Fetal alcohol spectrum disorders – Diagnostic difficulties in the neonatal period and new diagnostic approaches

1Institute of Medicine; Committee to Study Fetal Alcohol Syndrome; Kathleen Stratton, Cynthia Howe, Frederick C Bataglia (eds.). Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment. Washington, DC: The National Academies Press, 1996. https://doi.org/10.17226/4991Institute of Medicine; Committee to Study Fetal Alcohol Syndrome; Kathleen Stratton, Cynthia Howe, Frederick C Bataglia (eds.). Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment Washington, DC The National Academies Press 1996 https://doi.org/10.17226/499110.17226/4991Search in Google Scholar

2Bertrand J, Floyd LL, Weber MK; Fetal Alcohol Syndrome Prevention Team, Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC). Guidelines for identifying and referring persons with fetal alcohol syndrome. MMWR Recomm Rep. 2005;54(RR-11):1-14.Bertrand J Floyd LL Weber MK Fetal Alcohol Syndrome Prevention Team, Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC). Guidelines for identifying and referring persons with fetal alcohol syndrome MMWR Recomm Rep 200554RR-111 14Search in Google Scholar

3Hoyme HE, Kalberg WO, Elliott AJ, Blankenship J, Buckley D, Marais AS, Manning MA, Robinson LK, Adam MP, Abdul-Rahman O, Jewett T, Coles CD, Chambers C, Jones KL, Adnams CM, Shah PE, Riley EP, Charness ME, Warren, Kenneth R, May PA. Updated Clinical Guidelines for Diagnosing Fetal Alcohol Spectrum Disorders. Pediatrics. 2016;138(2):e20154256. doi: 10.1542/peds.2015-4256.Hoyme HE Kalberg WO Elliott AJ Blankenship J Buckley D Marais AS Manning MA Robinson LK Adam MP Abdul-Rahman O Jewett T Coles CD Chambers C Jones KL Adnams CM Shah PE Riley EP Charness ME Warren Kenneth R May PA. Updated Clinical Guidelines for Diagnosing Fetal Alcohol Spectrum Disorders Pediatrics 20161382e20154256 10.1542/peds.2015-4256496072627464676Open DOISearch in Google Scholar

4Suttie M, Foroud T, Wetherill L, Jacobson JL, Molteno CD, Meintjes EM, Hoyme HE, Khaole N, Robinson LK, Riley EP, Jacobson SW, Hammond P. Facial dysmorphism across the fetal alcohol spectrum. Pediatrics. 2013;131 (3):e779-88. doi: 10.1542/peds.2012-1371.Suttie M Foroud T Wetherill L Jacobson JL Molteno CD Meintjes EM Hoyme HE Khaole N Robinson LK Riley EP Jacobson SW Hammond P Facial dysmorphism across the fetal alcohol spectrum Pediatrics 2013131 3e779 88 10.1542/peds.2012-1371358184123439907Open DOISearch in Google Scholar

5Astley SJ, darren SK. Diagnosing the full spectrum of fetal alcohol-exposed individuals: introducing the 4-digit diagnostic code. Alcohol Alcohol. 2000;35(4):400-410. doi:10.1093/alcalc/35.4.400.Astley SJ darren SK. Diagnosing the full spectrum of fetal alcohol-exposed individuals: introducing the 4-digit diagnostic code Alcohol Alcohol 2000354400 410 10.1093/alcalc/35.4.40010906009Open DOISearch in Google Scholar

6Hoyme HE, May PA, Kalberg WO, Kodituwakku P, Gossage JP, Trujillo PM, Buckley DG, Miller JH, Aragon AS, Khaole N, Viljoen DL, Jones KL, Robinson LK. A practical clinical approach to diagnosis of fetal alcohol spectrum disorders: clarification of the 1996 institute of medicine criteria. Pediatrics. 2005;115(1):39-47. doi: 10.1542/peds.2004-0259.Hoyme HE May PA Kalberg WO Kodituwakku P Gossage JP Trujillo PM Buckley DG Miller JH Aragon AS Khaole N Viljoen DL Jones KL Robinson LK A practical clinical approach to diagnosis of fetal alcohol spectrum disorders: clarification of the 1996 institute of medicine criteria Pediatrics 2005115139 47 10.1542/peds.2004-0259138031115629980Open DOISearch in Google Scholar

7del Campo M, Jones KL. A review of the physical features of the fetal alcohol spectrum disorders. Eur J Med Genet. 2017;60(l):55-64. doi:10.1016/j.ejmg.2016.10.004.del Campo M Jones KL. A review of the physical features of the fetal alcohol spectrum disorders Eur J Med Genet 201760l55 64 10.1016/j.ejmg.2016.10.00427729236Open DOISearch in Google Scholar

8May PA, Gossage JP, Kalberg WO, Robinson LK, Buckley D, Manning M, Hoyme HE. Prevalence and epidemiologic characteristics of FASD from various research methods with an emphasis on recent in-school studies. Dev Disabil Res Rev. 2009;15(3):176-192. doi: 10.1002/ddrr.68.May PA Gossage JP Kalberg WO Robinson LK Buckley D Manning M Hoyme HE Prevalence and epidemiologic characteristics of FASD from various research methods with an emphasis on recent in-school studies Dev Disabil Res Rev 2009153176 192 10.1002/ddrr.6819731384Open DOISearch in Google Scholar

9May PA, Baete A, Russo J, Elliott AJ, Blankenship J, Kalberg WO, Buckley D, Brooks M, Hasken J, Abdul-Rahman O, Adam MP, Robinson LK, Manning M, Hoyme HE. Prevalence and characteristics of fetal alcohol spectrum disorders. Pediatrics. 2014;134(5):855-866. doi: 10.1542/peds.2013-3319.May PA Baete A Russo J Elliott AJ Blankenship J Kalberg WO Buckley D Brooks M Hasken J Abdul-Rahman O Adam MP Robinson LK Manning M Hoyme HE Prevalence and characteristics of fetal alcohol spectrum disorders Pediatrics 20141345855 866 10.1542/peds.2013-3319421079025349310Open DOISearch in Google Scholar

10May PA, Fiorentino D, Gossage JP, Kalberg WO, Hoyme HE, Robinson LK, Coriale G, Jones KL, del Campo M, Tarani L, Romeo M, Kodituwakku PW, Deiana L, Buckley D, Ceccanti M. Epidemiology of FASD in a province in Italy: Prevalence and characteristics of children in a random sample of schools. Alcohol Clin Exp Res. 2006;30(9):1562-1575. doi: 10.1111/j.l530-0277.2006.00188.x.May PA Fiorentino D Gossage JP Kalberg WO Hoyme HE Robinson LK Coriale G Jones KL del Campo M Tarani L Romeo M Kodituwakku PW Deiana L Buckley D Ceccanti M. Epidemiology of FASD in a province in Italy: Prevalence and characteristics of children in a random sample of schools Alcohol Clin Exp Res 20063091562 1575 10.1111/j.l530-0277.2006.00188.xOpen DOISearch in Google Scholar

11Petkovic G, Barisić I. FAS prevalence in a sample of urban schoolchildren in Croatia. Reprod Toxicol. 2010;29(2):237241. doi: 10.1016/j.reprotox.2009.11.006.Petkovic G Barisić I. FAS prevalence in a sample of urban schoolchildren in Croatia Reprod Toxicol 2010292237241 10.1016/j.reprotox.2009.11.00619922788Open DOISearch in Google Scholar

12Mattson SN, Roesch SC, Glass L, Deweese BN, Coles CD, Kable JA, May PA, Kalberg WO, Sowell ER, Adnams CM, Jones KL, Riley EP; CIFASD. Further development of a neurobehavioral profile of fetal alcohol spectrum disorders. Alcohol Clin Exp Res. 2013;37(3):517-528. doi: 10.1111/j.l530-0277.2012.01952.x.Mattson SN Roesch SC Glass L Deweese BN Coles CD Kable JA May PA Kalberg WO Sowell ER Adnams CM Jones KL Riley EP; CIFASD. Further development of a neurobehavioral profile of fetal alcohol spectrum disorders Alcohol Clin Exp Res 2013373517 528 10.1111/j.l530-0277.2012.01952.xOpen DOISearch in Google Scholar

13Kesmodel U Wisborg K, Olsen SF, Henriksen TB, Secher NJ. Moderate Alcohol Intake during Pregnancy and the Risk of Stillbirth and Death in the First Year of Life. Am J Epidemiol. 2002;155(4):305-312. doi: 10.1093/aje/155.4.305.Kesmodel U Wisborg K Olsen SF Henriksen TB Secher NJ Moderate Alcohol Intake during Pregnancy and the Risk of Stillbirth and Death in the First Year of Life Am J Epidemiol 20021554305 312 10.1093/aje/155.4.30511836194Open DOISearch in Google Scholar

14Henriksen TB, Hjollund NH, Jensen TK, Bonde JP, Andersson AM, Kolstad H, Ernst E, Giwercman A, Skakkebaek NE, Olsen J. Alcohol consumption at the time of conception and spontaneous abortion. Am J Epidemiol. 2004; 160(7):661-667. doi: 10.1093/aje/kwh259.Henriksen TB Hjollund NH Jensen TK Bonde JP Andersson AM Kolstad H Ernst E Giwercman A Skakkebaek NE Olsen J Alcohol consumption at the time of conception and spontaneous abortion Am J Epidemiol 2004 1607661 667 10.1093/aje/kwh25915383410Open DOISearch in Google Scholar

15Chiodo LM, Bailey BA, Sokol RJ, Janisse J, Delaney-Black V, Hannigan JH. Recognized spontaneous abortion in mid-pregnancy and patterns of pregnancy alcohol use. Alcohol. 2012;46(3):261-267. doi: 10.1016/j.alcohol.2011.11.006.Chiodo LM Bailey BA Sokol RJ Janisse J Delaney-Black V Hannigan JH Recognized spontaneous abortion in mid-pregnancy and patterns of pregnancy alcohol use Alcohol 2012463261 267 10.1016/j.alcohol.2011.11.006335491222440690Open DOISearch in Google Scholar

16Roussotte FF, Sulik KK, Mattson SN, Riley EP, Jones KL, Adnams CM, May PA, O’Connor MJ, Narr KL, Sowell ER. Regional brain volume reductions relate to facial dysmorphology and neurocognitive function in fetal alcohol spectrum disorders. Hum Brain Mapp. 2012;33(4):920-937. doi: 10.1002/hbm.21260.Roussotte FF Sulik KK Mattson SN Riley EP Jones KL Adnams CM May PA O’Connor MJ, Narr KL Sowell ER Regional brain volume reductions relate to facial dysmorphology and neurocognitive function in fetal alcohol spectrum disorders Hum Brain Mapp 2012334920 937 10.1002/hbm.21260381280221416562Open DOISearch in Google Scholar

17Gautam P, Lebel C, Narr KL, Mattson SN, May PA, Adnams CM, Riley EP, Jones KL, Kan EC, Sowell ER. Volume changes and brain-behavior relationships in white matter and subcortical gray matter in children with prenatal alcohol exposure. Hum Brain Mapp. 2015;36(6):2318-2329. doi: 10.1002/hbm.22772.Gautam P Lebel C Narr KL Mattson SN May PA Adnams CM Riley EP Jones KL Kan EC Sowell ER Volume changes and brain-behavior relationships in white matter and subcortical gray matter in children with prenatal alcohol exposure Hum Brain Mapp 20153662318 2329 10.1002/hbm.22772463152525711175Open DOISearch in Google Scholar

18Lebel C, Mattson SN, Riley EP, Jones KL, Adnams CM, May PA, Bookheimer SY, O’Connor MJ, Narr KL, Kan E, Abaryan Z, Sowell ER. A longitudinal study of the longterm consequences of drinking during pregnancy: heavy in utero alcohol exposure disrupts the normal processes of brain development. J Neurosci. 2012;32(44):15243-15251. doi: 10.1523/JNEUROSCI.1161-12.2012].Lebel C Mattson SN Riley EP Jones KL Adnams CM May PA Bookheimer SY O’Connor MJ, Narr KL Kan E Abaryan Z Sowell ER A longitudinal study of the longterm consequences of drinking during pregnancy: heavy in utero alcohol exposure disrupts the normal processes of brain development J Neurosci 2012324415243 15251 10.1523/JNEUROSCI.1161-12.2012]Open DOISearch in Google Scholar

19Jacobson SW, Jacobson JL, Molteno CD, Warton CMR, Wintermark P, Hoyme HE, De Jong G, Taylor P, Warton F, Lindinger NM, Carter RC, Dodge NC, Grant E, Warfield SK, Zöllei L, van der Kouwe AJW, Meintjes EM. Heavy Prenatal Alcohol Exposure is Related to Smaller Corpus Callosum in Newborn MRI Scans. Alcohol Clin Exp Res. 2017;41(5):965-975. doi: 10.1111/acer.13363.Jacobson SW Jacobson JL Molteno CD Warton CMR Wintermark P Hoyme HE De Jong G Taylor P Warton F Lindinger NM Carter RC Dodge NC Grant E Warfield SK Zöllei L van der Kouwe AJW Meintjes EM. Heavy Prenatal Alcohol Exposure is Related to Smaller Corpus Callosum in Newborn MRI Scans Alcohol Clin Exp Res 2017415965 975 10.1111/acer.13363540497628247416Open DOISearch in Google Scholar

20Feldman HS, Jones KL, Lindsay S, Slymen D, Klonoff-Cohen H, Kao K, Rao S, Chambers C. Prenatal alcohol exposure patterns and alcohol-related birth defects and growth deficiencies: a prospective study. Alcohol Clin Exp Res. 2012;36(4):670-676. doi: 10.1111/j.l530-0277.2011.01664.x.Feldman HS Jones KL Lindsay S Slymen D Klonoff-Cohen H Kao K Rao S Chambers C Prenatal alcohol exposure patterns and alcohol-related birth defects and growth deficiencies: a prospective study Alcohol Clin Exp Res 2012364670 676 10.1111/j.l530-0277.2011.01664.xOpen DOISearch in Google Scholar

21Riley EP, Infante MA, Warren KR. Fetal alcohol spectrum disorders: an overview. Neuropsychol Rev. 2011 ;21(2):7380. doi: 10.1007/s11065-011-9166-x.Riley EP Infante MA Warren KR Fetal alcohol spectrum disorders: an overview Neuropsychol Rev 20112127380 10.1007/s11065-011-9166-x377927421499711Open DOISearch in Google Scholar

22Stoler JM, Holmes LB. Under-recognition of prenatal alcohol effects in infants of known alcohol abusing women. J Pediatr. 1999;135(4):430-436. doi: 10.1016/S0022-3476(99)70164-2.Stoler JM Holmes LB Under-recognition of prenatal alcohol effects in infants of known alcohol abusing women J Pediatr 19991354430 436 10.1016/S0022-3476(99)70164-2Open DOISearch in Google Scholar

23Stoler JM, Holmes LB. Recognition of facial features of fetal alcohol syndrome in the newborn. Am J Med Genet C Semin Med Genet. 2004;127C(l):21-27. doi: 10.1002/ajmg.c.30012.Stoler JM Holmes LB Recognition of facial features of fetal alcohol syndrome in the newborn Am J Med Genet C Semin Med Genet 2004127Cl21–27 10.1002/ajmg.c.30012Open DOISearch in Google Scholar

24Murawski NJ, Moore EM, Thomas JD, Riley EP. Advances in Diagnosis and Treatment of Fetal Alcohol Spectrum Disorders: From Animal Models to Human Studies. Alcohol Res. 2015;37(1):97-108.Murawski NJ Moore EM Thomas JD Riley EP Advances in Diagnosis and Treatment of Fetal Alcohol Spectrum Disorders: From Animal Models to Human Studies Alcohol Res 201537197 108Search in Google Scholar

25Carter RC, Jacobson JL, Sokol RJ, Avison MJ, Jacobson SW. Fetal alcohol-related growth restriction from birth through young adulthood and moderating effects of maternal prepregnancy weight. Alcohol Clin Exp Res. 2013; 37(3):452-462. doi: 10.1111/j.l530-0277.2012.01940.x.Carter RC Jacobson JL Sokol RJ Avison MJ Jacobson SW Fetal alcohol-related growth restriction from birth through young adulthood and moderating effects of maternal prepregnancy weight Alcohol Clin Exp Res 2013 373452 462 10.1111/j.l530-0277.2012.01940.xOpen DOISearch in Google Scholar

26Jacobson JL, Jacobson SW, Sokol RJ. Effects of prenatal exposure to alcohol, smoking, and illicit drugs on postpartum somatic growth. Alcohol Clin Exp Res. 1994;18(2):317-323. doi: 10.1111/j.l530-0277.1994.tb00020.x.Jacobson JL Jacobson SW Sokol RJ Effects of prenatal exposure to alcohol, smoking, and illicit drugs on postpartum somatic growth Alcohol Clin Exp Res 1994182317 323 10.1111/j.l530-0277.1994.tb00020.xOpen DOISearch in Google Scholar

27Treit S, Zhou D, Chudley AE, et al. Relationships between Head Circumference, Brain Volume and Cognition in Children with Prenatal Alcohol Exposure. PLoS One. 2016;11 (2):e0150370. doi: 10.1371/journal.pone.0150370.Treit S Zhou D Chudley AE et al Relationships between Head Circumference, Brain Volume and Cognition in Children with Prenatal Alcohol Exposure PLoS One 201611 2e0150370 10.1371/journal.pone.0150370Open DOISearch in Google Scholar

28May PA, Blankenship J, Marais AS, Gossage JP, Kalberg WO, Barnard R, De Vries M, Robinson LK, Adnams CM, Buckley D, Manning M, Jones KL, Parry C, Hoyme HE, Seedat S. Approaching the prevalence of the full spectrum of fetal alcohol spectrum disorders in a South African population-based study. Alcohol Clin Exp Res. 2013;37(5):818-830. doi: 10.1111/acer.12033.May PA Blankenship J Marais AS Gossage JP Kalberg WO Barnard R De Vries M Robinson LK Adnams CM Buckley D Manning M Jones KL Parry C Hoyme HE Seedat S. Approaching the prevalence of the full spectrum of fetal alcohol spectrum disorders in a South African population-based study Alcohol Clin Exp Res 2013375818 830 10.1111/acer.12033Open DOISearch in Google Scholar

29Jones KL, Hoyme HE, Robinson LK, del Campo M, Manning MA, Prewitt LM, Chambers CD. Fetal alcohol spectrum disorders: Extending the range of structural defects. Am J Med Genet Part A. 2010;152A(ll):2731-2735. doi: 10.1002/ajmg.a.33675.Jones KL Hoyme HE Robinson LK del Campo M Manning MA Prewitt LM Chambers CD. Fetal alcohol spectrum disorders: Extending the range of structural defects Am J Med Genet Part A 2010152All2731–2735 10.1002/ajmg.a.33675Open DOISearch in Google Scholar

30Mateja WA, Nelson DB, Kroelinger CD, Ruzek S, Segal J. The association between maternal alcohol use and smoking in early pregnancy and congenital cardiac defects. J Womens Health (Larchmt). 2012;21(1):26-34. doi: 10.1089/ jwh.2010.2582.Mateja WA Nelson DB Kroelinger CD Ruzek S Segal J The association between maternal alcohol use and smoking in early pregnancy and congenital cardiac defects J Womens Health (Larchmt) 201221126 34 10.1089/jwh.2010.2582Open DOISearch in Google Scholar

31Slickers JE, Olshan AF, Siega-Riz AM, Honein MA, Aylsworth AS, National Birth Defects Prevention Study. Maternal body mass index and lifestyle exposures and the risk of bilateral renal agenesis or hypoplasia: the National Birth Defects Prevention Study. Am J Epidemiol. 2008;168(11):1259-1267. doi: 10.1093/aje/kwn248.Slickers JE Olshan AF Siega-Riz AM Honein MA Aylsworth AS National Birth Defects Prevention Study. Maternal body mass index and lifestyle exposures and the risk of bilateral renal agenesis or hypoplasia: the National Birth Defects Prevention Study Am J Epidemiol 2008168111259 1267 10.1093/aje/kwn248Open DOISearch in Google Scholar

32Rouse B, Matalon R, Koch R, Azen C, Levy H, Hanley W, Trefz F, De La Cruz F. Maternal phenylketonuria syndrome: Congenital heart defects, microcephaly, and developmental outcomes. J Pediatr. 2000;136(l):57-61. doi: 10.1016/S0022-3476(00)90050-7.Rouse B Matalon R Koch R Azen C Levy H Hanley W Trefz F De La Cruz F. Maternal phenylketonuria syndrome: Congenital heart defects, microcephaly, and developmental outcomes J Pediatr 2000136l57 61 10.1016/S0022-3476(00)90050-7Open DOISearch in Google Scholar

33Leibson T, Neuman G, Chudley AE, Koren G. The differential diagnosis of fetal alcohol spectrum disorder. J Popul Ther Clin Pharmacol. 2014;21(1):e1-e30.Leibson T Neuman G Chudley AE Koren G The differential diagnosis of fetal alcohol spectrum disorder J Popul Ther Clin Pharmacol 2014211e1 e30Search in Google Scholar

34Popova S, Lange S, Probst C, Gmel G, Rehm J. Estimation of national, regional, and global prevalence of alcohol use during pregnancy and fetal alcohol syndrome: a systematic review and meta-analysis. Lancet Glob Heal. 2017;5(3):e290-e299. doi: 10.1016/S2214-109X(17)30021-9.Popova S Lange S Probst C Gmel G Rehm J Estimation of national, regional, and global prevalence of alcohol use during pregnancy and fetal alcohol syndrome: a systematic review and meta-analysis Lancet Glob Heal 201753e290 e299 10.1016/S2214-109X(17)30021-9Open DOISearch in Google Scholar

35Mardby AC, Lupattelli A, Hensing G, Nordeng H. Consumption of alcohol during pregnancy—A multinational European study. Women Birth. 2017;30(4):e207-e213. doi: 10.1016/j.wombi.2017.01.003.Mardby AC Lupattelli A Hensing G Nordeng H Consumption of alcohol during pregnancy—A multinational European study Women Birth 2017304e207 e213 10.1016/j.wombi.2017.01.00328111037Open DOISearch in Google Scholar

36Lange S, Shield K, Koren G, Rehm J, Popova S. A comparison of the prevalence of prenatal alcohol exposure obtained via maternal self-reports versus meconium testing: a systematic literature review and meta-analysis. BMC Pregnancy Childbirth. 2014;14(1):127. doi: 10.1186/1471-2393-14-127.Lange S Shield K Koren G Rehm J Popova S A comparison of the prevalence of prenatal alcohol exposure obtained via maternal self-reports versus meconium testing: a systematic literature review and meta-analysis BMC Pregnancy Childbirth 2014141127 10.1186/1471-2393-14-127399214824708684Open DOISearch in Google Scholar

37Montag AC. Fetal alcohol-spectrum disorders: identifying at-risk mothers. Int J Womens Health. 2016;8:311-323. doi: 10.2147/IJWH.S85403.Montag AC Fetal alcohol-spectrum disorders: identifying at-risk mothers Int J Womens Health 20168311 323 10.2147/IJWH.S85403495959427499649Open DOISearch in Google Scholar

38Gareri J, Lynn H, Handley M, Rao C, Koren G. Prevalence of fetal ethanol exposure in a regional population-basedsample by meconium analysis of fatty acid ethyl esters. Ther Drug Monit. 2008;30(2):239-245. doi:10.1097/ FTD.0b013e318167cfe5.Gareri J Lynn H Handley M Rao C Koren G Prevalence of fetal ethanol exposure in a regional population-basedsample by meconium analysis of fatty acid ethyl esters Ther Drug Monit 2008302239 245 10.1097/FTD.0b013e318167cfe518367988Open DOISearch in Google Scholar

39Himes SK, Dukes KA, Tripp T, Petersen JM, Raffo C, Burd L, Odendaal H, Elliott AJ, Hereid D, Signore C, Willinger M, Huestis MA, Prenatal Alcohol in SIDS and Stillbirth (PASS) Network. Clinical sensitivity and specificity of meconium fatty acid ethyl ester, ethyl glucuronide, and ethyl sulfate for detecting maternal drinking during pregnancy. Clin Chem. 2015;61(3):523-532. doi:10.1373/clinchem.2014.233718.Himes SK Dukes KA Tripp T Petersen JM Raffo C Burd L Odendaal H Elliott AJ Hereid D Signore C Willinger M Huestis MA Prenatal Alcohol in SIDS and Stillbirth (PASS) Network. Clinical sensitivity and specificity of meconium fatty acid ethyl ester, ethyl glucuronide, and ethyl sulfate for detecting maternal drinking during pregnancy Clin Chem 2015613523 532 10.1373/clinchem.2014.233718448542725595440Open DOISearch in Google Scholar

40Berger L, Fendrich M, Jones J, Fuhrmann D, Plate C, Lewis D. Ethyl glucuronide in hair and fingernails as a longterm alcohol biomarker. Addiction. 2014;109(3):425-431. doi:10.1111/add.12402.Berger L Fendrich M Jones J Fuhrmann D Plate C Lewis D Ethyl glucuronide in hair and fingernails as a longterm alcohol biomarker Addiction 20141093425 431 10.1111/add.12402392715824524319Open DOISearch in Google Scholar