Characterization of phosphatidylethanol blood concentrations for screening alcohol consumption in early pregnancy

Kwak, Ho-Seok; Han, Ji Yoon; Choi, June-Seek; Ahn, Hyun Kyong; Ryu, Hyun-Mee; Chung, Hee-Jung; Cho, Dong-Hee; Shin, Chan-Young; Velázquez-Armenta, E. Yadira; Nava-Ocampo, Alejandro A

doi:10.3109/15563650.2013.859263

Cited by 25 publications

(35 citation statements)

References 20 publications

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“…Likelihood ratios suggested that the accuracy of PEth testing improved as PAE increased from low to moderate to heavy. However, findings of high levels of sensitivity (100%) and specificity (96%) in 1 study of heavy PAE 78 were not supported by 2 other studies in which sensitivity was 18% to 22%. 72,82 Hair Testing…”

Section: Blood Testingmentioning

confidence: 81%

“…Studies included data on participants from the United States (5), 72,74,79,81,82 Korea (2), 77,78 Spain (1), 83 South Africa (1), 73 and Finland (1), 80 and combined data from the United States and Jordan (1) 75 and Canada and Israel (1). 76 Diagnostic accuracy data were available for 8 types of biomarker: carbohydrate deficient transferrin (CDT), 72,80,82 ethyl sulfate (EtS), 72,82 ethyl glucuronide (EtG), 72,82,83 fatty acid ethyl esters (FAEEs), 72 -77, 79, 81 γ glutamyltransferase (GGT), 72,80,82 hemoglobin acetaldehyde adducts (Hb-Ach), 80 mean corpuscular volume (MCV), 80 and phosphatidylethanol (PEth) 72,78,82 within 6 matrices: meconium, 72 -77, 79 placenta, 81 maternal urine, 72,82 maternal blood, 72,78,80,82 maternal hair, 82,83 and infant blood.…”

Section: Figurementioning

confidence: 99%

“…76 Diagnostic accuracy data were available for 8 types of biomarker: carbohydrate deficient transferrin (CDT), 72,80,82 ethyl sulfate (EtS), 72,82 ethyl glucuronide (EtG), 72,82,83 fatty acid ethyl esters (FAEEs), 72 -77, 79, 81 γ glutamyltransferase (GGT), 72,80,82 hemoglobin acetaldehyde adducts (Hb-Ach), 80 mean corpuscular volume (MCV), 80 and phosphatidylethanol (PEth) 72,78,82 within 6 matrices: meconium, 72 -77, 79 placenta, 81 maternal urine, 72,82 maternal blood, 72,78,80,82 maternal hair, 82,83 and infant blood. 72 Eight studies investigated tests of moderate to heavy prenatal alcohol consumption, 72,73,75,76,78,[80][81][82] and 9 recruited women from high-risk settings, such as substance misuse clinics. 72 -76, 79 -82 Eight of the eligible studies recruited pregnant women who reported abstinence from alcohol as a comparison group.…”

Section: Figurementioning

confidence: 99%

“…72, 74 -79, 82 Two of these studies included an additional control group of pregnant women from cultures that promote abstinence from alcohol. 75,76 Three of the studies explored test performance for distinguishing between heavy drinkers and women with lower levels of prenatal alcohol consumption, 73,78,80,81 and 1 study did not report characteristics of the control group. 83 …”

Section: Figurementioning

confidence: 99%

“…Four studies investigated CDT, GGT, Hb-Ach, MCV, and PEth 72,78,80,82 within prenatal samples of maternal blood. Blood biomarkers generally demonstrated low sensitivity, although specificity was high (Table 4).…”

Section: Blood Testingmentioning

confidence: 99%

See 4 more Smart Citations

Objective Measures of Prenatal Alcohol Exposure: A Systematic Review

McQuire¹,

Paranjothy²,

Hurt³

et al. 2016

Pediatrics

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CONTEXT: Objective measurement of prenatal alcohol exposure (PAE) is essential for identifying children at risk for adverse outcomes, including fetal alcohol spectrum disorders. Biomarkers have been advocated for use in universal screening programs, but their validity has not been comprehensively evaluated. OBJECTIVE:To systematically review the validity of objective measures of PAE. DATA SOURCES:Thirteen electronic databases and supplementary sources were searched for studies published between January 1990 and October 2015.STUDY SELECTION: Eligible studies were those that evaluated the diagnostic accuracy of objective measures of PAE.DATA EXTRACTION: Three reviewers independently verified study inclusion, quality assessments, and extracted data. RESULTS:Twelve studies met inclusion criteria. Test performance varied widely across studies of maternal blood (4 studies; sensitivity 0%-100%, specificity 79%-100%), maternal hair (2 studies; sensitivity 19%-87%, specificity 56%-86%) maternal urine (2 studies; sensitivity 5%-15%, specificity 97%-100%), and biomarker test batteries (3 studies; sensitivity 22%-50%, specificity 56%-97%). Tests of the total concentration of 4 fatty acid ethyl esters (in meconium: 2 studies; in placenta: 1 study) demonstrated high sensitivity (82%-100%); however, specificity was variable (13%-98%).LIMITATIONS: Risk of bias was high due to self-report reference standards and selective outcome reporting.CONCLUSIONS: Current evidence is insufficient to support the use of objective measures of prenatal alcohol exposure in practice. Biomarkers in meconium and placenta tissue may be the most promising candidates for further large-scale population-based research. a Division of Population Medicine and b Specialist Unit for Review Evidence, Cardiff University, Cardiff, United KingdomMs McQuire developed the draft protocol and search strategy, data extraction sheet, and quality coding criteria; carried out study selection, data extraction, quality assessment, and evidence synthesis; and prepared the initial manuscript and subsequent revisions; Dr Paranjothy developed the initial concept for the study, contributed to development of the protocol, extracted data, verifi ed study inclusion decisions and quality assessments, and reviewed and revised the manuscript; Dr Hurt contributed to development of the protocol, extracted data, verifi ed study inclusion decisions and quality assessments, and reviewed and revised the manuscript; Ms Mann contributed to the design of the search strategy and reviewed and revised the manuscript; Dr Farewell provided statistical advice and reviewed and revised the manuscript; Dr Kemp contributed to development of the protocol and reviewed and revised the manuscript; and all authors approved the fi nal manuscript as submitted.This review has been registered at the PROSPERO international prospective register of systematic reviews (www. crd. york. ac. uk) (identifi er CRD42014015420).

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Section: Blood Testingmentioning

confidence: 81%