morphine and Alcohol-Related-Disorders

Despite extensive evidence of fetal and neonatal risk, a large number of pregnant women are involved in excessive alcohol and drug abuse, such as with cocaine, methamphetamine, opioids, and cannabinoids.

Topics: Adolescent; Adult; Alcohol-Related Disorders; Amphetamine-Related Disorders; Biomarkers; Cannabinoids; Child Welfare; Child, Preschool; Cocaine-Related Disorders; Esters; Fatty Acids; Female; Hair; Humans; Infant; Infant, Newborn; Meconium; Pregnancy; Pregnancy Complications; Prenatal Exposure Delayed Effects; Substance Abuse Detection; Substance-Related Disorders

To develop a laboratory marker to identify newborns exposed to alcohol.. Meconium was collected from 30 infants from Jordan who were unexposed and from 248 Cleveland study infants of varying exposure status. Retrospective maternal alcohol histories were obtained. Fatty acid ethyl esters (FAEEs) were quantified with gas chromatography/flame ionization and compared between abstainers and non-abstainers to identify FAEEs of interest. The area under the receiver operating characteristic curve, sensitivity, specificity, and positive and negative predictive values were calculated by using definitions of drinking obtained from a graphical representation.. Six of 7 FAEEs were significantly different between the non-abstainers and at least 1 of 2 of the abstaining groups. FAEEs best predicted drinks per drinking day, and ethyl linoleate had the greatest area under the curve (76%), with a sensitivity rate of 88%, a specificity rate of 64%, a positive predictive value of 9%, and a negative predictive value of 99%. No combination of FAEEs was better than a single ester for identifying drinkers.. Ethyl linoleate in meconium is a useful biological marker for identifying infants not exposed in utero to high levels of alcohol in a high-risk, substance-abusing, clinic-based sample.

Topics: Alcohol Drinking; Alcohol-Related Disorders; Area Under Curve; Biomarkers; Chromatography, Gas; Fatty Acids; Female; Humans; Infant; Infant, Newborn; Jordan; Meconium; Ohio; Predictive Value of Tests; Pregnancy; Retrospective Studies; ROC Curve; Sensitivity and Specificity; Substance Abuse Detection

The detection of fatty acid ethyl esters (FAEE) in neonatal meconium has been proposed as a novel screening method for intrauterine exposure to alcohol. We investigated the potential use of meconium FAEE screening in a high-risk neonatal population in the absence of maternal drinking history. One hundred forty-two meconium samples of neonates suspected of intrauterine illicit substance exposure and referred to the Motherisk Laboratory were analyzed for the existence of drugs by enzyme-linked immunosorbent assay (ELISA) and FAEE by gas chromatography-flame ionization detection (GC-FID). A positive FAEE test was previously defined as a cumulative measurement of 7 individual FAEE > or = 2 nmol/g. Seventy-one percent of the samples tested positive for at least 1 illicit drug, with cannabis being the most prevalent (52.3%). Fourteen percent of all samples tested positive for prenatal alcohol exposure, as evidenced by cumulative meconium FAEE > or = 2 nmol/g. Ethyl oleate, linoleate, palmitate, and arachidonate were detected most often and at the highest levels. At least 3 individual FAEE were detected in 95% of all positive samples, and none could be identified by the use of 1 selected FAEE. Significantly elevated levels of FAEE above the baseline and the presence of multiple FAEE species in meconium are exclusive to neonates who have likely been exposed to excessive amounts of alcohol in utero. Babies born to mothers who are suspected to use illicit drugs in pregnancy are at elevated risk for exposure also to alcohol in utero. Meconium FAEE are emerging biologic markers that can potentially facilitate earlier diagnosis and intervention for less apparent forms of alcohol-related disabilities that cannot be confirmed in the absence of maternal drinking history.

Topics: Alcohol Drinking; Alcohol-Related Disorders; Biomarkers; Enzyme-Linked Immunosorbent Assay; Fatty Acids; Female; Fetal Alcohol Spectrum Disorders; Humans; Infant, Newborn; Meconium; Medical History Taking; Pregnancy; Pregnancy Complications; Substance Abuse Detection