Flavio Maria Ceci, Marco Fiore*, Enzo Agostinelli, Tomoaki Tahara, Antonio Greco, Massimo Ralli, Antonella Polimeni, Marco Lucarelli, Roberta Colletti, Antonio Angeloni, Paola Tirassa, Mauro Ceccanti, Marisa Patrizia Messina, Mario Vitali, Carla Petrella and Giampiero Ferraguti Pages 3125 - 3141 ( 17 )
Background: Ethyl glucuronide (EtG) is a metabolite of ethanol used as a marker of alcohol drinking and is identified in urine. Gestational alcohol drinking harms the fetus, so disclosing any form of use and abuse of this substance during pregnancy is crucial. Many discovery methods have been planned to overcome this question, including using screening questionnaires as the AUDIT-C, T-ACE/TACER-3, and TWEAK.
Aim: The aim and novelties of this study were to compare biochemical data from urinary EtG assays (cut-off 100 ng/mL for risking drinking behavior) with the outcome of questionnaires and of a food diary routinely used in our hospital; moreover, for the first time, we analyzed in pregnant women the EtG values normalized by the amount of creatinine excreted according to methods previously established.
Methods: Random urine samples were collected from 309 pregnant women immediately after being interviewed. EtG was quantified using an enzyme immunoassay, and urinary creatinine was assessed using an enzymatic colorimetric method. Women who had not exhaustively answered one of the questionnaires or refused to provide urine samples were excluded. Finally, 309 women were considered for this study. Urine creatinine measurements were performed to determine if urine dilution might have resulted in false negatives in the challenge study. In order to accomplish this objective, as urinary creatinine concentrations are, on average, approximately 1 mg/mL, we used a normalized value of 100 ng EtG/mg Creatinine.
Results: Our data show that 20.4% of the pregnant women in the study were over the established normalized cut-off value. Poor to null concordance (unweighted k < 0.2) was found between EtG data and the screening interviews showed, on average, lower levels of alcohol consumption.
Conclusion: This study provides evidence that the assessment of maternal alcohol consumption during pregnancy, only indirectly estimated with questionnaires and food diary, can produce misleading results.
Fetal alcohol spectrum disorders, gestation, ethanol, woman, prenatal, mental retardation.
Department of Experimental Medicine, Sapienza University of Rome, Institute of Biochemistry and Cell Biology (IBBC-CNR), Rome, Department of Sensory Organs, Medical Faculty, Sapienza University of Rome, Rome, Department of Sensory Organs, Medical Faculty, Sapienza University of Rome, Rome, Department of Sensory Organs, Medical Faculty, Sapienza University of Rome, Rome, Department of Odontostomatological and Maxillofacial Sciences, Sapienza University of Rome, Department of Experimental Medicine, Sapienza University of Rome, Department of Experimental Medicine, Sapienza University of Rome, Department of Experimental Medicine, Sapienza University of Rome, Department of Sensory Organs, Medical Faculty, Sapienza University of Rome, Rome, Institute of Biochemistry and Cell Biology (IBBC-CNR), Rome, Sitac, Societa’ Italiana per lo Studio delle Patologie Alcool Derivate. Rome, Italy; Sapienza University of Rome, Department of Obstetrics and Gynecology, Sapienza University Hospital of Rome, ASUR Marche, AV4, Ancona, Institute of Biochemistry and Cell Biology (IBBC-CNR), Rome, Department of Experimental Medicine, Sapienza University of Rome