使用生物标志物估计萨克森-安哈尔特州（德国东北部）孕妇和非孕妇有害饮酒的患病率。

Estimated Prevalence of Harmful Alcohol Consumption in Pregnant and Nonpregnant Women in Saxony-Anhalt (NorthEast Germany) Using Biomarkers.

作者信息

Adler Jakob, Rissmann Anke, Kropf Siegfried, Mohnicke Klaus, Taneva Elina, Ansorge Thomas, Zenker Martin, Wex Thomas

机构信息

Medical Laboratory for Clinical Chemistry, Microbiology, Infectious Diseases and Genetics "Prof. Schenk/Dr. Ansorge & Colleagues, Magdeburg, Germany.

Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.

出版信息

Alcohol Clin Exp Res. 2021 Apr;45(4):819-827. doi: 10.1111/acer.14567. Epub 2021 Mar 21.

DOI:10.1111/acer.14567

PMID:33547677

Abstract

BACKGROUND

Alcohol consumption is commonly accepted in Western societies and is a known risk factor in pregnancy, which could lead to fetal alcohol spectrum disorders (FASDs). Prevalence of alcohol consumption during pregnancy is mostly unknown. Prevalence estimates in publications based on questionnaires are limited by possible underreporting due to social stigmatization. The aim of this study was to estimate the prevalence of harmful alcohol consumption in a large cohort of pregnant women using different biomarkers related to alcohol consumption and compare the findings with those of non-pregnant women METHODS: Routine parameters known to be influenced by alcohol consumption (γ-glutamyltransferase, GGT; carbohydrate-deficient transferrin, CDT/%CDT; mean corpuscular/cell volume, MCV; combined parameter of GGT and %CDT, GGT-CDT) were analyzed in serum samples of 2,182 pregnant women and 743 non-pregnant, age-matched females. Data were tested for (i) differences between pregnant and non-pregnant women and (ii) changes across the 3 trimesters of pregnancy.

RESULTS

Prevalence rates differ greatly according to the parameter and cutoff, which reflects the limitations of assessing alcohol consumption with biomarkers. The prevalence of harmful alcohol consumption on the basis of a single or several elevated parameters was 13.8% (95% CI: 12.4 to 15.2) in pregnant women and 18.6% (95% CI: 15.8 to 21.4) in non-pregnant women, though 85.0% of the elevated measurements were attributable to an isolated elevation in %CDT only. Using GGT-CDT as the parameter with the highest specificity according to the literature, the estimated prevalence of harmful alcohol consumption in pregnancy is 0.5% (95% CI: 0.2 to 0.7).

CONCLUSION

Estimated prevalence rates differ greatly with respect to the biomarkers and cutoffs used. The use of CDT/%CDT alone appears to overestimate harmful alcohol consumption during pregnancy.

摘要

背景

在西方社会，饮酒是普遍被接受的行为，且已知是孕期的一个风险因素，可能导致胎儿酒精谱系障碍（FASD）。孕期饮酒的患病率大多未知。基于问卷调查的出版物中的患病率估计受到社会污名化导致的可能漏报的限制。本研究的目的是使用与饮酒相关的不同生物标志物估计一大群孕妇中有害饮酒的患病率，并将结果与非孕妇进行比较。方法：在2182名孕妇和743名年龄匹配的非孕妇的血清样本中分析已知受饮酒影响的常规参数（γ-谷氨酰转移酶，GGT；缺糖转铁蛋白，CDT/%CDT；平均红细胞/细胞体积，MCV；GGT和%CDT的联合参数，GGT-CDT）。对数据进行了以下测试：（i）孕妇和非孕妇之间的差异；（ii）孕期三个阶段的变化。

结果

患病率根据参数和临界值的不同有很大差异，这反映了用生物标志物评估饮酒的局限性。基于一个或多个升高参数的有害饮酒患病率在孕妇中为13.8%（95%置信区间：12.4至15.2），在非孕妇中为18.6%（95%置信区间：15.8至21.4），尽管85.0%的升高测量值仅归因于%CDT的单独升高。根据文献，使用特异性最高的参数GGT-CDT时，孕期有害饮酒的估计患病率为0.5%（95%置信区间：0.2至0.7）。