Clinical Sensitivity and Specificity of Meconium Fatty Acid Ethyl Ester, Ethyl Glucuronide, and Ethyl Sulfate for Detecting Maternal Drinking during Pregnancy

• DOI: 10.1373/clinchem.2014.233718
• Publication Date: 2015-01-17T10:40:50Z
• Authors: Sarah K Himes; Kimberly A Dukes; Tara Tripp; Julie M Petersen; Cheri Raffo; Larry Burd; Hein Odendaal; Amy J Elliott; Dale Hereld; Caroline Signore; Marian Willinger; ; Marilyn A Huestis
• Keywords: Ethyl glucuronide

We investigated agreement between self-reported prenatal alcohol exposure (PAE) and objective meconium markers to determine the optimal marker threshold for identifying PAE.Meconium fatty acid ethyl esters (FAEE), glucuronide (EtG), sulfate (EtS) were quantified by LC-MS/MS in 0.1 g from infants of Safe Passage Study participants. Detailed PAE information was collected women with a validated timeline follow-back interview. Because formation begins during weeks 12-20, maternal drinking at or beyond 19 our variable.Of 107 women, 33 reported no consumption pregnancy, 16 stopped week 19, 58 drank (including 45 third-trimester drinkers). There moderate substantial ≥19 EtG ≥30 ng/g (κ = 0.57, 95% CI 0.41-0.73). This biomarker associated cutoff superior 7 FAEE sum ≥2 nmol/g all other individual combination cutoffs. With as gold standard condition self-report weeks' gestation test condition, 82% clinical sensitivity (95% 71.6-92.0) 75% specificity 63.2-86.8) observed. A significant dose-concentration relationship drinks per day also observed (all P < 0.01).Maternal better represented than currently used