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Phosphatidylethanol as Blood Biomarker of Alcohol Consumption in Early Pregnancy: An Observational Study in 4067 Pregnant Women.

BACKGROUND
The teratogenic effects of alcohol are well documented, but there is a lack of screening methods to detect alcohol use during pregnancy. Phosphatidylethanol 16:0/18:1 (PEth) is a specific and sensitive alcohol marker reflecting alcohol intake up to several weeks after consumption. The aim of this study was to investigate the prevalence of positive PEth values as an indicator of early prenatal alcohol exposure in a general population of pregnant women.


METHODS
Rhesus typing is routinely performed in Norway in all pregnancies around gestational week 12. Rhesus negative women have an additional test taken around week 24. Blood samples submitted to St. Olav University Hospital in Trøndelag, Norway, for Rhesus typing during the period September 2017 to October 2018, were collected. A total of 4533 blood samples from 4067 women were analysed for PEth (limit of quantification of 0.003 µM) in whole blood.


RESULTS
A total of 58 women had a positive PEth sample. Of these, 50 women were positive around gestational week 12, three women were positive around week 24, and in five cases the timing was unknown. There were no significant differences in proportions of women with positive PEth values related to age, or rural versus urban residency.


CONCLUSION
In an unselected pregnant population in Norway 1.4 % had a positive PEth sample around gestational week 12 whereas 0.4% had a positive sample around week 24. The use of PEth as an alcohol biomarker should be further investigated as a possible diagnostic tool in the antenatal setting.