Fetal marker reveals drinking before birth

Researchers in Italy have used markers in fetal meconium (the very earliest feces of a newborn) to measure alcohol exposure before birth.

In the study, published in Alcoholism: Clinical & Experimental Research, the researchers looked at 607 meconium samples from 7 hospitals across Italy. Because the meconium reflects the unborn child's environment in the last two trimesters of the pregnancy, the levels of fatty acid ethyl esters (FAEEs) and ethylglucuronide reflect the levels of alcohol that the woman consumed during this period. The samples were categorized as either reflecting heavy maternal alcohol use during pregnancy or occasional use to no use at all. In the study, higher biomarker scores were linked with low maternal education and younger maternal age.

"We found an overall prevalence of 7.9 percent Italian newborns prenatally exposed to maternal alcohol, with a large variability in the prevalence of fetal exposure in different Italian cities, ranging from zero percent in Verona in the north east to 29.4 percent in the capital. In any case, this exposure is underestimated or misreported," said Simona Pichini, a senior scientist at the Istituto Superiore di Sanita in Rome and corresponding author.

"The biggest challenge in estimating the incidence and prevalence of Fetal Alcohol Spectrum Disorder (FASD) is that maternal reports on their drinking are often not helpful, due to guilt, embarrassment, and fears of losing custody," explained Gideon Koren, director of The Motherisk Program at The Hospital for Sick Children, and also professor of pediatrics, pharmacology, pharmacy and medical genetics at The University of Toronto.

As well as the study confirming the value of this biomarker in the second and third trimesters of pregnancy, the researchers concluded that fetal alcohol exposure may be underestimated or misreported in Italy. Because biomarker tests are objective, the combination of these two could provide a clearer view of the exposure to alcohol, helping in epidemiological studies and education, as well as allowing monitoring and treatment of babies at risk of fetal alcohol syndrome before symptoms are seen.

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