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Assessing maternal alcohol consumption in pregnancy: comparison of confidential postnatal maternal interview and measurement of alcohol biomarkers in meconium
  1. Elizabeth MA Henderson1,2,
  2. David Tappin3,
  3. David Young4,
  4. Donata Favretto5,
  5. Helen Mactier3
  1. 1Paediatric Intensive Care, Royal Hospital for Children, Glasgow, UK
  2. 2Neonatology, Princess Royal Maternity, Glasgow, UK
  3. 3Department of Child Health, College of Medical, Vetinary and Life Sciences, University of Glasgow, Glasgow, UK
  4. 4Mathematics & Statistics, University of Strathclyde, Glasgow, UK
  5. 5Department of Health Science, University of Florence, Forensic Toxicology Division, Florence, Italy
  1. Correspondence to Dr Elizabeth MA Henderson, Paediatric Intensive Care, Royal Hospital for Children, Glasgow, G51 4TF, UK; elizabeth.henderson{at}ggc.scot.nhs.uk

Abstract

Objective Knowledge of alcohol consumption in pregnancy is important for early identification of children with fetal alcohol spectrum disorder. We investigated whether alcohol biomarkers fatty acid ethyl esters (FAEEs) and ethyl glucuronide (EtG) in meconium are predicted by maternal or newborn demographics and/or correlate with confidential early postnatal self-report of alcohol consumption in pregnancy.

Design Anonymised, observational population-based study.

Setting Inner-city maternity unit, Glasgow, UK.

Patients Singleton mother/infant dyads delivering every fourth day.

Interventions Mother: confidential postnatal interview. Baby: meconium sample for FAEEs and EtG.

Results 840/908 mothers consented. 370 (46.4%) reported alcohol consumption in pregnancy, generally of modest amount; for 114 (13.6%) this was after 20 weeks’ gestation. Alcohol consumption in later pregnancy was more commonly reported by older (31.3 vs 29.5 years) women of white British ethnicity (p<0.05); their babies were on average 118 g heavier (p=0.032). FAEEs were identified in all meconium samples; concentration was ≥600 ng/g in 39.6%. EtG concentration was ≥30 ng/g in 14.5%. Neither biomarker was associated with maternal age, body mass index or socioeconomic status but when EtG was ≥30 ng/g, the mother was less likely to identify as white British (71.3% vs 81.8%, p=0.028). Sensitivities of FAEEs ≥600 ng/g and EtG ≥30 ng/g were 43.1% and 11.6%, respectively for postnatal self-report of alcohol use in later pregnancy (specificities 60.6% and 84.8%).

Conclusions FAEEs and EtG measured in meconium have low sensitivity and specificity for self-reported alcohol consumption after 20 weeks’ gestation in an unselected Scottish population.

  • neonatology
  • child health
  • infant development

Data availability statement

Data are available on reasonable request.

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Data availability statement

Data are available on reasonable request.

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Footnotes

  • Twitter @Betty_Hende, @HMactier

  • Contributors EMAH participated in study design, recruited all subjects, 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 data analysis and 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 all manuscript revisions. All authors approved the final manuscript. EMAH is the guarantor.

  • Funding This work was funded by Yorkhill Children’s Charity grant number (YRSS/CRF/2014/01).

  • Competing interests None declared.

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

  • © Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.