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Assessing maternal alcohol consumption in pregnancy: does phosphatidylethanol measured from day 5 newborn blood spot cards have any value? An observational, population-based study
  1. Elizabeth M A Henderson1,2,
  2. David Tappin3,
  3. David Young4,
  4. Donata Favretto5,
  5. Helen Mactier1,3
  1. 1 Neonatology, Princess Royal Maternity, Glasgow, UK
  2. 2 Paediatric Intensive Care, NHS Greater Glasgow and Clyde, Glasgow, UK
  3. 3 Department of Child Health, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
  4. 4 Mathematics and Statistics, University of Strathclyde, Glasgow, UK
  5. 5 Department of Health Science, University of Florence, Forensic Toxicology Division, Florence, Italy
  1. Correspondence to Dr Elizabeth M A Henderson, Paediatric Intensive Care, NHS Greater Glasgow and Clyde, Glasgow G51 4TF, UK; elizabeth.henderson{at}


Objective Prenatal alcohol exposure (PAE) places children at risk of fetal alcohol spectrum disorder (FASD) but ascertainment of PAE is problematic. Early intervention for children at risk of FASD may help mitigate long-term difficulties. Phosphatidylethanol (PEth), a metabolite of alcohol, is incorporated into red cell membranes and can be measured in dried blood spot (DBS) cards. In the UK, DBS samples are collected on day 5 for routine newborn screening. We sought to examine if PEth measured from DBS correlates with postnatal maternal self-report of alcohol consumption in pregnancy.

Design Observational population-based study. Comparison of infant PEth concentration and self-report of maternal alcohol use during pregnancy.

Setting Large maternity unit in Glasgow, Scotland.

Participants All singleton mother–infant dyads delivered during each fourth consecutive 24-hour period.

Interventions Mother: direct, confidential, immediate postnatal interview by a single researcher examining alcohol use during pregnancy. Infant: one extra DBS collected coincident with routine newborn screening if bleeding continued.

Results 92.5% of eligible mothers agreed to participate. 510 DBS were obtained of which 502 were successfully analysed. 216 (43%) samples contained PEth at a concentration of ≥8 ng/mL and 148 (29.5%) at ≥20 ng/mL. The sensitivity of PEth ≥8 ng/mL and ≥20 ng/mL in identifying women who self-reported modest alcohol use after 36 weeks’ gestation was 50% and 36.4%, respectively.

Conclusion PEth measured from DBS obtained on day 5 of life does not reliably identify modest PAE after 36 weeks’ gestation from maternal self-report.

  • neonatology
  • child health

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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  • Twitter @Betty_Hende, @HMactier

  • Contributors EMAH participated in study design, recruited all participants, undertook some of the statistical analyses, wrote the first draft of the manuscript and participated in all subsequent revisions. DT participated in study design and critically reviewed the draft manuscript. DY advised on statistical analysis and critically reviewed the draft manuscript. DF supervised laboratory analyses and reviewed the draft manuscript. HM conceived and supervised the study, contributed to the draft manuscript and critically reviewed subsequent manuscript revisions. EMAH is guarantor.

  • Funding Funder was Yorkhill Children’s Charity (YRSS/CRF/2014/01).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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