title: Testing ethylglucuronide in maternal hair and nails for the assessment of fetal exposure to alcohol: comparison with meconium testing.
abstract: BACKGROUND
  The deleterious effects exerted by prenatal ethanol exposure include physical, mental, behavioral, and/or learning disabilities that are included in the term fetal alcohol spectrum disorder. The measurement of ethylglucuronide (EtG) in alternative biological matrices, including neonatal and maternal hair, neonatal meconium, and maternal nails, is receiving increasing interest for the accurate evaluation of the in utero exposure to alcohol.
  
  
  OBJECTIVE
  To evaluate the correlation between EtG in maternal hair and nails with EtG in neonatal meconium to further explore the suitability of these biomarkers in disclosing prenatal exposure to ethanol.
  
  
  METHODS
  A total of 151 maternal hair strands (0-6 cm), nail clips (2-6 mm), and corresponding neonatal meconium and nails samples were obtained from neonatal wards of 4 Mediterranean public hospitals: Rome, Florence, and Belluno in Italy and Barcelona in Spain. Hair, nails, and meconium were analyzed for the presence of EtG by validated liquid chromatography mass spectrometry assay. Meconium was also analyzed for the presence of fatty acid ethyl esters (FAEEs) as a complementary biomarker of potential in utero exposure to alcohol.
  
  
  RESULTS
  Eighteen newborns resulted in utero exposed to maternal alcohol consumption by FAEE testing in meconium with EtG values between 0.5 and 1.5 nmol/g. Unfortunately, none of these cases were confirmed by the presence of EtG in maternal hair and nails samples, which resulted all negative to this biomarker.
  
  
  CONCLUSIONS
  The results confirm that FAEEs and EtG in meconium are the best biomarkers to assess in utero exposure to maternal alcohol. EtG in hair and nails are not good biomarkers to disclose alcohol consumption lower than on daily basis and lower than 1-2 alcoholic units per day.
authors.affiliation: Department of Public Health, Neuroscience, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Morini
authors.forename: Emilia
authors.initials: E
authors.lastname: Marchei
authors.forename: Luigi
authors.initials: L
authors.lastname: Tarani
authors.forename: Marzia
authors.initials: M
authors.lastname: Trivelli
authors.forename: Gherardo
authors.initials: G
authors.lastname: Rapisardi
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Elicio
authors.forename: Juan
authors.initials: J
authors.lastname: Ramis
authors.forename: Oscar
authors.initials: O
authors.lastname: Garcia-Algar
authors.forename: Luigi
authors.initials: L
authors.lastname: Memo
authors.forename: Roberta
authors.initials: R
authors.lastname: Pacifici
authors.forename: Angelo
authors.initials: A
authors.lastname: Groppi
authors.forename: Paolo
authors.initials: P
authors.lastname: Danesino
authors.forename: Simona
authors.initials: S
authors.lastname: Pichini
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects / Q000378:metabolism*; D015415:Biomarkers / Q000032:analysis; D002853:Chromatography, Liquid / Q000379:methods; D004952:Esters / Q000032:analysis; D000431:Ethanol / Q000009:adverse effects / Q000378:metabolism*; D005227:Fatty Acids / Q000032:analysis; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000175:diagnosis; D005965:Glucuronates / Q000032:analysis*; D006197:Hair / Q000737:chemistry; D006801:Humans; D007231:Infant, Newborn; D013058:Mass Spectrometry / Q000379:methods; D018811:Maternal Exposure; D008470:Meconium / Q000737:chemistry*; D009262:Nails / Q000737:chemistry; D011247:Pregnancy
chemical_list: D015415:Biomarkers; D004952:Esters; D005227:Fatty Acids; D005965:Glucuronates; C093924:ethyl glucuronide; D000431:Ethanol