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Determining the pattern and prevalence of alcohol consumption in pregnancy by measuring biomarkers in meconium
  1. Carolyn Abernethy1,
  2. Karen E McCall1,
  3. Gail Cooper2,3,
  4. Donata Favretto4,
  5. Fabio Vaiano4,
  6. Elisabetta Bertol4,
  7. Helen Mactier1,2
  1. 1Neonatal Unit, Princess Royal Maternity Hospital, Glasgow, UK
  2. 2School of Medicine, University of Glasgow, Glasgow, UK
  3. 3Department of Forensic Toxicology, Office of Chief Medical Examiner, New York, USA
  4. 4Forensic Toxicology Division, Department of Health Science, University of Florence, Florence, Italy
  1. Correspondence to Dr Helen Mactier, Department of Neonatology, Neonatal Unit, Princess Royal Maternity, 8-16, Alexandra Parade, Glasgow G31 2ER, UK; Helen.Mactier{at}ggc.scot.nhs.uk

Abstract

Objective To investigate the feasibility of determining the pattern and prevalence of alcohol consumption in pregnancy by measuring ethanol biomarkers in meconium.

Design Population-based observational study.

Setting Inner-city maternity unit in Scotland, UK.

Population Random sample of singleton infants delivered after 36 completed weeks’ gestation.

Methods Fatty acid ethyl esters (FAEEs) and ethyl glucuronide (EtG) in meconium were measured by liquid chromatography-mass spectroscopy. Samples were frozen at −20°C before analysis. Results were compared anonymously with demographic data including maternal age, parity, smoking, ethnicity and postcode and with infant gestation, birth weight and head circumference. Written informed consent was obtained from all subjects.

Results 235 samples of meconium were analysed (70% of eligible babies). Only four (1%) of mothers declined to participate. FAAEs were detected in all, including four samples below the limit of quantification (10 ng/g). 98 (42%) samples had FAEE concentrations >600 ng/g. EtG was detectable in 93 (40%) samples; in 35 (15%) EtG concentration was >30 ng/g. No mother reported heavy alcohol consumption in pregnancy. FAAE concentration correlated with EtG (Pearson’s coefficient; p<0.001). There was no association between either biomarker and maternal age, parity, smoking, ethnicity or postcode, or infant gestation, birth weight or head circumference.

Conclusion Measurement of ethanol biomarkers in meconium is a feasible tool for determining the pattern and prevalence of alcohol consumption in pregnancy. Data suggest that at least 15% of pregnant women in the west of Scotland are consuming significant quantities of alcohol during latter pregnancy.

  • fatty acid ethyl esters
  • ethylglucuronide
  • meconium
  • newborn

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Footnotes

  • Contributors CCA: recruited patients and drafted initial manuscript. KMcC: recruited patients and extensively revised manuscript. GC: involved in study design and contributed to revisions of manuscript. DF: oversaw analyses of samples. FV and EB: analysed samples and contributed to revisions of the manuscript. HM: conceived study and extensively revised the manuscript. All authors approved the final version of the manuscript.

  • Funding The study was funded by a grant from Scottish government (CASE 126426/Meconium).

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The study was approved by West of Scotland Ethics Committee 4.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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