Alcohol Consumption during Pregnancy: Analysis of Two Direct Metabolites of Ethanol in Meconium

Abstract

Alcohol consumption in young women is a widespread habit that may continue during pregnancy and induce alterations in the fetus. We aimed to characterize prevalence of alcohol consumption in parturient women and to assess fetal ethanol exposure in their newborns by analyzing two direct metabolites of ethanol in meconium. This is a cross-sectional study performed in September 2011 and March 2012 in a series of women admitted to an obstetric unit following childbirth. During admission, socio-demographic and substance use (alcohol, tobacco, cannabis, cocaine, and opiates) during pregnancy were assessed using a structured questionnaire and clinical charts. We also recorded the characteristics of pregnancy, childbirth, and neonates. The meconium analysis was performed by liquid chromatography—tandem mass spectrometry (LC-MS/MS) to detect the presence of ethyl glucuronide (EtG) and ethyl sulfate (EtS). Fifty-one parturient and 52 neonates were included and 48 meconium samples were suitable for EtG and EtS detection. The median age of women was 30 years (interquartile range (IQR): 26–34 years); EtG was present in all meconium samples and median concentration of EtG was 67.9 ng/g (IQR: 36.0–110.6 ng/g). With respect to EtS, it was undetectable (<0.01 ng/g) in the majority of samples (79.1%). Only three (6%) women reported alcohol consumption during pregnancy in face-to-face interviews. However, prevalence of fetal exposure to alcohol through the detection of EtG and EtS was 4.2% and 16.7%, respectively. Prevention of alcohol consumption during pregnancy and the detection of substance use with markers of fetal exposure are essential components of maternal and child health.

A utilitarian comparison of two alcohol use biomarkers with self-reported drinking history collected in antenatal clinics

“…This will shed further light on the accuracy question in the future. But, from this binary analysis and the results of three previous studies comparing biomarker results with self-report in Southern Africa [12,46,47], we can conclude that alcohol use reporting in this region is generally accurate, much more so than that reported in most comparative biomarker/self-report studies from Europe [40–45] and North America [13]. There has traditionally been a lack of stigma surrounding recreational binge drinking in this population and this may also make accurate reporting more likely [2].…”

O uso de questionários na investigação do consumo mundial de bebidas alcoólicas por gestantes: uma revisão sistemática

“…Alguns estudos relataram a associação do uso de bebidas alcoólicas com outras variáveis: presença de eventos estressantes (38,97); depressão (32,46); tabagismo (26,43,51,55,57,63,94,101,104,107); abandono do cônjuge ou parceiro (53); crenças (108); violência doméstica (5,63,77,107) e baixo apoio social (42). Ainda, o nível de escolaridade baixo foi associado ao maior consumo de bebidas alcoólicas por gestantes (62,104).…”

“…. Os demais estudos sugerem modelos para futuras intervenções e novas pesquisas(24,30,39,44,45,49,52,54,56,61,67,83,86,97,100,103,106).de mulheres que continuaram a beber álcool durante a gravidez Identificação de fatores para beber durante a gravidez 5,5% das mulheres continuaram consumindo álcool após o reconhecimento da gravidez O consumo de álcool baixo a moderado durante a gravidez pode influenciar negativamente o desenvolvimento e o comportamento infantil O uso de álcool durante a amamentação foi relatado por 60,7% e 69,6% das mulheres com 8 semanas e 12 meses após o parto, respectivamente 8,1% consumiram álcool durante a gravidez Uma em cada cinco mulheres na Holanda consome álcool durante a gravidez Maior probabilidade de continuar bebendo durante a gravidez em mulheres com nível superior 72,15% das mulheres consumiram álcool no período da gestação, onde 54,5% dos seus parceiros também consumiram álcool nesse período Fatores associados ao consumo de álcool: idade materna e uso ilícito de outras drogas Quase 2/3 das mulheres se abstiveram totalmente de álcool durante a gravidez 33,6% das mulheres se abstiveram do consumo de álcool antes da gravidez 91% consumiram álcool antes da gravidez e menos de 20% durante a gravidez Comparou a abstinência de álcool na gravidez entre pais primíparos e experientes Relatos de abstinência (72% a 89%) de bebida alcoólica na gestação dentre as entrevistadas.…”

Metabolomics and fetal alcohol spectrum disorder

“…This does not mean, however, that these tests are foolproof. In fact, Sanvisens et al (2016) analyzed meconium using liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) and found that EtG was present in all of the samples, but EtS was undetectable in most. While only 6% of women reported alcohol consumption during pregnancy, prevalence through the detection of EtG and EtS was 4.2% and 16.7%, respectively.…”