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Newborn Phosphatidylethanol Screening to Detect Fetal Alcohol Exposure in Uruguay

乌拉圭新生儿磷脂酰乙醇筛查以检测胎儿酒精暴露情况

基本信息

批准号：
9116730
负责人：
MICHAEL F. FLEMING
金额：
$ 45.91万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-08-01 至 2019-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9116730
关键词：
18 year old Adverse effects Age Alcohol consumption Alcohols Applications Grants Behavioral Biological Biological Assay Biological Markers Birth Blood Caring Child Childhood Clinical Communities Congenital Abnormality Country Cross-Sectional Studies Data Detection Developing Countries Development Developmental Delay Disorders Diagnosis Disabled Persons Early Diagnosis Esters Ethanol Metabolism Exhibits Fatty Acids Fetal Alcohol Exposure Fetal Alcohol Spectrum Disorder Frequencies Future Goals Hair Half-Life Healthcare Heavy Drinking Heel Hospitals Hour Infant International Intervention Interview Kinetics Learning Measures Meconium Methods Mothers Nail plate Neonatal Screening Neurologic Neuronal Plasticity Newborn Infant Patient Self-Report Pattern Pediatric Hospitals Perinatology Physicians Pilot Projects Predictive Value Pregnancy Pregnant Women Prevalence Problem behavior Public Health Public Policy Recruitment Activity Reporting Research Risk Sampling Schedule Schools Science Sensitivity and Specificity Social Security Source Spottings Study Section Technology Teratogens Testing Time Umbilical cord structure United States Uruguay Woman Work alcohol consumption during pregnancy alcohol exposure alcohol research binge drinking design disability drinking effective intervention effective therapy follow-up formative assessment handicapping condition improved innovation maternal cigarette smoking phosphatidylethanol policy implication prenatal programs public health relevance screening standard measure

项目摘要

DESCRIPTION (provided by applicant): Prenatal alcohol exposure is the leading preventable cause of birth defects in the United States, producing an array of neurological, behavioral and physical abnormalities collectively known as Fetal Alcohol Spectrum Disorders (FASD). Early diagnosis of FASD is the key to effective interventions and treatments, particularly for children under the age of 3 who may benefit from early neuroplasticity and reduce the long-term adverse effects. The long-term goal of our research program is to provide the science to support routine newborn screening for prenatal alcohol exposure. The primary aim of this international U01 grant proposal is to examine the association between maternal alcohol use and newborn phosphatidylethanol (PEth) levels in their newborn children, in a country (Uruguay) where significant alcohol use is common during pregnancy. Our previous work in public health care hospitals in Montevideo, Uruguay documented high rates of alcohol use during pregnancy (60%) and PEth levels in newborns (79%). PEth is a new biomarker that detects episodic heavy drinking (3 or more drinks) in the last 30 days. The test is 100% specific in detecting recent alcohol use with no known false positives. This proposed design is a cross-sectional study that will include1500 women 18 years and older and their newborns. Women who are admitted to one of two selected public health care hospitals in Montevideo, Uruguay for obstetrical care will be recruited to participate in the study. Maternal alcohol use will be assessed using a validated measure developed by Drs. Phil May and Wilsnack. The interview schedule has become the standard measure to assess maternal alcohol use and fetal alcohol exposure in the US and other countries. Maternal alcohol biomarker assays will include ethylglucuronide (EtG) in hair and nails and PEth in blood obtained at the time of delivery. Newborn umbilical cord and routine 48 hour heel stick blood will be collected to assess newborn PEth levels. By collecting newborn PEth levels at birth and 48 hours later we can assess the PEth kinetics to determine the optimum time to measure newborn PEth levels. By comparing newborn Peth levels with maternal self-reported alcohol use and alcohol biomarkers this innovative study will provide new information on the sensitivity and specificity of PEth as a newborn biomarker of prenatal alcohol exposure. The findings from this study could have enormous public health and policy implications, should PEth prove to be a highly sensitive and specific indicator of risky prenatal alcohol exposure. Analysis of PEth in dried blood spot cards would be the first assay to identify prenatal alcohol exposure in a universally available sample of newborn blood. Future work may also help us correlate newborn PEth levels with long-term behavioral, learning and developmental deficits in children and assist in early diagnosis of children with FASD.