title: Assessment of prenatal exposure to ethanol by meconium analysis: results of an Italian multicenter study.
abstract: BACKGROUND
  This study estimated in 7 Italian cities the prevalence of prenatal exposure to ethanol by determining fatty acid ethyl esters (FAEEs; palmitic, palmitoleic, stearic, oleic, linoleic, linolenic, and arachidonic esters) and ethyl glucuronide (EtG) in neonatal meconium samples.
  
  
  METHODS
  A total of 607 meconium samples were obtained from neonatal wards of 7 public hospitals: Verona and San Daniele del Friuli in the northeast of the country, Reggio Emilia in the middle east, Florence and Rome in the center, and Naples and Crotone in the southwest of the peninsula. Meconium biomarkers were assessed by a validated methodology using liquid chromatography-tandem mass spectrometry and the results categorized using the accepted cutoff of 2 nmol/g total amount of 7 FAEEs and 2 nmol/g EtG, to differentiate between heavy maternal ethanol use during pregnancy and occasional or no use at all.
  
  
  RESULTS
  On the basis of the above-reported cutoffs, the overall prevalence of newborns prenatally exposed to maternal ethanol was 7.9%: 0% in Verona, 4.0% in San Daniele del Friuli, 4.9% in Naples, 5.0% in Florence, 6.2% in Crotone, up to 10.6% in Reggio Emilia, and 29.4% in Rome. Low maternal education level and younger maternal age were associated with biomarker scores over the cutoff. There was also a significant correlation between the highest percentage of prenatal exposure in the capital and certain maternal sociodemographic characteristics.
  
  
  CONCLUSIONS
  These results indicate considerable variability in the prevalence of fetal exposure to ethanol in different Italian cities, as determined by the objective measurement of biomarkers in meconium. These data, together with previous ones obtained in Barcelona, Spain, indicate that gestational ethanol exposure is widespread, at least in parts of Europe.
authors.affiliation: Istituto Superiore di Sanitá, Roma, Italy. simona.pichini@iss.it
authors.forename: Simona
authors.initials: S
authors.lastname: Pichini
authors.forename: Emilia
authors.initials: E
authors.lastname: Marchei
authors.forename: Federica
authors.initials: F
authors.lastname: Vagnarelli
authors.forename: Luigi
authors.initials: L
authors.lastname: Tarani
authors.forename: Francesco
authors.initials: F
authors.lastname: Raimondi
authors.forename: Rosalba
authors.initials: R
authors.lastname: Maffucci
authors.forename: Bruno
authors.initials: B
authors.lastname: Sacher
authors.forename: Massimo
authors.initials: M
authors.lastname: Bisceglia
authors.forename: Gherardo
authors.initials: G
authors.lastname: Rapisardi
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Elicio
authors.forename: Paolo
authors.initials: P
authors.lastname: Biban
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Zuccaro
authors.forename: Roberta
authors.initials: R
authors.lastname: Pacifici
authors.forename: Andrea
authors.initials: A
authors.lastname: Pierantozzi
authors.forename: Luca
authors.initials: L
authors.lastname: Morini
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000378:metabolism; D015415:Biomarkers / Q000032:analysis; D004952:Esters / Q000032:analysis; D000431:Ethanol / Q000032:analysis*; D005227:Fatty Acids / Q000032:analysis; D005260:Female; D005965:Glucuronates / Q000032:analysis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008297:Male; D008470:Meconium / Q000737:chemistry*; D011247:Pregnancy; D015995:Prevalence; D015813:Substance Abuse Detection / Q000379:methods* / Q000706:statistics & numerical data
chemical_list: D015415:Biomarkers; D004952:Esters; D005227:Fatty Acids; D005965:Glucuronates; C093924:ethyl glucuronide; D000431:Ethanol