Abstract
Our study aimed to estimate the prevalence of heavy fetal alcohol exposure through the analysis of meconium FAEEs as an objective biomarker of fetal exposure. We conducted a study on meconium samples collected nationwide through the Maternal-Infant Research on Environmental Chemicals (MIREC) Study Group. FAEE in meconium was quantified by an established headspace solid-phase microextraction coupled with gas chromatography-mass spectrometry (SPME GC-MS). Out of 1315 samples collected in 10 Canadian obstetric units coast to coast between 2008-2011, the estimated prevalence of positive meconium FAEE ranged between 1.16% and 2.40%, translating into at least 1800 new cases of FASD in Canada each year. Positive maternal self- reports of heavy alcohol use were tenfold lower (0.24%). Use of meconium FAEE revealed tenfold more cases of heavy exposure to maternal drinking than did maternal reports. The use of objective measures of maternal alcohol exposure is critical in accurately estimating risks and in monitoring effective prevention of FASD.
Highlights
Due to the range of symptoms and deficits seen in children with FASD diagnosis can be extremely challenging
Since the discovery by Bearer that Fatty acid ethyl esters (FAEEs) are excellent biomarkers for fetal alcohol exposure to alcohol[24], several studies looking at baseline FAEE levels, infants born to women who did not drink alcohol during pregnancy had low meconium FAEE levels[25]
Out of a total of 2000 women approached, 1436 meconium samples were available from the Maternal-Infant Research on Environmental Chemicals (MIREC) Biobank, with 1315 eligible for FAEE analysis and 125 either not having sufficient quantity (NSQ) for analysis or were identified to be postnatal stool
Summary
Due to the range of symptoms and deficits seen in children with FASD diagnosis can be extremely challenging. All domains of neuro-cognition have been found to be adversely affected by prenatal alcohol exposure including language, visuospatial functioning, verbal memory and learning[14]. These behavioural deficits contribute to a series of secondary disabilities in FASD15 with 60% lifetime prevalence of trouble with the law[16], inappropriate sexual behaviour, and mental health disorders[13]. Most studies reporting on gestational use of alcohol rely on maternal self-reports, which are grossly inaccurate due to maternal guilt, shame and fear of losing custody of the child[19,20,21,22] This has led to the search for biological markers of fetal alcohol exposure. Because meconium is produced in the second and third trimesters of pregnancy, positive FAEE levels indicate late drinking, long after the woman became aware of her pregnancy; it is an important marker of alcohol dependence
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