Retrospective assessment of prenatal alcohol exposure by detection of phosphatidylethanol in stored dried blood spot cards: An objective method for determining prevalence rates of alcohol consumption during pregnancy

Abstract

Baldwin, A., Jones, J., Jones, M., Plate, C., & Lewis, D. (2015). Retrospective assessment of prenatal alcohol exposure by detection of phosphatidylethanol in stored dried blood spot cards: An objective method for determining prevalence rates of alcohol consumption during pregnancy. The International Journal Of Alcohol And Drug Research, 4(2), 131-137. doi:http://dx.doi.org/10.7895/ijadr.v4i2.209Aims: To analyze the efficacy of screening banked newborn dried blood spots (DBS) for detection of phosphatidylethanol(PEth), a direct alcohol biomarker, with the purpose of performing a retrospective assessment of statewide prevalence rates ofalcohol consumption in late pregnancy that results in risky prenatal alcohol exposure.Design: Residual DBS samples collected for newborn screening and stored by a state department of public health wereexamined for concentrations of PEth. The prevalence of prenatal alcohol exposure, as determined by this direct alcoholbiomarker, was compared to prevalence rates of alcohol consumption during pregnancy that have been derived from multiplestate-based and national studies using maternal self-report surveys.Setting: DBS cards representative of the general newborn population were collected from multiple hospitals across a singlemidwestern state.Participants: Two hundred fifty anonymous newborn DBS collected for routine metabolic screening in a midwestern state wererequested through the Virtual Repository of Dried Blood Spots.Measures: Concentrations of PEth, a highly specific biomarker of alcohol consumption, were analyzed using a liquidchromatography–tandem mass spectrometry method validated by our laboratory.Findings: Of 2 50 D BS e xamined, 4 % w ere p ositive f or PEth ( PEth ≥ 8 n g/ml) which is indicative of exposure to maternalalcohol consumption during the last month of pregnancy.Conclusions: Detection of PEth from newborn DBS cards can identify prenatal alcohol exposure and also be used forretrospective surveillance of alcohol consumption during the last three to four weeks of pregnancy, using specimens that arecollected for routine metabolic screening and stored by many state health departments.