Ethyl linolenate is elevated in meconium of very-low-birth-weight neonates exposed to alcohol in utero.
The health implications of in utero alcohol exposure have been difficult to study in very-low-birth-weight newborns (VLBW) because of an inability to identify maternal alcohol exposure. Fatty acid ethyl esters (FAEEs) are elevated in meconium of alcohol-exposed term newborns. We hypothesized that meconium FAEEs would be similarly elevated in alcohol-exposed VLBW premature newborns.



In a retrospective cohort study of 64 VLBW neonates, newborns were classified into Non-Exposed, Any Exposure, or Weekly Exposure groups based on an in-depth structured maternal interview. Meconium FAEE concentrations were quantified via gas chromatography mass spectrometry.



Alcohol exposure during Trimester 1 (Any Exposure) occurred in ~30% of the pregnancies, while 11% of the subjects reported drinking ≥ 1 drink/week (Weekly Exposure). Meconium ethyl linolenate was higher in Any Exposure (P = 0.01) and Weekly Exposure groups (P = 0.005) compared to the Non-Exposed VLBW group. There was a significant positive correlation between Trimester 1 drinking amounts and the concentration of meconium ethyl linolenate (P = 0.005). Adjusted receiver operating characteristic (ROC) curves evaluating ethyl linolenate to identify alcohol-exposed VLBW newborns generated areas under the curve of 88% with sensitivities of 86-89% and specificities of 83-88%.



Despite prematurity, meconium FAEEs hold promise to identify the alcohol-exposed VLBW newborn.
Emory University School of Medicine, Atlanta, Georgia.
Teresa S
TS
Gross
Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Emory University, Atlanta, Georgia.
Frank
F
Harris
Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Emory University, Atlanta, Georgia.
Lou Ann S
LA
Brown
Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Emory University, Atlanta, Georgia.
Theresa W
TW
Gauthier
D000428:Alcohol Drinking / Q000009:adverse effects*; D015415:Biomarkers / Q000032:analysis; D015331:Cohort Studies; D000431:Ethanol; D005227:Fatty Acids / Q000032:analysis; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D008042:Linolenic Acids / Q000032:analysis*; D018811:Maternal Exposure; D008470:Meconium / Q000737:chemistry*; D011247:Pregnancy; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires
D015415:Biomarkers; D005227:Fatty Acids; D008042:Linolenic Acids; D000431:Ethanol; C039896:ethyl linolenate