Baña A, Tabernero M J, Pérez-Muñuzuri A, López-Suárez O, Dosil S, Cabarcos P, Bermejo A, Fraga J M, Couce M L
Servicio de Neonatología, Departamento de Pediatria, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain.
Departamento de Medicina Legal, Facultad de Medicina, Universidad de Santiago, Santiago de Compostela, Spain.
J Neonatal Perinatal Med. 2014;7(1):47-54. doi: 10.3233/NPM-1471413.
Alcohol consumption during pregnancy, even when moderate, implies a risk of impaired neurodevelopment, physical impairments and malformations. Its early identification is essential for establishing preventive measures to diminish disabilities among newborns.
To determine the frequency of consumption of substance use in pregnant women, we have used the techniques of gas chromatography/mass spectrometry and liquid chromatography/tandem mass spectrometry to detect drugs and markers of chronic consumption of alcohol in meconium. We performed a prospective study during a period of 10 months among 110 infants in our hospital, assessing anthropometry, neuromuscular development and determination of toxic substances in urine and meconium. Furthermore, meconium analysis identified fatty acid ethyl esters (FAEEs) and ethyl glucuronide (Etg). We also conducted a survey regarding the obstetric history, toxic habits, and employment status of the mothers.
According to early detection markers analyzed in meconium (FAEE >1000 ng/g and/or Etg >50 ng/g meconium), 34.65% of pregnant women consumed alcohol during pregnancy, and 17% were positive for both markers. Within the positive cases, 50% of those exceeding a FAEE's value of 5000 ng/g in meconium had low birth-weight children. Only 5/110 mothers (4.5%) admitted to occasional alcohol consumption during pregnancy. Nobody admitted to frequent intake. The cocaine test was positive in three cases; two of them were positive for alcohol as well.
As expected, many screening devices do not accurately capture use during pregnancy and supplemental methods such as meconium analysis of biomarkers of chronic alcohol consumption may be warranted.
孕期饮酒，即便适量，也意味着存在神经发育受损、身体缺陷和畸形的风险。早期识别对于制定预防措施以减少新生儿残疾至关重要。
为确定孕妇物质使用的频率，我们运用气相色谱/质谱联用技术和液相色谱/串联质谱联用技术检测胎粪中的药物及慢性酒精摄入标志物。我们在本院对110名婴儿进行了为期10个月的前瞻性研究，评估人体测量学指标、神经肌肉发育情况，并测定尿液和胎粪中的有毒物质。此外，胎粪分析确定了脂肪酸乙酯（FAEEs）和葡萄糖醛酸乙酯（Etg）。我们还就母亲的产科病史、有毒习惯和就业状况进行了一项调查。
根据胎粪中分析的早期检测标志物（FAEE>1000 ng/g和/或Etg>50 ng/g胎粪），34.65%的孕妇在孕期饮酒，17%的孕妇两种标志物均呈阳性。在阳性病例中，胎粪中FAEE值超过5000 ng/g的孕妇中有50%的新生儿出生体重低。只有5/110名母亲（4.5%）承认在孕期偶尔饮酒。无人承认频繁饮酒。可卡因检测有3例呈阳性；其中2例酒精检测也呈阳性。
正如预期的那样，许多筛查手段无法准确捕捉孕期的物质使用情况，可能需要采用补充方法，如对慢性酒精摄入生物标志物进行胎粪分析。
