors.forename: Lisa
authors.initials: L
authors.lastname: Lum
authors.forename: Henry
authors.initials: H
authors.lastname: Roukema
authors.forename: Joey
authors.initials: J
authors.lastname: Gareri
authors.forename: Hazel
authors.initials: H
authors.lastname: Lynn
authors.forename: Gideon
authors.initials: G
authors.lastname: Koren
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects; D015415:Biomarkers / Q000032:analysis; D000431:Ethanol / Q000008:administration & dosage*; D005227:Fatty Acids / Q000032:analysis*; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000175:diagnosis; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008431:Maternal-Fetal Exchange; D008470:Meconium / Q000737:chemistry*; D009829:Oleic Acids / Q000032:analysis; D011247:Pregnancy; D018566:Pregnancy, High-Risk / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D005227:Fatty Acids; D009829:Oleic Acids; D000431:Ethanol; C033180:ethyl oleate