Aims Alcohol consumption in pregnancy has adverse consequences for the developing fetus, but is typically under-reported. Measuring alcohol metabolites in infant meconium has potential to identify prenatal alcohol exposure; local pilot data indicated an incidence of significant alcohol consumption in pregnancy of 15%. We sought to confirm this finding and, with a much larger sample, to identify demographic factors associated with alcohol consumption in pregnancy.
Methods Mothers of singleton infants delivering during every 4th 24 hour period were invited to provide a sample of their baby’s meconium for analysis of fatty acid ethyl esters (FAEEs) and ethyl glucuronide (EtG), and to undergo confidential interview by a single investigator. Meconium samples were frozen at −20o C and transported to Italy for analysis. All mothers provided written informed consent.
Results 1013 eligible mothers were identified over 71 collection days, of whom 905 were approached for consent. 843 mothers agreed to participant (93.1%; 79.5% of all eligible mothers). 741 samples of meconium were collected; 730 (98.5%) were suitable for analysis. FAEEs were detectable in all meconium samples, and the concentration was >600 ng/L in 39.5%. EtG was detected in 300 (41%) samples; concentration was >30 ng/L in 14.5%. 114 (13.5%) mothers admitted to consuming alcohol at any point after 20 weeks’ gestation, of whom only 8 declared >3 units on any one occasion. Maternal smoking was predictive of lower FAEE concentration (samples<600 ng/L, 28.4% smokers; samples>600 ng/L, 22.2% smokers (p=0.056)); the same relationship was observed for EtG (samples<30 ng/L, 27.5% smokers;>30 ng/L, 17.9% smokers (p=0.021)). Non-smoking mothers were more likely to provide meconium samples.
Conclusions Analysis of infant meconium is a feasible way to study alcohol consumption in pregnancy. Confidential, standardised postnatal interview underestimates the amount, but not the prevalence of alcohol consumption from mid-gestation.
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