Biomarkers for the Detection of Prenatal Alcohol Exposure: A Review

Bager, Heidi; Christensen, Lars Porskjær; Husby, Steffen; Bjerregaard, Lene Berit Skov

doi:10.1111/acer.13309

Cited by 58 publications

(43 citation statements)

References 77 publications

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“…PEth is known to be better in retrospective monitoring (2-4 weeks) of moderate alcohol consumption. 20 PEth results suggest a reduction in positive cases in the period after PCC in line with less self-reported binge drinking.…”

Section: Discussionmentioning

confidence: 76%

Change in Lifestyle Behaviors After Preconception Care: A Prospective Cohort Study

et al. 2020

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Purpose: To evaluate the effects of preconception care (PCC) consultations by change in lifestyle behaviors. Setting and Intervention: Women in deprived neighborhoods of 14 Dutch municipalities were encouraged to visit a general practitioner or midwife for PCC. Sample: The study included women aged 18 to 41 years who had a PCC consultation. Design: In this community-based prospective cohort study, we assessed initiation of folic acid supplementation, cessation of smoking, alcohol consumption, and illicit drug use. Measures: Self-reported and biomarker data on behavioral changes were obtained at baseline and 3 months later. Analysis: The changes in prevalence were assessed with the McNemar test. Results: Of the 259 included participants, paired analyses were available in 177 participants for self-reported outcomes and in 82 for biomarker outcomes. Baseline self-reported prevalence of no folic acid use was 36%, smoking 12%, weekly alcohol use 22%, and binge drinking 17%. Significant changes in prevalence toward better lifestyle during follow-up were seen for folic acid use (both self-reported, P < .001; and biomarker-confirmed, P = .008) and for self-reported binge drinking ( P = .007). Conclusion: Our study suggests that PCC contributes to initiation of folic acid supplementation and cessation of binge drinking in women who intend to become pregnant. Although based on a small sample, the study adds to the limited body of evidence regarding the benefits of PCC in improving periconception health.

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Section: Discussionmentioning

confidence: 76%

Change in Lifestyle Behaviors After Preconception Care: A Prospective Cohort Study

et al. 2020

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“…As with any retrospective human autopsy study, this report has limitations. Maternal histories and details of PNAE were inconsistently reported and self-reported levels of consumption are frequently lower than reality ( 82 ). Therefore, our estimate of alcohol consumption is crude.…”

Section: Discussionmentioning

confidence: 99%

Human Brain Abnormalities Associated With Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorder

Jarmasz

Basalah

Chudley

et al. 2017

Journal of Neuropathology &Amp; Experimental Neurology

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Fetal alcohol spectrum disorder (FASD) is a common neurodevelopmental problem, but neuropathologic descriptions are rare and focused on the extreme abnormalities. We conducted a retrospective survey (1980–2016) of autopsies on 174 individuals with prenatal alcohol exposure or an FASD diagnosis. Epidemiologic details and neuropathologic findings were categorized into 5 age groups. Alcohol exposure was difficult to quantify. When documented, almost all mothers smoked tobacco, many abused other substances, and prenatal care was poor or nonexistent. Placental abnormalities were common (68%) in fetal cases. We identified micrencephaly (brain weight <5th percentile) in 31, neural tube defects in 5, isolated hydrocephalus in 6, corpus callosum defects in 6 (including some with complex anomalies), probable prenatal ischemic lesions in 5 (excluding complications of prematurity), minor subarachnoid heterotopias in 4, holoprosencephaly in 1, lissencephaly in 1, and cardiac anomalies in 26 cases. The brain abnormalities associated with prenatal alcohol exposure are varied; cause–effect relationships cannot be determined. FASD is likely not a monotoxic disorder. The animal experimental literature, which emphasizes controlled exposure to ethanol alone, is therefore inadequate. Prevention must be the main societal goal, however, a clear understanding of the neuropathology is necessary for provision of care to individuals already affected.

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“…EtG is a direct metabolite of ethanol, which is formed by enzymatic conjugation of ethanol with glucuronic acid . Alcohol in urine is normally detected for only a few hours, whereas EtG can be detected up to 3/4 days after the complete elimination of alcohol from the body .…”

Section: Methodsmentioning

confidence: 99%

Fetus morphology changes by second‐trimester ultrasound in pregnant women drinking alcohol

et al. 2019

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Fetal alcohol spectrum disorders (FASDs) are a group of negative conditions occurring in children exposed to alcohol during gestation. The early discovery of FASD is crucial for mother and infant follow-ups. In this study, we investigated in pregnant women the association between urine ethylglucuronide (EtG-a biomarker of alcohol drinking) and indicators of the physical characteristics of FASD by prenatal ultrasound in the second trimester of gestation. We also correlated these data with the AUDIT-C, T-ACE/TACER-3, TWEAK, and food habit diary, screening questionnaires used to disclose alcohol drinking during pregnancy. Forty-four pregnant women were randomly enrolled and examined for ultrasound investigation during the second trimester of gestation. Urine samples were provided by pregnant women immediately after the routine interviews. EtG determinations were performed with a cutoff established at 100 ng/mL, a value indicating occasional alcohol drinking. Fifteen of the enrolled pregnant women overcame the EtG cutoff (34.09%). Analysis of variance (ANOVA) revealed that the fetuses of the positive EtG pregnant women had significantly longer interorbital distance and also significantly increased frontothalamic distance (P's < 0.02). Quite interestingly, no direct correlation was found between EtG data and both food diary and AUDIT-C. However, a significant correlation was observed between urinary EtG and T-ACE (r = 0.375; P = 0.012) and between urinary EtG and TWEAK (r = 0.512; P < 0.001) and a concordance with all questionnaire for EtG values higher than 500 ng/mL. This study provides clinical evidence that the diagnosis of maternal alcohol consumption during pregnancy by urine EtG may disclose FASD-related damage in the fetus.

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Biomarkers for the Detection of Prenatal Alcohol Exposure: A Review

Cited by 58 publications

References 77 publications

Change in Lifestyle Behaviors After Preconception Care: A Prospective Cohort Study

Change in Lifestyle Behaviors After Preconception Care: A Prospective Cohort Study

Human Brain Abnormalities Associated With Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorder

Fetus morphology changes by second‐trimester ultrasound in pregnant women drinking alcohol

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