Assessing prevalence of alcohol consumption in early pregnancy: Self-report compared to blood biomarker analysis
Assessing prevalence of alcohol consumption in early pregnancy: Self-report compared to blood biomarker analysis
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DOI：
10.1016/j.ejmg.2018.05.009
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发表时间：
2018-09-01
影响因子：
1.9
通讯作者：
Brown, Nigel W.
中科院分区：
文献类型：
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作者：
Howlett, Helen;Mackenzie, Shonag;Brown, Nigel W.
只有能够识别出高危人群，才能为怀孕期间饮酒的女性提供适当的产前和产后护理。我们的目的是通过自我报告和血液生物标志物分析来比较怀孕前三个月的饮酒流行率。对 2014 年怀孕前三个月产前预约时采集的 600 份常规血液样本进行了匿名分析，以检测是否存在碳水化合物缺乏转铁蛋白 (CDT)，这是慢性酒精暴露的有效标志物（戒酒后 2-3 周恢复正常）和 γ-谷氨酰转移酶 (GGT)，这是一种在酒精暴露后长达 8 周升高的肝酶。在一个单独的女性样本中，收集了 2015 年产前检查期间采集的数据，记录了女性自我报告的饮酒情况。报告在妊娠前三个月饮酒的女性比例为 0.8%。相比之下，74.1% 的女性表示在怀孕前饮酒。 CDT 分析显示，妊娠前三个月的患病率为 1.4%，GGT 的患病率为 3.5%。尽管CDT升高的人通常GGT水平较高，但只有1人CDT和GGT呈阳性。 CDT 分析和自我报告的结果可能会因不同原因低估患病率。 GGT 似乎缺乏特异性，但它可能具有支持 CDT 分析结果的价值。使用额外的血液生物标志物或血液生物标志物与自我报告相结合的进一步研究可能有助于准确检测妊娠期饮酒史。
Providing appropriate antenatal and postnatal care for women who drink alcohol in pregnancy is only possible if those at risk can be identified. We aimed to compare the prevalence of alcohol consumption in the first trimester of pregnancy using self-report and blood biomarker analysis. Six-hundred routine blood samples from 2014, taken at the antenatal booking appointment, in the first trimester of pregnancy, were anonymously analysed for the presence of Carbohydrate Deficient Transferrin (CDT), a validated marker of chronic alcohol exposure (normalising 2-3 weeks from abstinence) and Gamma-glutamyltransferase (GGT), a liver enzyme elevated for up to 8 weeks after alcohol exposure. In a separate sample of women, from 2015, data taken during the antenatal visit, documenting women's self-reported alcohol consumption, were collected. The percentage of women who reported alcohol intake in the first trimester was 0.8%. This compared to 74.1% of women who reported consuming alcohol before pregnancy. CDT analysis revealed a prevalence rate of 1.4% and GGT a prevalence rate of 3.5% in the first trimester of pregnancy. Although those with elevated CDT generally had high levels of GGT, only one person was positive for CDT and GGT. Results from CDT analysis and self-report may underestimate prevalence for different reasons. GGT appeared to lack specificity, but it may have value in supporting findings from CDT analysis. Further studies using additional blood biomarkers, or a combination of blood biomarkers and self-report, may be beneficial in accurately detecting alcohol drinking history in pregnancy.