The Incidence of Prenatal Alcohol Exposure in Montevideo Uruguay As Determined by Meconium Analysis

Abstract

Prenatal alcohol exposure can lead to a wide range of deficits known as fetal alcohol spectrum disorder. Epidemiologic studies regarding alcohol consumption in pregnancy have concentrated on North America, but recent reports have suggested that consumption is significant in many parts of the world. In Uruguay, alcohol consumption has changed into more risky and dangerous patterns and thus has a theoretical risk of having a high rate of prenatal alcohol exposure. This study characterizes the incidence of prenatal alcohol exposure in Montevideo, Uruguay, using a novel biomarker, fatty acid ethyl esters, in meconium as well as a survey to mothers. Nine hundred five meconium samples were collected from Hospital Pereira Rossell and Hospital de Clínicas in Montevideo, Uruguay. A maternal questionnaire was also completed. Meconium was analyzed for fatty acid ethyl esters using liquid-liquid and solid phase extraction with gas chromatography-flame ionization detection. Meconium was also analyzed for other drugs of abuse using enzyme-linked immunosorbent assay. Forty-four percent of meconium samples were above the positive cutoff for fatty acid ethyl esters and represent those newborns with risky prenatal exposure during the final two trimesters of pregnancy. Infants with prenatal alcohol exposure were more likely to have prenatal exposure to tobacco (odds ratio, 1.56; 95% confidence interval, 1.11-2.20) or any illicit drug (odds ratio, 2.29; 95% confidence interval, 0.98-5.31). Ethyl linoleate was a significant predictor of infant birth weight along with prenatal tobacco exposure, maternal body mass index, and infant sex. This study highlights a 44% incidence of prenatal alcohol exposure.

Fetal exposure to ethanol: relationship between ethyl glucuronide in maternal hair during pregnancy and ethyl glucuronide in neonatal meconium

“…In relation to EtG, different cut-offs have been proposed (30 and 50 ng/mg) to disclosing intrauterine exposure to ethanol but EtG lacks a universally established cut-off value at the present time [10][11][12]. However, the degree of agreement between detection of ethanol metabolites in neonatal meconium and maternal self-reported ethanol intake during pregnancy remains unclear [4][5][6][7][8][9][13][14][15][16][17][18][19]. It has been shown that reliance on maternal self-reporting is associated with a high probability of error, with substantial underreporting [14,18,20,21].…”

Determination of maternal-fetal biomarkers of prenatal exposure to ethanol: A review

“…In the same year, Garcia-Algar et al highlighted 45% ethanol use during pregnancy in a low socioeconomic status cohort from Barcelona (Spain). Similarly, Hutson et al [93] studied the prenatal alcohol exposure in Montevideo (Uruguay). Forty-four percent of meconium samples were above the positive cut-off for FAEEs and represent the newborns with risky prenatal exposure during the final two trimesters of pregnancy [93].…”

“…Similarly, Hutson et al [93] studied the prenatal alcohol exposure in Montevideo (Uruguay). Forty-four percent of meconium samples were above the positive cut-off for FAEEs and represent the newborns with risky prenatal exposure during the final two trimesters of pregnancy [93]. Another study on a cohort from South America was done by Roehsig et al [94].…”

Alcohol and Developing Neuronal Circuits

“…Higher rates of drinking during pregnancy have been found in South Africa (20%) and Australia (35%; Giglia & Binns, 2007;Vythilingum, Roos, Faure, Geerts, & Stein, 2012). In certain populations of European (Ireland, Russia, and Spain) and Latin-American (Uruguay) countries, studies indicate that approximately 50% of women drink alcoholic beverages while pregnant (Donnelly et al, 2008;Garcia-Algar et al, 2008;Hutson, Magri, Gareri, & Koren, 2010;Kristjanson, Wilsnack, Zvartau, Tsoy, & Novikov, 2007). A significant number of women drink before knowing they are pregnant and then stop (Alvik, Heyerdahl, Haldorsen, & Lindemann, 2006;Ethen et al, 2009;Floyd, Decoufle, & Hungerford, 1999).…”