Estimation of Prenatal Alcohol Exposure: Comparison of Retrospective Survey and Measurement of Fatty Acid Ethyl Esters, Ethyl Sulfate and Ethyl Glucuronide Concentrations in Neonatal Meconium

Determining the concentration of fatty acid ethyl esters (FAEEs), ethyl sulfate (EtS), and ethyl glucuronide (EtG) is crucial for establishing the actual scale of prenatal alcohol ex-posure (PAE) and the early diagnosis of Fetal Alcohol Spectrum Disorders (FASD). The study’s main objective was to compare two methods of detecting PAE: retrospective sur-veys of maternal alcohol consumption and chromatographic analysis of newborn meco-nium for these alcohol biomarkers. The study involved 478 mothers from the Pomeranian Province, with parallel samples of newborn meconium collected for analysis. Biomarker analysis involved determining the concentration of 9 FAEEs by Gas Chromatography–Mass Spectrometry (GC-MS) and EtG and EtS by Liquid Chromatography–Tandem Mass Spectrometry (LC-MS/MS). The study also aimed to determine the cut-off concentrations and usefulness of these PAE markers. Only approximately 4% of mothers reported drink-ing alcohol during pregnancy, suggesting a significant underestimation of the actual PAE scale compared to objective biomarker analysis. The use of the cumulative biomarker in-dex (CBI2) ≥ 5 suggests that alcohol consumption during pregnancy affected approximate-ly 3% of the studied population, highlighting the low reliability of maternal self-declarations. The most reliable information about PAE was provided by a combination of EtG and EtS biomarkers. The study confirms the difficulty in obtaining a reliable history of alcohol exposure during pregnancy.