PT  - JOURNAL ARTICLE
AU  - Janet Bryanton
AU  - Joey Gareri
AU  - Diane Boswall
AU  - Mary Jean McCarthy
AU  - Bonnie Fraser
AU  - Donna Walsh
AU  - Bridget Freeman
AU  - Gideon Koren
AU  - Kathy Bigsby
TI  - Incidence of prenatal alcohol exposure in Prince Edward Island: a population-based descriptive study
AID  - 10.9778/cmajo.20140011
DP  - 2014 Apr 01
TA  - CMAJ Open
PG  - E121--E126
VI  - 2
IP  - 2
4099  - http://www.cmajopen.ca/content/2/2/E121.short
4100  - http://www.cmajopen.ca/content/2/2/E121.full
AB  - Background Fetal alcohol spectrum disorder (FASD) is a leading preventable cause of neurodevelopmental disability in North America. The stigma associated with alcohol use and abuse during pregnancy makes it difficult to obtain information on prenatal alcohol use through self-reporting. We assessed the incidence of prenatal alcohol exposure in Prince Edward Island to facilitate future public health initiatives addressing FASD. Methods Prenatal alcohol exposure was examined via population-based collection of meconium and analysis of fatty acid ethyl esters (FAEEs). Fatty acid ethyl esters are nonoxidative metabolites of ethanol that are produced in the fetus. Meconium FAEE concentrations of 2.0 nmol/g or greater are indicative of frequent prenatal alcohol exposure during the last 2 trimesters of pregnancy. Samples were collected from 1307 neonates between Nov. 8, 2010, and Nov. 8, 2011, in hospitals in PEI, or from those born to mothers who resided in PEI but gave birth in Halifax, Nova Scotia. Samples were frozen and shipped for analysis. Fatty acid ethyl esters were analyzed by gas chromatography–mass spectrometry and quantified by means of deuterated internal standards. Results Of the 1307 samples collected, 1271 samples were successfully analyzed. Positive results for FAEEs were obtained in 3.1% (n = 39) of samples collected within the first 24 hours after birth. Interpretation Not all neonates exposed to heavy prenatal alcohol in utero will exhibit FASD; based on current estimates of predictive value for disease by exposure, our findings suggest that 1.3% of neonates born in PEI during this 1-year period will have FASD. In its application to an entire provincial birth cohort, this study successfully implemented a public health–centred approach for evaluating population-based risk of FASD, with implications for practice across Canada.