Bager Heidi, Christensen Lars Porskjaer, Husby Steffen, Bjerregaard Lene
Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense C, Denmark.
Department of Chemical Engineering, Biotechnology and Environmental Technology, University of Southern Denmark, Odense M, Denmark.
Alcohol Clin Exp Res. 2017 Feb;41(2):251-261. doi: 10.1111/acer.13309. Epub 2017 Jan 18.
Alcohol exposure during pregnancy can cause adverse effects to the fetus, because it interferes with fetal development, leading to later physical and mental impairment. The most common clinical tool to determine fetal alcohol exposure is maternal self-reporting. However, a more objective and useful method is based on the use of biomarkers in biological specimens alone or in combination with maternal self-reporting. This review reports on clinically relevant biomarkers for detection of prenatal alcohol exposure (PAE). A systematic search was performed to ensure a proper overview in existing literature. Studies were selected to give an overview on clinically relevant neonatal and maternal biomarkers. The direct biomarkers fatty acid ethyl esters (FAEEs), ethyl glucuronide (EtG), ethyl sulfate, and phosphatidylethanol (PEth) were found to be the most appropriate biomarkers in relation to detection of PAE. To review each biomarker in a clinical context, we have compared the advantages and disadvantages of each biomarker, in relation to its window of detectability, ease of collection, and the ease and cost of analysis of each biomarker. The biomarkers PEth, FAEEs, and EtG were found to be applicable for detection of even low levels of alcohol exposure. Meconium is an accessible matrix for determination of FAEEs and EtG, and blood an accessible matrix for determination of PEth.
孕期饮酒会对胎儿造成不良影响，因为它会干扰胎儿发育，导致日后出现身心损伤。确定胎儿酒精暴露情况最常用的临床工具是孕妇自我报告。然而，一种更客观、更有用的方法是仅基于生物样本中的生物标志物或结合孕妇自我报告来使用。本综述报告了用于检测产前酒精暴露（PAE）的临床相关生物标志物。进行了系统检索以确保对现有文献有恰当的概述。选择研究以概述临床相关的新生儿和孕妇生物标志物。发现直接生物标志物脂肪酸乙酯（FAEEs）、葡萄糖醛酸乙酯（EtG）、硫酸乙酯和磷脂酰乙醇（PEth）是与检测PAE相关的最合适生物标志物。为了在临床背景下审视每种生物标志物，我们比较了每种生物标志物在可检测窗口、采集便利性以及每种生物标志物分析的难易程度和成本方面的优缺点。发现生物标志物PEth、FAEEs和EtG甚至适用于检测低水平的酒精暴露。胎粪是用于测定FAEEs和EtG的可获取基质，血液是用于测定PEth的可获取基质。
