Citation: Bearer, C.F., Stoler, J.M., Cook, J.D., and Carpenter, SlJ. (2004). Biomarkers of alcohol use in pregnancy. Alcohol Research & Health, 28(1), 38-43.
Article Type: Review
Conclusions: The identification of an appropriate (reliable and valid as well as practical and ethically acceptable) biomarker for prenatal alcohol exposure is an important step in both prevention and intervention of FASD. Much research still needs to be done in this area.
Summary: A common theme in the literature surrounding FASD is the need for both prevention and early intervention, as well as the questionable accuracy of maternal self-report. Of significant advantage, therefore, would be a biological test that could be used to identify prenatal alcohol exposure and in the process: facilitate interventions with pregnant women who are drinking; identify affected infants in order to provide early treatment and care; and promote an enhanced scientific understanding of alcohol effects. Research has been conducted to develop tests that can identify the presence of toxins such as illicit drugs in both the pregnant woman as well as the newborn infant, and all of these have both benefits and drawbacks. The author reviews both maternal and newborn biological possibilities (“biomarkers”) for developing testing protocols (e.g. blood, urine, saliva, amnionic fluid), and outlines the advantages and disadvantages of each. In addition, the promise of the field of proteomics (the study of how proteins in the body react to untoward conditions) is highlighted.
Implications: The merits and ethical considerations of mandatory screening for toxins during pregnancy have been debated both in the U.S.and internationally. Inherent in toxicity screening are both benefits to the mother and fetus, as well as potential dangers. Reducing the impact of prenatal alcohol exposure can be facilitated by the identification and administration of biomarker tests, but many decisions still need to be made regarding thresholds and actions taken as a result of a positive test.
Email Address: cfb3@case.edu