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Author Notes:

Corresponding author: Theresa W. Gauthier, Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Emory University School of Medicine, Atlanta, Georgia, United States of America. Email: tgauthi@emory.edu.

Conceived and designed the experiments: TWG SSM DMG LAB. Performed the experiments: SSM FLH. Analyzed the data: TWG TSG LAB. Contributed reagents/materials/analysis tools: TWG SSM TSG LAB. Wrote the paper: TWG SSM TSG DMG LAB.

The authors would like to thank Mona Brown, RN, Joel Andrews, RN, and Celeste Sarmiento for subject enrollment and questionnaire administration, Brian G. Burns and Eman Dosunmu-Doriney for placental collection, and Mojgan Zavareh for sample processing and GC/MS analyses.

FAEE analysis was performed by the Emory + Children’s Pediatric Research Center Biomarkers Core.

The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

The authors have declared that no competing interests exist.


Research Funding:

Funded by National Institutes of Health P50 AA-135757 (TWG, DMG, LAS), the National Center for Advancing Translational Sciences of the National Institutes of Health UL1TR000454, the National Institutes of Health TL1TR000456 (TSG) and by the Cancer Tissue and Pathology Shared Resource of the Winship Cancer Institute of Emory University (P30CA138292).

Placental Fatty Acid Ethyl Esters Are Elevated with Maternal Alcohol Use in Pregnancies Complicated by Prematurity


Journal Title:



Volume 10, Number 5


, Pages e0126552-e0126552

Type of Work:

Article | Final Publisher PDF


The accumulation of fatty acid ethyl esters (FAEEs) in meconium of term newborns has been described as one potential biomarker of maternal alcohol use during pregnancy. FAEEs accumulate in multiple alcohol-exposed fetal tissues and in the placenta. Limited research has focused on the identification of the premature newborn exposed to alcohol in utero.We hypothesized that maternal alcohol use occurs in a significant proportion of premature deliveries and that this exposure can be detected as elevated placental FAEEs. The goals of this study were to 1) determine the prevalence ofmaternal alcohol use in the premature newborn and 2) investigate whether placental FAEEs could identify those newborns with fetal alcohol exposure. This prospective observational study evaluated 80 placentas from 80 women after premature delivery. Subjects were interviewed for alcohol intake and placental FAEEs were quantified via GC/MS. Receiver Operator Characteristic (ROC) Curves were generated to evaluate the ability of placental FAEEs to predict maternal drinking during pregnancy. Adjusted ROC curves were generated to adjust for gestational age, maternal smoking, and illicit drug use. 30% of the subjects admitted to drinking alcohol during pregnancy and approximately 14% answered questions indicative of problem drinking (designated AUDIT+). The specific FAEEs ethyl stearate and linoleate, as well as combinations of oleate + linoleate + linolenate (OLL) and of OLL + stearate, were significantly (p<0.05) elevated in placentas from AUDIT+ pregnancies. Adjusted ROC Curves generated areas under the curve ranging from88-93% with negative predictive values of 97%for AUDIT+ pregnancies. We conclude that nearly one third of premature pregnancies were alcohol-exposed, and that elevated placental FAEEs hold great promise to accurately determine maternal alcohol use, particularly heavy use, in pregnancies complicated by premature delivery.

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© 2015 Gauthier et al.

This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits distribution, public display, and publicly performance, making multiple copies, distribution of derivative works, provided the original work is properly cited. This license requires copyright and license notices be kept intact, credit be given to copyright holder and/or author.

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