Journal Articles

A utilitarian comparison of two alcohol use biomarkers with self-reported drinking history collected in antenatal clinics

March 15, 2018

Philip A. May, Julie M. Hasken, Marlene M. De Vries, Anna-Susan Marais, Julie M. Stegall, Daniel Marsden, Charles D.H. Parry, Soraya Seedat, Barbara Tabachnick (2018). A utilitarian comparison of two alcohol use biomarkers with self-reported drinking history collected in antenatal clinics. Reproductive Toxicology 77(25-32).

Author Affiliations:

University of North Carolina at Chapel Hill, Nutrition Research Institute, United States
Stellenbosch University, Faculty of Medicine and Health Sciences, Stellenbosch 7600, South Africa
Fulbright U.S. Student, 2015, Stellenbosch University, Faculty of Medicine and Health Sciences, Stellenbosch 7600, South Africa
Alcohol, Tobacco, and Other Drug Research Unit, South African Medical Research Council, Cape Town, 7501, South Africa
California State University, Northridge, CA 90802, United States

Abstract:

Background
Alcohol use is reported accurately among pregnant women in some populations.

Methods
Self-reported alcohol use via the AUDIT and 90-day recall for 193 women from antenatal clinics was compared to biomarker results: phosphatidylethanol (PEth) from bloodspots and ethyl glucuronide (EtG) in fingernails.

Results
AUDIT was positive for 67.9% of respondents, and 65.3% directly reported drinking. Individual biomarkers detected less drinking (PEth = 57.0%, EtG = 38.9%) than self-report. But 64.8% had drinking-positive values (>8 ng) on one or both biomarkers, which was not significantly different from self-report. Biomarkers indicated that 3.1% −6.8% of drinkers denied drinking. Combined biomarker sensitivity was 95% −80% and specificity 49% −76% for drinking in the previous 7–90 days. Combined biomarker results have their best yield (89.6%) and accuracy (78.8%) when measuring 90 day drinking.

Conclusions
Women reported their alcohol use accurately, and the combined use of PEth and EtG is supported.

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