Ongoing regional prevalence study of fetal alcohol exposure as determined by Meconium analysis of fatty acid ethyl esters

Abstract

Background/Aims Fatty acid ethyl esters (FAEE) in meconium have been established as a novel biomarker for fetal alcohol exposure. This study is the first application of the FAEE test as a neonatal screening tool. A positive cut-off value was established by our laboratory in a baseline study of 183 non-drinking women. We aim to apply this positive cut-off value to the meconium FAEE levels of a regional neonatal population in southwestern Ontario in order to establish a fetal alcohol exposure prevalence value for the area. Methods This is an anonymous prevalence study. One meconium sample is collected from each subject. Samples are obtained from five regional birthing hospitals (one tertiary care). FAEE content is determined by gas chromatography following liquid-liquid and solid-phase extraction. Palmitic, palmitoleic, stearic, oleic, linoleic, linolenic, and arachidonic acid ethyl esters are measured. Results 498 samples were collected between January 1st and September 1st, 2004. The coverage rate for this segment of the study is 78.80%. 102 samples have been analyzed: 4 samples have measured above the positive cut-off of 2.0 nmol total FAEE/g meconium. Conclusions The preliminary results of this study demonstrate a fetal alcohol exposure rate of 3.92%. This value represents a 13-fold increase over the rate of heavy drinking in pregnancy (≥14 drinks/ week) established by the CDC through anonymous surveys in both 1997 and 2002. Clinical Pharmacology & Therapeutics (2005) 77, P93–P93; doi: 10.1016/j.clpt.2004.12.250