Español (Spanish)
Identifying
Alcohol-Exposed Pregnancies through Biomarkers
Moderate-to-heavy alcohol use by pregnant women is known to be harmful
to the developing fetus. Currently, there is no specific laboratory
marker to indicate fetal alcohol syndrome. Obtaining such a marker could
lead to the identification and treatment of women at risk for an
alcohol-exposed pregnancy, who may not otherwise provide this
information because of the stigma associated with prenatal alcohol use.
Also, research has shown that early identification of children with
fetal alcohol exposure reduces secondary disabilities resulting from the
condition. Possible biomarkers include maternal blood and meconium
(first stool of the newborn infant) testing. The studies described below
are designed to devise and test sensitive and specific biomarkers to
help identify alcohol-exposed pregnancies and/or newborns exposed to
alcohol prenatally.
Funded Projects:
University Hospital of Cleveland—Cleveland, Ohio
It is estimated that 1% of all newborns are affected by prenatal alcohol
exposure. However, identifying alcohol-exposed newborns is difficult.
Currently, there is no systematic approach, nor definitive laboratory
tool that can be used for such identification. A biological marker,
fatty acid ethyl esters (FAEE), would allow earlier identification and
intervention for affected infants, and recognition of women at risk for
alcohol abuse. This also facilitates research on dose-response
relationships between alcohol exposure and alcohol-related birth
defects. The project proposes that FAEE in meconium is a useful
biological marker for exposure of low-to-moderate maternal alcohol use
during pregnancy, and for identification of a group of infants at high
risk for poor neurodevelopmental outcomes. The study seeks to validate
FAEE in meconium as a biomarker of prenatal exposure to alcohol.
University of Maryland—Baltimore, Maryland
The purpose of this study is to investigate the use of biochemical tests
and ultrasound findings to identify women who abuse alcohol and are at
risk for having a child affected adversely by prenatal alcohol exposure.
Criteria, derived from alcohol-use questionnaires, biochemical markers
and ultrasound studies, are being developed to identify at-risk,
pregnant women who need special counseling or intervention. This
information will be correlated with infant development indices taken at
birth and at 6 and 12 months of age to predict the prenatal risk for
fetal alcohol syndrome (FAS) and other prenatal alcohol-related
conditions. Eliminating or reducing alcohol consumption during pregnancy
would have a significant effect on the incidence of fetal alcohol
syndrome and other prenatal alcohol-related conditions.
Massachusetts General Hospital—Boston,
Massachusetts
The goals of this project are to: (1) identify women at risk for having an
alcohol-exposed pregnancy through a combination of questionnaire
screening and biochemical markers of alcohol use, and (2) motivate the
women at risk to decrease their alcohol intake through brief
intervention meetings and results of their blood marker levels
throughout their pregnancies. Previous studies show that certain blood
markers can be used to identify alcohol-using pregnant women more
accurately than women’s self-reported use. This study will use a
combination of blood markers and self-report to identify women at risk
of having an alcohol-exposed pregnancy. Pregnant women receiving
prenatal care at obstetric clinics at several sites in the Boston area
receive a questionnaire to determine if they are risk drinkers. The
women who are not identified as risk drinkers on the questionnaire serve
as the comparison group for the study. Women who are identified as risk
drinkers are asked to provide a blood sample, and a series of blood
markers of alcohol use are assessed. Women with positive blood markers
are then asked to participate in a series of brief interventions and
agree to ongoing monitoring of and feedback on the blood markers
throughout their pregnancy. Infant outcomes will be assessed on all
women participating in the study and the role of specific markers on the
achievement of alcohol abstinence or reduction will also be explored.
Related Publications:
Bearer CF, Santiago LM, O’Riordan MA, Buck K,
Lee S, Singer LT. Fatty acid ethyl esters: Quantitative biomarkers for
maternal alcohol consumption. J Pediatr. 2005;146:824-830. [Abstract]
Bearer CF, Stoler JM, Cook JD, Carpenter SJ. Biomarkers of alcohol use
in pregnancy. Alcohol Research & Health 2005;1:38-43. [Full
text]
Lanphear B, Bearer CF. Biomarkers in paediatric research and practice.
Archives of Disease in Childhood 2005;90:594-600. [Abstract]
Cook JD, O’Kane JL, McArdle P, Yu Y, Owusu R, Squibb KS, Powell JL. The
maternal ADH genetic profile as a risk indicator for FAS and FASD.
Clin Chem 2004;50:A67.
Moya J, Bearer CF, Etzel R. Children’s behavior and physiology and how
it affects exposure to environmental contaminants. Pediatrics
2004;113(4 Suppl):996-1006. [Abstract]
Stoler JM, Holmes LB. Recognition of facial features of fetal alcohol
syndrome in the newborn. American Journal of Medical Genetics Part C
(Semin. Med. Genet.) 2004;127C:21-27. [Abstract]
Bearer CF. Meconium as a biological marker of prenatal exposure.
Ambulatory Pediatrics 2003;3:40-43. [Abstract]Bearer CF, Jacobson JL, Jacobson SW, Barr D, Croxford J, Molteno CD,
Viljoen DL, Marais AS, Chiodo LM, Cwik AS. Validation of a new biomarker
of fetal exposure to alcohol. J Pediatr 2003;143(4):463-469. [Abstract]
Cook JD. Biochemical markers
of alcohol use in pregnant women. Clin Biochem 2003;36:9-19. [Abstract]
[Return
to Top]
|