Moore Christine, Jones Joseph, Lewis Douglas, Buchi Karen
US Drug Testing Laboratories, 1700 S. Mount Prospect Rd., Des Plaines, IL 60018, USA.
Clin Chem. 2003 Jan;49(1):133-6. doi: 10.1373/49.1.133.
Fetal alcohol syndrome (FAS), alcohol-related birth defects (ARBDs), and alcohol-related neurodevelopment disorders (ARNDs) in neonates are often the result of maternal alcohol consumption during pregnancy. Facial characteristics are associated with FAS, but ARBDs and ARNDs are more difficult to diagnose. Fetal exposure to alcohol can cause central nervous system dysfunction, pre- and postnatal growth problems, cardiac defects in neonates, and attention deficit disorders and mental retardation in older children. To date, diagnosis of fetal alcohol effect has depended largely on maternal interview, although clinical tests are becoming more widely used. Fatty acid ethyl esters (FAEEs) are formed in the body by esterification of ethanol with free fatty acids and trans-esterification of glycerides and have been detected in the meconium of newborns. This report estimates the prevalence of fetal alcohol exposure in two populations by detecting FAEEs in meconium.
We analyzed the prevalence of FAEEs in the meconium of two separate groups of neonates by use of solid-phase extraction and analysis by gas chromatography-mass spectrometry in the chemical ionization mode. In the first study, meconium samples were taken anonymously from babies born in a large, regional perinatal center in Hawaii. In the second study, specimens were obtained from infants admitted to six different newborn intensive care units within the state of Utah.
In the first study, 73 of 436 (16.7%) meconium specimens tested were considered positive for FAEEs. When broken down into quartiles, the mean total FAEEs measured were 1,059, 3,133, 6,628, and 62,115 ng/g. In the second study, 35 of 289 (12.1%) specimens were considered positive. When broken into quartiles, the mean total FAEEs were 1,139, 3,067, 7,674, and 50,143 ng/g. The overall FAEE profiles of the two study sets were remarkably similar.
In an adequate meconium specimen, a total FAEE concentration >10,000 ng/g may indicate that the newborn has been exposed to significant amounts of alcohol during pregnancy.
胎儿酒精综合征（FAS）、酒精相关出生缺陷（ARBDs）以及新生儿酒精相关神经发育障碍（ARNDs）通常是孕期母亲饮酒所致。面部特征与FAS相关，但ARBDs和ARNDs更难诊断。胎儿暴露于酒精可导致中枢神经系统功能障碍、产前和产后生长问题、新生儿心脏缺陷以及大龄儿童的注意力缺陷障碍和智力发育迟缓。迄今为止，胎儿酒精影响的诊断很大程度上依赖于对母亲的访谈，尽管临床检测的应用越来越广泛。脂肪酸乙酯（FAEEs）是乙醇与游离脂肪酸酯化以及甘油酯转酯化在体内形成的，已在新生儿胎粪中检测到。本报告通过检测胎粪中的FAEEs来估计两个人群中胎儿酒精暴露的患病率。
我们采用固相萃取法，并以化学电离模式通过气相色谱 - 质谱联用仪进行分析，来分析两组不同新生儿胎粪中FAEEs的患病率。在第一项研究中，从夏威夷一个大型地区围产期中心出生的婴儿中匿名采集胎粪样本。在第二项研究中，样本取自犹他州六家不同新生儿重症监护病房收治的婴儿。
在第一项研究中，436份检测的胎粪标本中有73份（16.7%）被认为FAEEs呈阳性。按四分位数划分，测得的平均总FAEEs分别为1059、3133、6628和62115 ng/g。在第二项研究中，289份标本中有35份（12.1%）被认为呈阳性。按四分位数划分，平均总FAEEs分别为1139、3067、7674和50143 ng/g。两组研究的总体FAEE谱非常相似。
在一份足够的胎粪标本中，总FAEE浓度 >10000 ng/g可能表明新生儿在孕期接触了大量酒精。
