Phosphatidylethanol Levels in Postpartum Women and Their Newborns in Uruguay and Brazil

Baldwin, Aileen E.; Hayes, Nicole; Ostrander, Erika; Magri, Raquel; Sass, Nelson; Mesquita, Maria dos Anjos; Martínez, M.; Juliani, Monica Correa; Cabral, P. B.; Fleming, Michael F.

doi:10.1111/acer.14339

Cited by 10 publications

(17 citation statements)

References 48 publications

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“…All the included papers were original articles, of which there were seven prospective cohort/longitudinal studies [ 1 , 7 , 13 , 15 , 16 , 18 , 20 ], six cross-sectional studies [ 17 , 21 , 22 , 23 , 24 , 25 ], one retrospective study [ 26 ], and two observational-descriptive studies [ 27 , 28 ] ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

Phosphatidylethanol in Maternal or Neonatal Blood to Detect Alcohol Exposure during Pregnancy: A Systematic Review

Franceschetto

Perilli

Cinquetti

et al. 2022

Life

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Background: Alcohol consumption during pregnancy, even at low doses, may damage the fetus. Pregnant women tend to underreport their alcohol consumption generating the need for sensitive and specific biomarkers, among which PEth has emerged due to its high specificity and possibility to be measured in both maternal and neonatal blood. The aim of this study is to systematically review the latest 20 years of literature for depicting the state of the art, the limitations, and the prospects of PEth for estimating alcohol consumption during pregnancy. Materials and methods: A systematic search, adhering to PRISMA guidelines, of the latest 20 years of literature through “MeSH” and “free-text” protocols in the databases PubMed, SCOPUS, and Web of Science, with time limits 1 January 2002–1 March 2022, was performed. The inclusion criteria were as follows: PEth used for detecting alcohol consumption during pregnancy, quantified in blood through liquid chromatography coupled to mass spectrometry, and full texts in the English language. Opinion papers, editorials, and narrative reviews were excluded. Results: Sixteen (16) papers were included in the present review (0.81% of total retrieved records). All the included records were original articles, of which there were seven prospective cohort/longitudinal studies, six cross-sectional studies, two observational-descriptive studies, and one retrospective study. All studies assayed PEth in at least one biological matrix; seven (7) studies quantified PEth in maternal blood, seven studies in newborn blood, and only two studies in both maternal and neonatal blood. In several included papers, PEth proved more sensitive than self-reports for identifying pregnant women with an active alcohol intake with the diagnostic efficiency improving with the increase of the maternal alcohol intake. Conclusions: Further studies, performed on wider and well-stratified populations, are needed to drive any definitive conclusion. PEth is a promising marker for monitoring alcohol use in pregnancy; however, at the present time, its use is still limited mainly by the absence of a globally agreed interpretative cut-off, the paucity of data regarding its specificity/sensitivity, and the lack of standardization on the diagnostic efficiency of the different isoforms.

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Section: Resultsmentioning

confidence: 99%

Phosphatidylethanol in Maternal or Neonatal Blood to Detect Alcohol Exposure during Pregnancy: A Systematic Review

Franceschetto

Perilli

Cinquetti

et al. 2022

Life

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“…Another study by the same authors revealed that 17% had a positive PEth sample after 3 to 4 weeks of abstinence when using a limit of quantification of 0.0031 µM (Kwak et al, 2014), that is, similar to our study. Studies with a larger number of participants have been carried out immediately after birth, where PEth has been measured in dried blood spots or umbilical cord blood (Bakhireva et al, 2014; Bakhireva et al, 2017; Baldwin et al, 2020; Bracero et al, 2017; Maxwell et al, 2019). These studies have shown a significantly higher proportion of alcohol‐exposed pregnancies than in our study.…”

Section: Discussionmentioning

confidence: 99%

Phosphatidylethanol as Blood Biomarker of Alcohol Consumption in Early Pregnancy: An Observational Study in 4,067 Pregnant Women

Finanger

Spigset

Gråwe

et al. 2021

Alcoholism Clin & Exp Res

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Background: The teratogenic effects of alcohol are well documented, but there is a lack of screening methods to detect alcohol use during pregnancy. Phosphatidylethanol 16:0/18:1 (PEth) is a specific and sensitive biomarker reflecting alcohol intake up to several weeks after consumption. The aim of this study was to investigate the prevalence of positive PEth values as an indicator of early prenatal alcohol exposure in a general population of pregnant women.Methods: Rhesus typing is routinely performed in Norway in all pregnancies around gestational week 12. Rhesus-negative women have an additional test taken around week 24. Blood samples submitted to St. Olav University Hospital in Trøndelag, Norway, for Rhesus typing during the period September 2017 to October 2018 were collected. A total of 4,533 whole blood samples from 4,067 women were analyzed for PEth (limit of quantification of 0.003 µM).Results: Fifty-eight women had a positive PEth sample. Of these, 50 women were positive around gestational week 12, 3 women were positive around week 24, and in 5 cases, the timing was unknown. There were no significant differences in proportions of women with positive PEth values related to age, or rural versus urban residency.Conclusion: In an unselected pregnant population in Norway, 1.4% had a positive PEth sample around gestational week 12, whereas 0.4% had a positive sample around week 24. The use of PEth as an alcohol biomarker should be further investigated as a diagnostic tool in the antenatal setting.

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Section: Applicationsmentioning

confidence: 99%

“…PEth analysis has been applied to study prenatal alcohol exposure and emerged as a potential universal newborn screening candidate (Bakhireva et al, 2014; Baldwin et al, 2020). Besides the DBS of newborns, also elevated PEth concentrations in maternal material are indicative of exposure to maternal alcohol consumption during the last 3–4 weeks of pregnancy (Baldwin et al, 2020). PEth might be especially useful as a cost‐effective screening for children at risk of fetal alcohol spectrum disorder in high‐risk populations where prenatal alcohol use is common (Bakhireva et al, 2013; Baldwin et al, 2020).…”

Section: Applicationsmentioning

confidence: 99%

“…Besides the DBS of newborns, also elevated PEth concentrations in maternal material are indicative of exposure to maternal alcohol consumption during the last 3–4 weeks of pregnancy (Baldwin et al, 2020). PEth might be especially useful as a cost‐effective screening for children at risk of fetal alcohol spectrum disorder in high‐risk populations where prenatal alcohol use is common (Bakhireva et al, 2013; Baldwin et al, 2020). However, there is no established cut‐off concentration for PEth for the assessment of fetal alcohol spectrum, hence more research is needed (Bakhireva et al, 2014).…”

Section: Applicationsmentioning

confidence: 99%

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Current evolutions, applications, and challenges of phosphatidylethanol analysis for clinical and forensic purposes

Luginbühl¹,

Uytfanghe

Stöth

et al. 2022

WIREs Forensic Science

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Phosphatidylethanols (PEth) are a group of abnormal phospholipids which are formed within the human body in the presence of ethanol. As PEth accumulates in red blood cells, which prolongs its detectability, it became popular as a direct alcohol biomarker. When alcohol is consumed regularly, PEth concentrations in the human blood reach an equilibrium (plateau) between formation and degradation which is representative of drinking habits. A wide range of applications has been demonstrated for PEth, whereby in most studies it could provide advancements regarding accuracy and precision when compared to already established alcohol biomarkers (carbohydrate-deficient transferrin, gamma-glutamyltransferase, and ethyl glucuronide). Although PEth has been the focus of many research projects all around the world, the final breakthrough from the research laboratory into the clinical mass market is still ongoing. In this overview article, we discuss the evolution of PEth analysis, its applications, and the associated challenges. The main reasons that hinder the use of PEth in the mass market were identified as (a) the lack of implementing a uniform reference measurement system, which should ensure that every single PEth result is comparable and/or (b) ensuring good laboratory practice dedicated to PEth analysis, which should guarantee that every result obtained by an individual laboratory is correct. These challenges regarding PEth analytics must be carefully addressed in the near future before the implementation of common cut-off values and international guidelines can take place.

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Phosphatidylethanol Levels in Postpartum Women and Their Newborns in Uruguay and Brazil

Cited by 10 publications

References 48 publications

Phosphatidylethanol in Maternal or Neonatal Blood to Detect Alcohol Exposure during Pregnancy: A Systematic Review

Phosphatidylethanol in Maternal or Neonatal Blood to Detect Alcohol Exposure during Pregnancy: A Systematic Review

Phosphatidylethanol as Blood Biomarker of Alcohol Consumption in Early Pregnancy: An Observational Study in 4,067 Pregnant Women

Current evolutions, applications, and challenges of phosphatidylethanol analysis for clinical and forensic purposes

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