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Article

Estimation of Prenatal Alcohol Exposure: Comparison of Retrospective Survey and Measurement of Fatty Acid Ethyl Esters, Ethyl Sulfate, and Ethyl Glucuronide Concentrations in Neonatal Meconium

by
Marek Wiergowski
1,*,†,
Iwona Jańczewska
2,†,
Jolanta Wierzba
3,
Monika Cichoń-Kotek
3,
Mateusz Kacper Woźniak
1,
Agata Kot-Wasik
4,
Marek Biziuk
4,
Jacek Sein Anand
5,6,
Daria Barbara Schetz
7,
Małgorzata Glińska
2 and
Katarzyna Hinca
2
1
Department of Forensic Medicine, Faculty of Medicine, Medical University of Gdańsk, Dębowa 23 St., 80-204 Gdańsk, Poland
2
Division of Neonatology, Department of Gynecology, Obstetrics and Neonatology, Faculty of Medicine, 17 Mariana Smoluchowskiego St., 80-214 Gdańsk, Poland
3
Department of Obstetric and Gynaecological Nursing, Institute of Nursing and Midwifery, Medical University of Gdańsk, Dębinki 7 St., 80-214 Gdańsk, Poland
4
Department of Analytical Chemistry, Faculty of Chemistry, Gdańsk University of Technology, 11/12 Narutowicza St., 80-233 Gdańsk, Poland
5
Division of Clinical Toxicology, Faculty of Health Sciences with the Institute of Maritime and Tropical Medicine, Medical University of Gdansk, 80-211 Gdańsk, Poland
6
Pomeranian Centre of Toxicology, Kartuska 4/6 St., 80-104 Gdańsk, Poland
7
Department of Pharmacology, Faculty of Medicine, Medical University of Gdańsk, Dębowa 23 St., 80-204 Gdańsk, Poland
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Toxics 2026, 14(2), 155; https://doi.org/10.3390/toxics14020155
Submission received: 13 December 2025 / Revised: 26 January 2026 / Accepted: 30 January 2026 / Published: 4 February 2026
(This article belongs to the Section Drugs Toxicity)
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Abstract

Determining the concentration of fatty acid ethyl esters (FAEEs), ethyl sulfate (EtS), and ethyl glucuronide (EtG) is crucial for establishing the true scale of prenatal alcohol exposure (PAE) and enabling early diagnosis of fetal alcohol spectrum disorders. This study primarily aimed to compare two detection methods: retrospective maternal alcohol consumption surveys and chromatographic analysis of newborn meconium. Among 478 mothers, parallel survey data and meconium samples were collected. Nine FAEEs were measured by gas chromatography–mass spectrometry, and EtG and EtS by liquid chromatography–tandem mass spectrometry. The study also aimed to establish marker cut-offs and evaluate their clinical utility. While only 4% (approximately) of mothers reported alcohol consumption during pregnancy, the biomarker analysis suggested a significant underestimation of the actual PAE scale, highlighting the limitations of self-reported data. Analysis using the cumulative biomarker index for two biomarkers with a threshold of ≥5 indicated that alcohol consumption affected approximately 3% of the studied population, further demonstrating the low reliability of maternal self-reports. Ultimately, this study confirms that the combined EtG and EtS measurements provide the most reliable diagnostic information for PAE and underscores the necessity of objective meconium screening in clinical practice.
Keywords: alcohol consumption biomarkers; ethyl glucuronide; ethyl sulfate; fatty acid ethyl esters; meconium; fetal alcohol spectrum disorders; prenatal alcohol exposure; liquid chromatography–tandem mass spectrometry; gas chromatography–mass spectrometry alcohol consumption biomarkers; ethyl glucuronide; ethyl sulfate; fatty acid ethyl esters; meconium; fetal alcohol spectrum disorders; prenatal alcohol exposure; liquid chromatography–tandem mass spectrometry; gas chromatography–mass spectrometry
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MDPI and ACS Style

Wiergowski, M.; Jańczewska, I.; Wierzba, J.; Cichoń-Kotek, M.; Woźniak, M.K.; Kot-Wasik, A.; Biziuk, M.; Sein Anand, J.; Schetz, D.B.; Glińska, M.; et al. Estimation of Prenatal Alcohol Exposure: Comparison of Retrospective Survey and Measurement of Fatty Acid Ethyl Esters, Ethyl Sulfate, and Ethyl Glucuronide Concentrations in Neonatal Meconium. Toxics 2026, 14, 155. https://doi.org/10.3390/toxics14020155

AMA Style

Wiergowski M, Jańczewska I, Wierzba J, Cichoń-Kotek M, Woźniak MK, Kot-Wasik A, Biziuk M, Sein Anand J, Schetz DB, Glińska M, et al. Estimation of Prenatal Alcohol Exposure: Comparison of Retrospective Survey and Measurement of Fatty Acid Ethyl Esters, Ethyl Sulfate, and Ethyl Glucuronide Concentrations in Neonatal Meconium. Toxics. 2026; 14(2):155. https://doi.org/10.3390/toxics14020155

Chicago/Turabian Style

Wiergowski, Marek, Iwona Jańczewska, Jolanta Wierzba, Monika Cichoń-Kotek, Mateusz Kacper Woźniak, Agata Kot-Wasik, Marek Biziuk, Jacek Sein Anand, Daria Barbara Schetz, Małgorzata Glińska, and et al. 2026. "Estimation of Prenatal Alcohol Exposure: Comparison of Retrospective Survey and Measurement of Fatty Acid Ethyl Esters, Ethyl Sulfate, and Ethyl Glucuronide Concentrations in Neonatal Meconium" Toxics 14, no. 2: 155. https://doi.org/10.3390/toxics14020155

APA Style

Wiergowski, M., Jańczewska, I., Wierzba, J., Cichoń-Kotek, M., Woźniak, M. K., Kot-Wasik, A., Biziuk, M., Sein Anand, J., Schetz, D. B., Glińska, M., & Hinca, K. (2026). Estimation of Prenatal Alcohol Exposure: Comparison of Retrospective Survey and Measurement of Fatty Acid Ethyl Esters, Ethyl Sulfate, and Ethyl Glucuronide Concentrations in Neonatal Meconium. Toxics, 14(2), 155. https://doi.org/10.3390/toxics14020155

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