Clinical sensitivity and specificity of meconium fatty acid ethyl ester, ethyl glucuronide, and ethyl sulfate for detecting maternal drinking during pregnancy
We investigated agreement between self-reported prenatal alcohol exposure (PAE) and objective meconium alcohol markers to determine the optimal meconium marker and threshold for identifying PAE. Meconium fatty acid ethyl esters (FAEE), ethyl glucuronide (EtG), and ethyl sulfate (EtS) were quantified...
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| Veröffentlicht in: | Clinical chemistry (Baltimore, Md.) Md.), 2015-03, Vol.61 (3), p.523-532 |
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| creator | Himes, Sarah K Dukes, Kimberly A Tripp, Tara Petersen, Julie M Raffo, Cheri Burd, Larry Odendaal, Hein Elliott, Amy J Hereld, Dale Signore, Caroline Willinger, Marian Huestis, Marilyn A |
| description | We investigated agreement between self-reported prenatal alcohol exposure (PAE) and objective meconium alcohol markers to determine the optimal meconium marker and threshold for identifying PAE.
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 self-reported drinking at or beyond 19 weeks was our exposure variable.
Of 107 women, 33 reported no alcohol consumption in pregnancy, 16 stopped drinking by week 19, and 58 drank beyond 19 weeks (including 45 third-trimester 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 self-report 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).
Maternal alcohol consumption at ≥19 weeks was better represented by meconium EtG ≥30 ng/g than currently used FAEE cutoffs. |
| doi_str_mv | 10.1373/clinchem.2014.233718 |
| format | Article |
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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 self-reported drinking at or beyond 19 weeks was our exposure variable.
Of 107 women, 33 reported no alcohol consumption in pregnancy, 16 stopped drinking by week 19, and 58 drank beyond 19 weeks (including 45 third-trimester 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 self-report 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).
Maternal alcohol consumption at ≥19 weeks was better represented by meconium EtG ≥30 ng/g than currently used FAEE cutoffs.</description><identifier>ISSN: 0009-9147</identifier><identifier>EISSN: 1530-8561</identifier><identifier>DOI: 10.1373/clinchem.2014.233718</identifier><identifier>PMID: 25595440</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Alcohol Drinking ; Alcohol use ; Alcohols ; Behavior ; Biomarkers ; Biomarkers - blood ; Chromatography, Liquid ; Esters ; Esters - chemistry ; Ethanol ; Fatty acids ; Fatty Acids - blood ; Fatty Acids - chemistry ; Female ; Fetal alcohol syndrome ; Genealogy ; Glucuronates - blood ; Humans ; Limit of Detection ; Meconium - chemistry ; Pregnancy ; Sensitivity and Specificity ; Sulfates ; Sulfuric Acid Esters - blood ; Tandem Mass Spectrometry ; Womens health</subject><ispartof>Clinical chemistry (Baltimore, Md.), 2015-03, Vol.61 (3), p.523-532</ispartof><rights>2014 American Association for Clinical Chemistry.</rights><rights>Copyright American Association for Clinical Chemistry Mar 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c381t-8c9653d195ad7144bd86f8eeb19bd793b2ec5fa5703550f4ada112aa0dd60b153</citedby><cites>FETCH-LOGICAL-c381t-8c9653d195ad7144bd86f8eeb19bd793b2ec5fa5703550f4ada112aa0dd60b153</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25595440$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Himes, Sarah K</creatorcontrib><creatorcontrib>Dukes, Kimberly A</creatorcontrib><creatorcontrib>Tripp, Tara</creatorcontrib><creatorcontrib>Petersen, Julie M</creatorcontrib><creatorcontrib>Raffo, Cheri</creatorcontrib><creatorcontrib>Burd, Larry</creatorcontrib><creatorcontrib>Odendaal, Hein</creatorcontrib><creatorcontrib>Elliott, Amy J</creatorcontrib><creatorcontrib>Hereld, Dale</creatorcontrib><creatorcontrib>Signore, Caroline</creatorcontrib><creatorcontrib>Willinger, Marian</creatorcontrib><creatorcontrib>Huestis, Marilyn A</creatorcontrib><creatorcontrib>Prenatal Alcohol in SIDS and Stillbirth (PASS) Network</creatorcontrib><creatorcontrib>for the Prenatal Alcohol in SIDS and Stillbirth (PASS) Network</creatorcontrib><title>Clinical sensitivity and specificity of meconium fatty acid ethyl ester, ethyl glucuronide, and ethyl sulfate for detecting maternal drinking during pregnancy</title><title>Clinical chemistry (Baltimore, Md.)</title><addtitle>Clin Chem</addtitle><description>We investigated agreement between self-reported prenatal alcohol exposure (PAE) and objective meconium alcohol markers to determine the optimal meconium marker and threshold for identifying PAE.
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 self-reported drinking at or beyond 19 weeks was our exposure variable.
Of 107 women, 33 reported no alcohol consumption in pregnancy, 16 stopped drinking by week 19, and 58 drank beyond 19 weeks (including 45 third-trimester 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 self-report 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).
Maternal alcohol consumption at ≥19 weeks was better represented by meconium EtG ≥30 ng/g than currently used FAEE cutoffs.</description><subject>Alcohol Drinking</subject><subject>Alcohol use</subject><subject>Alcohols</subject><subject>Behavior</subject><subject>Biomarkers</subject><subject>Biomarkers - blood</subject><subject>Chromatography, Liquid</subject><subject>Esters</subject><subject>Esters - chemistry</subject><subject>Ethanol</subject><subject>Fatty acids</subject><subject>Fatty Acids - blood</subject><subject>Fatty Acids - chemistry</subject><subject>Female</subject><subject>Fetal alcohol syndrome</subject><subject>Genealogy</subject><subject>Glucuronates - blood</subject><subject>Humans</subject><subject>Limit of Detection</subject><subject>Meconium - chemistry</subject><subject>Pregnancy</subject><subject>Sensitivity and Specificity</subject><subject>Sulfates</subject><subject>Sulfuric Acid Esters - blood</subject><subject>Tandem Mass Spectrometry</subject><subject>Womens health</subject><issn>0009-9147</issn><issn>1530-8561</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpdkUtLxDAUhYMoOj7-gUjAjQs7Jk3Sx1IGXyC40XVJk5sx2qZj0gjzZ_ytps7owtXlXL5zws1B6JSSOWUlu1KddeoV-nlOKJ_njJW02kEzKhjJKlHQXTQjhNRZTXl5gA5DeEuSl1Wxjw5yIWrBOZmhr0WKsUp2OIALdrSfdlxj6TQOK1DWWDXpweAe1OBs7LGR40QoqzGMr-sOQxjBX27Fsosq-kRquPyJ2axD7JIPsBk81jCCGq1b4j6tvEtva2_d-7TR0U9j5WHppFPrY7RnZBfgZDuP0MvtzfPiPnt8untYXD9milV0zCpVF4JpWgupS8p5q6vCVAAtrVtd1qzNQQkjRUmYEMRwqSWluZRE64K06cuO0MUmd-WHj5guanobFHSddDDE0NCiIISRXPCEnv9D34Y4XfFDUVHWXEyBfEMpP4TgwTQrb3vp1w0lzdRf89tfM_XXbPpLtrNteGx70H-m38LYN95qnEM</recordid><startdate>201503</startdate><enddate>201503</enddate><creator>Himes, Sarah K</creator><creator>Dukes, Kimberly A</creator><creator>Tripp, Tara</creator><creator>Petersen, Julie M</creator><creator>Raffo, Cheri</creator><creator>Burd, Larry</creator><creator>Odendaal, Hein</creator><creator>Elliott, Amy J</creator><creator>Hereld, Dale</creator><creator>Signore, Caroline</creator><creator>Willinger, Marian</creator><creator>Huestis, Marilyn A</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4U-</scope><scope>7QO</scope><scope>7RV</scope><scope>7TM</scope><scope>7U7</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>BKSAR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PCBAR</scope><scope>PDBOC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>RC3</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>201503</creationdate><title>Clinical sensitivity and specificity of meconium fatty acid ethyl ester, ethyl glucuronide, and ethyl sulfate for detecting maternal drinking during pregnancy</title><author>Himes, Sarah K ; Dukes, Kimberly A ; Tripp, Tara ; Petersen, Julie M ; Raffo, Cheri ; Burd, Larry ; Odendaal, Hein ; Elliott, Amy J ; Hereld, Dale ; Signore, Caroline ; Willinger, Marian ; Huestis, Marilyn A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c381t-8c9653d195ad7144bd86f8eeb19bd793b2ec5fa5703550f4ada112aa0dd60b153</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Alcohol Drinking</topic><topic>Alcohol use</topic><topic>Alcohols</topic><topic>Behavior</topic><topic>Biomarkers</topic><topic>Biomarkers - 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Academic</collection><jtitle>Clinical chemistry (Baltimore, Md.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Himes, Sarah K</au><au>Dukes, Kimberly A</au><au>Tripp, Tara</au><au>Petersen, Julie M</au><au>Raffo, Cheri</au><au>Burd, Larry</au><au>Odendaal, Hein</au><au>Elliott, Amy J</au><au>Hereld, Dale</au><au>Signore, Caroline</au><au>Willinger, Marian</au><au>Huestis, Marilyn A</au><aucorp>Prenatal Alcohol in SIDS and Stillbirth (PASS) Network</aucorp><aucorp>for the Prenatal Alcohol in SIDS and Stillbirth (PASS) Network</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical sensitivity and specificity of meconium fatty acid ethyl ester, ethyl glucuronide, and ethyl sulfate for detecting maternal drinking during pregnancy</atitle><jtitle>Clinical chemistry (Baltimore, Md.)</jtitle><addtitle>Clin Chem</addtitle><date>2015-03</date><risdate>2015</risdate><volume>61</volume><issue>3</issue><spage>523</spage><epage>532</epage><pages>523-532</pages><issn>0009-9147</issn><eissn>1530-8561</eissn><abstract>We investigated agreement between self-reported prenatal alcohol exposure (PAE) and objective meconium alcohol markers to determine the optimal meconium marker and threshold for identifying PAE.
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 self-reported drinking at or beyond 19 weeks was our exposure variable.
Of 107 women, 33 reported no alcohol consumption in pregnancy, 16 stopped drinking by week 19, and 58 drank beyond 19 weeks (including 45 third-trimester 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 self-report 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).
Maternal alcohol consumption at ≥19 weeks was better represented by meconium EtG ≥30 ng/g than currently used FAEE cutoffs.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>25595440</pmid><doi>10.1373/clinchem.2014.233718</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0009-9147 |
| ispartof | Clinical chemistry (Baltimore, Md.), 2015-03, Vol.61 (3), p.523-532 |
| issn | 0009-9147 1530-8561 |
| language | eng |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE |
| subjects | Alcohol Drinking Alcohol use Alcohols Behavior Biomarkers Biomarkers - blood Chromatography, Liquid Esters Esters - chemistry Ethanol Fatty acids Fatty Acids - blood Fatty Acids - chemistry Female Fetal alcohol syndrome Genealogy Glucuronates - blood Humans Limit of Detection Meconium - chemistry Pregnancy Sensitivity and Specificity Sulfates Sulfuric Acid Esters - blood Tandem Mass Spectrometry Womens health |
| title | Clinical sensitivity and specificity of meconium fatty acid ethyl ester, ethyl glucuronide, and ethyl sulfate for detecting maternal drinking during pregnancy |
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