Clinical sensitivity and specificity of meconium fatty acid ethyl ester, ethyl glucuronide, and ethyl sulfate for detecting maternal drinking during pregnancy

Sarah K. Himes, Kimberly A. Dukes, Tara Tripp, Julie M. Petersen, Cheri Raffo, Larry Burd, Hein Odendaal, Amy Elliott, Dale Hereld, Caroline Signore, Marian Willinger, Marilyn A. Huestis

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: We investigated agreement between selfreported prenatal alcohol exposure (PAE) and objective meconium alcohol markers to determine the optimal meconium marker and threshold for identifying PAE. METHODS: Meconium fatty acid ethyl esters (FAEE), ethyl glucuronide (EtG), and ethyl sulfate (EtS) were quantified by LC-MS/MS in 0.1 g meconium from infants of Safe Passage Study participants. Detailed PAE information was collected from women with a validated timeline follow-back interview. Because meconium formation begins during weeks 12-20, maternal selfreported drinking at or beyond 19 weeks was our exposure variable. RESULTS: Of 107 women, 33 reported no alcohol consumption in pregnancy, 16 stopped drinking by week 19, and 58 drank beyond 19 weeks (including 45 thirdtrimester drinkers). There was moderate to substantial agreement between self-reported PAE at ≥19 weeks and meconium EtG ≥30 ng/g (κ = 0.57, 95% CI 0.41-0.73). This biomarker and associated cutoff was superior to a 7 FAEE sum ≥2 nmol/g and all other individual and combination marker cutoffs. With meconium EtG ≥30 ng/g as the gold standard condition and maternal selfreport at ≥19 weeks' gestation as the test condition, 82% clinical sensitivity (95% CI 71.6-92.0) and 75% specificity (95% CI 63.2- 86.8) were observed. A significant dose- concentration relationship between self-reported drinks per drinking day and meconium EtG ≥30 ng/g also was observed (all P < 0.01). CONCLUSIONS: Maternal alcohol consumption at ≥19 weeks was better represented by meconium EtG ≥30 ng/g than currently used FAEE cutoffs.

Original languageEnglish (US)
Pages (from-to)523-532
Number of pages10
JournalClinical Chemistry
Volume61
Issue number3
DOIs
StatePublished - Mar 1 2015

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Meconium
Drinking
Esters
Fatty Acids
Alcohols
Mothers
Sensitivity and Specificity
Pregnancy
Alcohol Drinking
Biomarkers
ethyl glucuronide
diethyl sulfate
Interviews

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical

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Clinical sensitivity and specificity of meconium fatty acid ethyl ester, ethyl glucuronide, and ethyl sulfate for detecting maternal drinking during pregnancy. / Himes, Sarah K.; Dukes, Kimberly A.; Tripp, Tara; Petersen, Julie M.; Raffo, Cheri; Burd, Larry; Odendaal, Hein; Elliott, Amy; Hereld, Dale; Signore, Caroline; Willinger, Marian; Huestis, Marilyn A.

In: Clinical Chemistry, Vol. 61, No. 3, 01.03.2015, p. 523-532.

Research output: Contribution to journalArticle

Himes, SK, Dukes, KA, Tripp, T, Petersen, JM, Raffo, C, Burd, L, Odendaal, H, Elliott, A, Hereld, D, Signore, C, Willinger, M & Huestis, MA 2015, 'Clinical sensitivity and specificity of meconium fatty acid ethyl ester, ethyl glucuronide, and ethyl sulfate for detecting maternal drinking during pregnancy', Clinical Chemistry, vol. 61, no. 3, pp. 523-532. https://doi.org/10.1373/clinchem.2014.233718
Himes, Sarah K. ; Dukes, Kimberly A. ; Tripp, Tara ; Petersen, Julie M. ; Raffo, Cheri ; Burd, Larry ; Odendaal, Hein ; Elliott, Amy ; Hereld, Dale ; Signore, Caroline ; Willinger, Marian ; Huestis, Marilyn A. / Clinical sensitivity and specificity of meconium fatty acid ethyl ester, ethyl glucuronide, and ethyl sulfate for detecting maternal drinking during pregnancy. In: Clinical Chemistry. 2015 ; Vol. 61, No. 3. pp. 523-532.
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T1 - Clinical sensitivity and specificity of meconium fatty acid ethyl ester, ethyl glucuronide, and ethyl sulfate for detecting maternal drinking during pregnancy

AU - Himes, Sarah K.

AU - Dukes, Kimberly A.

AU - Tripp, Tara

AU - Petersen, Julie M.

AU - Raffo, Cheri

AU - Burd, Larry

AU - Odendaal, Hein

AU - Elliott, Amy

AU - Hereld, Dale

AU - Signore, Caroline

AU - Willinger, Marian

AU - Huestis, Marilyn A.

PY - 2015/3/1

Y1 - 2015/3/1

N2 - BACKGROUND: We investigated agreement between selfreported prenatal alcohol exposure (PAE) and objective meconium alcohol markers to determine the optimal meconium marker and threshold for identifying PAE. METHODS: Meconium fatty acid ethyl esters (FAEE), ethyl glucuronide (EtG), and ethyl sulfate (EtS) were quantified by LC-MS/MS in 0.1 g meconium from infants of Safe Passage Study participants. Detailed PAE information was collected from women with a validated timeline follow-back interview. Because meconium formation begins during weeks 12-20, maternal selfreported drinking at or beyond 19 weeks was our exposure variable. RESULTS: Of 107 women, 33 reported no alcohol consumption in pregnancy, 16 stopped drinking by week 19, and 58 drank beyond 19 weeks (including 45 thirdtrimester drinkers). There was moderate to substantial agreement between self-reported PAE at ≥19 weeks and meconium EtG ≥30 ng/g (κ = 0.57, 95% CI 0.41-0.73). This biomarker and associated cutoff was superior to a 7 FAEE sum ≥2 nmol/g and all other individual and combination marker cutoffs. With meconium EtG ≥30 ng/g as the gold standard condition and maternal selfreport at ≥19 weeks' gestation as the test condition, 82% clinical sensitivity (95% CI 71.6-92.0) and 75% specificity (95% CI 63.2- 86.8) were observed. A significant dose- concentration relationship between self-reported drinks per drinking day and meconium EtG ≥30 ng/g also was observed (all P < 0.01). CONCLUSIONS: Maternal alcohol consumption at ≥19 weeks was better represented by meconium EtG ≥30 ng/g than currently used FAEE cutoffs.

AB - BACKGROUND: We investigated agreement between selfreported prenatal alcohol exposure (PAE) and objective meconium alcohol markers to determine the optimal meconium marker and threshold for identifying PAE. METHODS: Meconium fatty acid ethyl esters (FAEE), ethyl glucuronide (EtG), and ethyl sulfate (EtS) were quantified by LC-MS/MS in 0.1 g meconium from infants of Safe Passage Study participants. Detailed PAE information was collected from women with a validated timeline follow-back interview. Because meconium formation begins during weeks 12-20, maternal selfreported drinking at or beyond 19 weeks was our exposure variable. RESULTS: Of 107 women, 33 reported no alcohol consumption in pregnancy, 16 stopped drinking by week 19, and 58 drank beyond 19 weeks (including 45 thirdtrimester drinkers). There was moderate to substantial agreement between self-reported PAE at ≥19 weeks and meconium EtG ≥30 ng/g (κ = 0.57, 95% CI 0.41-0.73). This biomarker and associated cutoff was superior to a 7 FAEE sum ≥2 nmol/g and all other individual and combination marker cutoffs. With meconium EtG ≥30 ng/g as the gold standard condition and maternal selfreport at ≥19 weeks' gestation as the test condition, 82% clinical sensitivity (95% CI 71.6-92.0) and 75% specificity (95% CI 63.2- 86.8) were observed. A significant dose- concentration relationship between self-reported drinks per drinking day and meconium EtG ≥30 ng/g also was observed (all P < 0.01). CONCLUSIONS: Maternal alcohol consumption at ≥19 weeks was better represented by meconium EtG ≥30 ng/g than currently used FAEE cutoffs.

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DO - 10.1373/clinchem.2014.233718

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