Urinary ethyl glucuronide for the assessment of alcohol consumption during pregnancy: Comparison between biochemical data and screening questionnaires

Background: Ethyl glucuronide (EtG) is a metabolite of ethanol used as a marker of alcohol drinking and is identified in urine. Gestational alcohol drinking harms the fetus, so, disclosing any form of use and abuse of this substance during pregnancy is crucial. Many discovery methods have been planned to overcome this question, including that of using screening questionnaires as the AUDIT-C, T-ACE/TACER-3, and TWEAK. Aim: The aim and novelties of this study were to compare biochemical data from urinary EtG assays (cut-off 100 ng/mL for risking drinking behavior) with the outcome of questionnaires and of a food diary routinely used in our hospital; moreover, for the first time, we analyzed in pregnant women the EtG values normalized by the amount of creatinine excreted according to methods previously established [1]. Methods: Random urine samples were collected from 309 pregnant women immediately after being interviewed. EtG was quantified using an enzyme immunoassay and urinary creatinine was assessed using an enzymatic colorimetric method. Women that had not exhaustively answered one of the questionnaires, or that refused to provide urine samples were excluded. In the end, 309 women had a complete set of data and were considered for this study. Urine creatinine measurements were performed to determine if urine dilution might have resulted in false negatives in the challenge study. In order to accomplish this objective, as urinary creatinine concentrations are, on average, approximately 1 mg/mL, we used a normalized value of 100 ng EtG/mg Creatinine [1]. Results: Our data show that 20.4% of the pregnant women in the study were over the established normalized cut-off value. Poor to null concordance (unweighted k < 0.2) was found between EtG data and the screening interviews, that show, on average, lower levels of alcohol consumption. Conclusion: In conclusion, this study provides evidence that the assessment of maternal alcohol consumption during pregnancy, only indirectly estimated with questionnaires and food diary, can produce misleading ratings.

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Alcohol Use During Pregnancy and Associated Factors Among Pregnant Women in Sub-saharan Africa: Further Analysis of the Recent Demographic and Health Survey Data

10.21203/rs.3.rs-877983/v1 ◽

2021 ◽

Author(s):

Bezawit Mulat ◽

Wallelign Alemnew ◽

Kegnie Shitu

Keyword(s):

Alcohol Consumption ◽

Alcohol Use ◽

Pregnant Women ◽

Alcohol Drinking ◽

Associated Factors ◽

Educational Status ◽

Sub Saharan Africa ◽

African Countries ◽

Sub Saharan ◽

Pregnant Mothers

Abstract BackgroundAlcohol drinking during pregnancy is towering in spite of the well-established prove on its unfavorable pregnancy results and destitute child improvement. Despite such enormous consequences, there are limited data that explore about the extent of alcohol drinking and its associated factors among mothers during pregnancy in sub-Saharan Africa. ObjectiveThis study aimed to assess the prevalence and associated factors of alcohol consumption during pregnancy among pregnant mothers in sub-Saharan Africa. MethodA community based crossectional demographic and health survey was conducted from 2013 to 2017 among four Sub-Sahara African countries: Burundi, Ethiopia, Liberia and Zimbabwe. A two-stage stratified sampling technique was employed to select the participants. Multivariable Logistic regression analysis was used to identify factors associated with alcohol consumption during pregnancy. A p-value less than 0.05 and 95% confidence interval were used to declare statistical significance.ResultA total of 3,953 weighed sample of pregnant mothers were included in the study. The mean age of the participants was 27.3 (± 6.8) years with an age range of 15-49 years. The overall prevalence of alcohol use during pregnancy was 22.8% with (95% CI (21.5, 24)) and it was significantly associated with increased age (AOR=1.02, 95% CI (1.01, 1.04)), Muslim religion follower ( AOR=0.07, 95% (0.05,0.11), husband/partner’s educational status of primary (AOR=0.7 ,95% CI (0.55,0.84), secondary (AOR=0.53, 95% CI ( 0.41,0.7)) and higher (AOR=0.49 , 95% CI(0.31,0.8), being currently working (AOR=1.5,95% CI ( 1.09,1.55) , having ANC visit ( AOR=0.82, 95% C I(0.68,0.98) and increased gravidity ( AOR=0.93,95% CI( 0.86,0.99).Conclusion Alcohol drinking during pregnancy was high among pregnants in sub-Saharan African countries. Maternal age, religion, husband educational status, current working status of the mother, presence of ANC visit and gravidity of the mother were factors which have significant association with alcohol drinking during pregnancy. This calls a tailored behavior change intervention to reduce alcohol use during pregnancy. More emphasis should also be given for pregnant women with no ANC visit, lower gravidity, and an illiterate husband, currently working and Christianity followers.

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General practitioners, pregnancy and addictions in France in 2015

European Journal of Public Health ◽

10.1093/eurpub/ckz186.620 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

R Andler ◽

C Cogordan ◽

A Pasquereau ◽

J-F Buyck ◽

V Nguyen-Thanh

Keyword(s):

Alcohol Consumption ◽

Alcohol Use ◽

Pregnant Women ◽

General Practitioners ◽

Tobacco Smoking ◽

Alcohol Drinking ◽

Health Hazard ◽

Active Role ◽

Antenatal Visit ◽

Smoking During Pregnancy

Abstract Background Tobacco smoking and alcohol drinking during pregnancy result in serious health hazard for both the baby and the mother. In France, about 17% of pregnant women smoke and 20% consume alcohol. General practitioners (GPs) can have an active role in preventing those behaviors as they often interact with pregnant patients: one quarter of French pregnant women have had at least one antenatal visit with a GP. The aim of our study is to describe French GPs’ practices (screening and counseling) toward pregnant patients regarding tobacco smoking and alcohol drinking. Methods In 2015, a telephone survey was set based on a stratified random sampling of metropolitan France GPs. A representative sample of 1,414 French GPs completed the study. Results Screening for alcohol consumption at least once for every patient was done by 61% of GPs and for smoking by 82% of GPs. Counselling to quit alcohol consumption was done by 77% of GPs while counselling to quit smoking was done by about 90% of them. GPs’ practices were significantly better among those who had more recent ongoing training. Regular drinkers GPs were less likely to systematically screen for alcohol use and GPs’ alcohol use frequency was adversely related to recommending quitting. Current and former smokers GPs were less likely to recommend quitting to pregnant patients smoking over 5 cigarettes per day. Conclusions Screening for alcohol use and smoking during pregnancy is not yet systematic among GPs in France. GPs’ prevention role with pregnant patients could be emphasized, potentially through initial and ongoing trainings adaptation. Besides, as regular alcohol use and smoking are related to unwanted practices, prevention for the benefit of GPs could be even more fruitful. Key messages Screening for alcohol use and smoking during pregnancy is not systematically done by French GPs. GPs’ prevention role with pregnant patients could be emphasized, potentially through initial and ongoing trainings adaptation.

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Dilute-and-Shoot HPLC-UV Method for Determination of Urinary Creatinine as a Normalization Tool in Mycotoxin Biomonitoring in Pigs

Molecules ◽

10.3390/molecules25102445 ◽

2020 ◽

Vol 25 (10) ◽

pp. 2445

Author(s):

Agnieszka Tkaczyk ◽

Piotr Jedziniak

Keyword(s):

Mobile Phase ◽

Matrix Effects ◽

Colorimetric Method ◽

Elisa Test ◽

Hplc Method ◽

Urine Samples ◽

Hplc Separation ◽

Urinary Creatinine ◽

Precision And Accuracy

A simple, rapid, and accurate HPLC-UV method was developed for the determination of creatinine in pig urine. Usually, it is determined in urine in biomonitoring of xenobiotics to correct for variations in dilutions of urine samples. The colorimetric method (based on Jaffe reaction), which was mainly used for this purpose in mycotoxin biomonitoring, is not a reliable approach for pig urine. Therefore, a novel and accurate HPLC method for creatinine determination was developed. The sample preparation was based on the dilute and shoot approach. An HPLC separation was performed with a porous graphitic carbon column with an aqueous mobile phase to achieve satisfactory retention time for creatinine. The method has been successfully validated, applied for the determination of creatinine in pig urine, and compared with other methods commonly used for that purpose—a colorimetric method based on Jaffe reaction and commercial ELISA test. The developed HPLC method shows the highest precision and accuracy for pig urine samples. Finally, the method was applied as a normalization tool in LC-MS/MS mycotoxin biomarkers analysis. The standardization to a constant creatinine level (0.5 mg/mL) enables similar matrix effects for eleven mycotoxin biomarkers for pig urine samples with different creatinine levels.

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Identifying psychosocial determinants related to alcohol consumption during pregnancy: a systematic literature review

10.31234/osf.io/awkdz ◽

2018 ◽

Author(s):

Sylvia Roozen ◽

Gjalt - Jorn Ygram Peters ◽

Gerjo Kok ◽

Leopold Curfs

Keyword(s):

Alcohol Consumption ◽

Pregnant Women ◽

Perceived Risk ◽

Human Subjects ◽

Meta Analysis ◽

Univariate Analysis ◽

Childbearing Age ◽

Psychosocial Determinants ◽

Maternal Alcohol ◽

Maternal Alcohol Consumption

BackgroundFetal Alcohol Spectrum Disorders (FASD) is an important global health problem in need of prevention. For FASD prevention it is important to understand why pregnant women engage or do not engage in drinking alcohol. It remains unknown which psychosocial determinants related to maternal alcohol consumption are most in need of prevention. The objective of this study was to identify these.MethodWe searched in PubMed, PsychINFO, PsychARTICLES, ERIC, CINAHL, EMBASE and MEDLINE databases up to May 2018 using an extensive query consisting of keywords related to pregnancy (e.g., maternal, prenatal), alcohol use (e.g., alcohol, drink) and determinants (e.g., attitude, norm). Studies were excluded when not published in English, were reviews, or involved non-human subjects. Substantial heterogeneity precluded aggregation or meta-analysis of the data. Instead, data were qualitatively inspected.ResultsA total of 23 studies including 150 identified items were eligible for data analysis. Studies covered over 15 psychosocial determinants (e.g., attitude, perceived social norm, risk perception). Studies differed in their operationalizations. As a majority of data was based on univariate analysis, little is known about the relationship with specific drinking behaviors. The majority of studies targeted perceived risk and motivation to comply with each social referents' approval or disapproval. A large proportion of studies focused on disadvantages and risks of maternal alcohol consumption. Results from these studies show that women do not continue to drink because the risks are unknown to them. Cautious interpretation is needed while the observed heterogeneity hindered firm conclusions. Conclusion We aimed to identify all relevant psychosocial determinants of maternal alcohol consumption behavior(s). The state of the literature precludes such conclusions. It remains unknown which determinants are most in need of intervention. It is recommended for future studies to (i) identify all possible psychosocial determinants of drinking during pregnancy using both quantitative and qualitative methods; (ii) include different target groups (e.g., women with unplanned pregnancies, pregnant women, women in childbearing age); (iii) identify key environmental agents; (iv) operationalize their measures based on theoretical models; (v) report specific variables such as the study method and association with behavior.

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Biomarkers of Alcohol Consumption in Body Fluids - Possibilities and Limitations of Application in Toxicological Analysis

Current Medicinal Chemistry ◽

10.2174/0929867324666171005111911 ◽

2019 ◽

Vol 26 (1) ◽

pp. 177-196 ◽

Cited By ~ 5

Author(s):

Mateusz Kacper Woźniak ◽

Marek Wiergowski ◽

Jacek Namieśnik ◽

Marek Biziuk

Keyword(s):

Alcohol Consumption ◽

Forensic Toxicology ◽

Body Fluids ◽

Ethyl Esters ◽

Ethyl Glucuronide ◽

Human Organism ◽

Analytical Toxicology ◽

Preparation Methods ◽

Toxicological Analysis

Background:Ethyl alcohol is the most popular legal drug, but its excessive consumption causes social problems. Despite many public campaigns against alcohol use, car accidents, instances of aggressive behaviour, sexual assaults and deterioration in labor productivity caused by inebriated people is still commonplace. Fast and easy diagnosis of alcohol consumption is required in order to introduce proper and effective therapy, and is crucial in forensic toxicology analysis. The easiest method to prove alcohol intake is determination of ethanol in body fluids or in breath. However, since ethanol is rapidly metabolized in the human organism, only recent consumption can be detected using this method. Because of that, the determination of alcohol biomarkers was introduced for monitoring alcohol consumption over a wider range of time.Objective:The objective of this study was to review published studies focusing on the sample preparation methods and chromatographic or biochemical techniques for the determination of alcohol biomarkers in whole blood, plasma, serum and urine.Methods:An electronic literature search was performed to discuss possibilities and limitations of application of alcohol biomarkers in toxicological analysis.Results:Authors described the markers of alcohol consumption such as: ethanol, its nonoxidative metabolites (ethyl glucuronide, ethyl sulfate, phosphatidylethanol, ethyl phosphate, fatty acid ethyl esters) and oxidative metabolites (acetaldehyde and acetaldehyde adducts). We also discussed issues concerning the detection window of these biomarkers, and possibilities and limitations of their use in routine analytical toxicology for monitoring alcohol consumption or sobriety during alcohol therapy.

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Effect of the Covid-19 Italian lockdown on human health: the analysis of alcohol consumption for aware quarantine (Preprint)

10.2196/preprints.25366 ◽

2020 ◽

Author(s):

Chiara Mazzarella ◽

Annamaria Spina ◽

Marcello Dallio ◽

Antonietta Gerarda Gravina ◽

Mario Romeo ◽

...

Keyword(s):

Alcohol Consumption ◽

Alcohol Abuse ◽

Psychosocial Factors ◽

Alcohol Drinking ◽

Psychosocial Support ◽

Human Life ◽

Stressful Event ◽

Drinking Behaviour ◽

Drinking Habits ◽

Specific Subset

BACKGROUND Italy has been one of the first western countries seriously involved in the COVID-19 pandemic in the first months of 2020 and so that the national government was forced to impose a long lockdown period, stopping all the people aggregation outdoor and indoor activities. From a social point of view this period of domestic confinement resulted in deep changes of behaviours and lifestyles, promoting in many people the onset of psychological symptoms and signs (including anxiety, depression, insomnia, and irritability among others) already known as associated with drug and alcohol abuse OBJECTIVE this study aims to assess the variation of alcohol drinking habits in a sample of Italian citizens during the COVID-19 lockdown and to identify the psychosocial factors surrounding it, in order to assess the specific subset of the population that could need psychosocial support during these events METHODS An online anonymous questionnaire was created and submitted from 9th April 2020 to 28th April 2020 using social medias and e-mails. Questions were related to personal details such as age, work, instruction, and, moreover, to alcohol drinking habits during the lockdown, including Alcohol Use Disorders Identification Test (AUDIT C) test questions RESULTS A total of 1234 surveys were filled out by subjects with an age range from 18 to 80 years old. An increase in both anxiety and fear has been detected in most of the participants (63% and 61% respectively) with a direct (r=0.652; p<0.001) relationship between them. Participants older than 50 years showed the strongest correlation between alcohol consumption, fear, and anxiety, (r=0.830, P <0.001 and r=0.741, P<0.001, respectively). Subjects living alone experienced a stronger association between anxiety, fear, and higher level of alcohol consumption (r: 0.529; P<0.001; r: 0.628, P<0.001 respectively). Moreover, 18% of participants increased alcohol consumption drinking during the lockdown. These subjects showed a lower frequency of alcohol consumption before the lockdown in comparison to the rest of the study population (2.5±0.96 vs 3±1.03, P<0.0001 respectively). Moreover, comparing the abovementioned groups, the percentage of subjects who experienced higher alcohol assumption before the 11th of March was higher in those that didn't change their drinking behaviour during the lockdown in comparison to that portion of them that experienced a worsening of alcohol abuse (r: 30.422, P<0.0001) CONCLUSIONS according to these data, during the Italian lockdown due to COVID 19 pandemic, different kind of people experienced an increase in alcohol drinking. Several psychosocial factors are involved in determining the increase in harmful alcohol consumption during this extraordinary stressful event and they must be addressed by the healthcare support in order to avoid awful lockdown impact on human life

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The consumption of low-calorie sweetener containing foods during pregnancy: results from the ROLO study

European Journal of Clinical Nutrition ◽

10.1038/s41430-021-00935-0 ◽

2021 ◽

Author(s):

Marie C. Conway ◽

Shona Cawley ◽

Aisling A. Geraghty ◽

Niamh M. Walsh ◽

Eileen C. O’Brien ◽

...

Keyword(s):

Pregnant Women ◽

Dietary Intervention ◽

Intervention Group ◽

Glycaemic Index ◽

Dietary Advice ◽

Control Group ◽

Food Groups ◽

Food Diary ◽

Low Calorie ◽

Child Health Outcomes

Abstract Background/objectives Women with gestational diabetes (GDM) are advised to adapt a low glycaemic index (GI) diet, which may impact consumption of low-calorie sweeteners (LCS). LCS are increasingly popular as they add sweetness without contributing calories. This study aims to investigate the reported intakes of LCS-containing foods in women during pregnancy. Subjects/methods Pregnant women recruited for the ROLO study were included in this analysis (n = 571). Women were randomised to receive either an intervention of low-GI dietary advice or usual antenatal care. Women completed a 3-day food diary in each trimester. Nine LCS-containing food groups were identified, and the quantity (g/day) consumed was calculated. Results One-third of all pregnant women consumed LCS across each trimester of pregnancy. Of those in the intervention group who were LCS consumers in trimester 1, 71.6% were consumers in trimester 2, and 54.1% remained consumers in trimester 3. In the control group, less women remained consumers in trimester 2 and 3 at 58.1% and 41.9%, respectively. In trimester 2, following the dietary intervention, the proportion of LCS consumers in the intervention group was significantly higher than the proportion of consumers who were in the control group (p < 0.001). The most commonly consumed food groups were low-calorie fruit drinks, diet-cola drinks, and low-calorie yoghurts. Conclusions One-third of pregnant women consumed LCS. The proportion of LCS consumers increased in the intervention group compared to the control group. Further research is needed to determine exposure levels to individual LCS, and the effect of prenatal exposure to LCS on maternal and child health outcomes.

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Development and validation of a method for the simultaneous analysis of fatty acid ethyl esters, ethyl sulfate and ethyl glucuronide in neonatal meconium: application in two cases of alcohol consumption during pregnancy

Analytical and Bioanalytical Chemistry ◽

10.1007/s00216-021-03248-0 ◽

2021 ◽

Vol 413 (11) ◽

pp. 3093-3105

Author(s):

Mateusz Kacper Woźniak ◽

Laura Banaszkiewicz ◽

Justyna Aszyk ◽

Marek Wiergowski ◽

Iwona Jańczewska ◽

...

Keyword(s):

Mass Spectrometry ◽

Fatty Acid ◽

Alcohol Consumption ◽

Solid Phase ◽

Fatty Acid Ethyl Esters ◽

Ethyl Esters ◽

Ethyl Glucuronide ◽

Published Data ◽

Ethyl Sulfate ◽

Analytical Approaches

AbstractAlcohol consumption during pregnancy constitutes one of the leading preventable causes of birth defects and neurodevelopmental disorders in the exposed children. Fatty acid ethyl esters (FAEEs), ethyl glucuronide (EtG) and ethyl sulfate (EtS) have been studied as potential biomarkers of alcohol consumption. However, most analytical approaches proposed for their analysis in meconium samples consist of separated extraction procedures requiring the use of two meconium aliquots, which is costly in terms of both time and materials. Therefore, the aim of this study was to develop and validate a method for the simultaneous extraction of 9 FAEEs, EtG and EtS from one meconium aliquot. The sample was homogenized using methanol, and then FAEEs were extracted with hexane while EtG and EtS were isolated using acetonitrile. Then, extracts were applied to solid-phase extraction columns and analysed by gas chromatography mass spectrometry (FAEEs) and liquid chromatography tandem mass spectrometry (EtG and EtS). Calibration curves were linear with r values greater than 0.99. The LODs ranged from 0.8 to 7.5 ng/g for FAEEs and were 0.2 ng/g and 0.8 ng/g for EtS and EtG, respectively. LOQs ranged from 5 to 25 ng/g for FAEEs and were 1 ng/g and 2.5 ng/g for EtS and EtG, respectively. Accuracies and precisions were between 93.8 and 107% and between 3.5 and 9.7%, respectively. The recovery values ranged from 89.1 to 109%. The method proved to be sensitive, specific, simple and fast and allowed for the reduction of the amount of organic solvent used for extraction compared to other published data while higher recoveries were obtained. The method was used for analysis of meconium samples in two cases of mothers who were consuming alcohol during pregnancy.

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