G194 Identifying the pattern and prevalence of alcohol consumption in pregnancy. (May 2019) - Henderson, E
Abstract : Aims: Alcohol consumption in pregnancy has adverse consequences for the developing fetus, but is typically under-reported. Measuring alcohol metabolites in infant meconium has potential to identify prenatal alcohol exposure; local pilot data indicated an incidence of significant alcohol consumption in pregnancy of 15%. We sought to confirm this finding and, with a much larger sample, to identify demographic factors associated with alcohol consumption in pregnancy. Methods: Mothers of singleton infants delivering during every 4th 24 hour period were invited to provide a sample of their baby's meconium for analysis of fatty acid ethyl esters (FAEEs) and ethyl glucuronide (EtG), and to undergo confidential interview by a single investigator. Meconium samples were frozen at −20 o C and transported to Italy for analysis. All mothers provided written informed consent. Results: 1013 eligible mothers were identified over 71 collection days, of whom 905 were approached for consent. 843 mothers agreed to participant (93.1%; 79.5% of all eligible mothers). 741 samples of meconium were collected; 730 (98.5%) were suitable for analysis. FAEEs were detectable in all meconium samples, and the concentration was >600 ng/L in 39.5%. EtG was detected in 300 (41%) samples; concentration was >30 ng/L in 14.5%. 114 (13.5%) mothers admitted to consuming alcohol at any point after 20 weeks' gestation, of whom only 8 declared >3 units on any one occasion. Maternal smoking was predictive of lower FAEE concentration (samples<600 ng/L, 28.4% smokers; samples>600 ng/L, 22.2% smokers (p=0.056)); the same relationship was observed for EtG (samples<30 ng/L, 27.5% smokers;>30 ng/L, 17.9% smokers (p=0.021)). Non-smoking mothers were more likely to provide meconium samples. Conclusions: Analysis of infant meconium is a feasible way to study alcohol consumption in pregnancy. Confidential, standardised postnatal interview underestimates the amount, but not the prevalence of alcohol consumption from mid-gestation.