Alcohol consumption in pregnancy: an ISS study
The workshop “Prevention, early diagnosis and targeted treatment of Foetal Alcohol Spectrum Disorders (FASDs) and Foetal Alcohol Syndrome (FAS)” was held on 9-10 May 2022. Organized by the National Centre for Addictions and Doping of the Istituto Superiore di Sanità (ISS), the event was a valuable opportunity to learn more about these permanent, yet invisible, conditions, which are still little known in Italy.
The leading experts on FAS and FASDs provided an overview of current scientific evidence and prevention strategies, discussed the risks of alcohol consumption, and explained how to make an early diagnosis in newborns when prenatal alcohol exposure is suspected. The objective was to allow professionals to share their experiences with a view to facilitating a rapid response through targeted treatment. This is essential to minimizing secondary disabilities in people with FASDs or fully expressed FAS and helping them live a comfortable and safe life, as independently as possible. The final part of the workshop featured speeches from members of the Italian Association for Disorders Caused by Prenatal Alcohol and/or Drug Exposure (AIDEFAD), and a review of the project “Prevention, early diagnosis and targeted treatment of Foetal Alcohol Spectrum Disorders (FASDs) and Foetal Alcohol Syndrome (FAS)” of the National Centre for Disease Prevention and Control (CCM), during which key findings from laboratory tests and training activities were presented.
The workshop’s scientific director, Simona Pichini, shared some data from the study, which highlighted a downward trend in the number of women drinking alcohol during the 9 months of pregnancy.
As part of the research, which involved mothers and newborns from across the country, (maternal) hair samples and neonatal meconium samples were tested for a highly specific metabolite of ethanol, ethyl glucuronide (EtG). The preliminary results, obtained from non-paired cohorts of pregnant women and newborn babies, showed that a marginal proportion of Italian women (0.1%) engaged in heavy drinking during pregnancy, and that only a small percentage of babies were exposed to alcohol before birth.
Participants in the study included non-paired groups of 20 delivering mothers and 20 newborns per city, recruited from public hospitals in Northern, Central and Southern Italy (including the islands).
Meconium and hair samples (up to 8 cm long) were collected within 24 hours after childbirth and subsequently analysed.
Ethyl glucuronide was quantified in both biological matrices using a validated method combining gas chromatography and tandem mass spectrometry.
Hair EtG concentrations lower than 5 pg/mg were considered as indicative of abstinence, concentrations >5 pg/mg, but lower than 30 pg/mg, as indicative of low alcohol consumption during pregnancy, and ≥30 pg/mg of excessive drinking. To date, 781 hair samples and 642 meconium samples have been analysed:
- Only one in 781 (0.1%) women was found to have chronic excess alcohol consumption, with EtG concentrations > 30 pg/mg, while EtG concentrations >5 pg/mg and >11 pg/mg were recorded in 8.2% and 1.4% of hair samples, respectively
- Prenatal alcohol exposure was confirmed in four babies (0.6%) with meconium EtG >30 ng/g
- Most of the women involved in the study (mean age: 34 years) were Italian citizens (88%) and had a job (69%); 44% had a university degree and 39% a higher-education qualification. The four exposed babies did not exhibit clear signs of disabilities or defects at birth
It is important to remember that alcohol consumption during pregnancy, and subsequent foetal exposure, can cause adverse perinatal outcomes such as: preterm birth, withdrawal symptoms, tremors, hyperreflexia and abnormal physical and mental development later in life. Available data, however, show that existing health policies have helped raise Italian women’s awareness of the risks of consuming alcohol during pregnancy.