Title:Urinary Ethyl Glucuronide for the Assessment of Alcohol Consumption
During Pregnancy: Comparison between Biochemical Data and
Screening Questionnaires
Volume: 29
Issue: 17
Author(s): 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
Affiliation:
- Institute of Biochemistry and
Cell Biology (IBBC-CNR), Rome, Italy
Keywords:
Fetal alcohol spectrum disorders, gestation, ethanol, woman, prenatal, mental retardation.
Abstract:
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.
