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Prevalence of Prenatal Alcohol Exposure in the State of Texas as Assessed by Phosphatidylethanol in Newborn Dried Blood Spot Specimens
Author(s) -
Bakhireva Ludmila N.,
Sharkis Janet,
Shrestha Shikhar,
MirandaSohrabji Tristan J.,
Williams Sonnie,
Miranda Rajesh C.
Publication year - 2017
Publication title -
alcoholism: clinical and experimental research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.267
H-Index - 153
eISSN - 1530-0277
pISSN - 0145-6008
DOI - 10.1111/acer.13375
Subject(s) - medicine , dried blood , demography , alcohol dependence , phosphatidylethanol , environmental health , alcohol , pediatrics , chemistry , phospholipid , biochemistry , chromatography , membrane , sociology , phosphatidylcholine
Background While 2 to 5% of school‐aged children in the United States are estimated to be affected by fetal alcohol spectrum disorders ( FASD ), the prevalence of prenatal alcohol exposure ( PAE ) might be substantially underreported. Our objective was to systematically estimate the prevalence of PAE in Texas by measuring a direct ethanol metabolite, phosphatidylethanol ( PE th), in 1,000 infant residual dried blood spots (ir DBS s) in the Texas Newborn Screening Repository. Methods All public health regions ( PHR s) were represented proportional to their 2014 birth rate (~0.25% of total births). A cross‐sectional study design (unit of observation: individual ir DBS cards/infants) with additional ecologic subanalysis (unit of observation: aggregate measures for each Texas PHR ) was utilized. The study used PE th‐ir DBS to estimate the prevalence of PAE within 1 month before delivery for the state of Texas and each Texas PHR . The ecologic subanalysis compared different geographical regions’ aggregate prevalence of PAE with (i) retail liquor licenses, (ii) median household income by PHR , and (iii) prevalence of birth outcomes commonly associated with FASD . Results The sample included an equal number of males and females; 47.8% non‐Hispanic White, 40.8% Hispanic, 6.6% African American, and 4.8% Asian infants. In the entire sample, 8.4% of ir DBS s were positive for PE th (>20 ng/ml) indicative of PAE within approximately 1 month before delivery. Large regional differences were observed with mostly urban, high median‐income regions demonstrating the highest prevalence. Conclusions Results of this first systematic statewide PAE prevalence study demonstrate that PAE might be more prevalent than previously thought. Active case ascertainment efforts for FASD coupled with systematic objective assessment of PAE should expand to the national level to better estimate public health needs required to provide adequate services for children affected by PAE .