Abstract：
Fetal alcohol exposure is a growing public health concern. However, ascertaining its true extent remains challenging as maternal self-reports may lack validity. Increasingly, interest has turned to more objective measures of prenatal alcohol use (PAU) of which one, meconium, is recognized as a valuable tool. This review assesses both the international prevalence of PAU obtained using meconium biomarkers in general maternity populations and, when feasible, the level of agreement between meconium biomarkers and self-reported PAU. A systematic literature search for studies reporting the prevalence of PAU, as determined by meconium biomarker testing, was conducted using multiple electronic databases from 1990 to 2023. Seventeen studies were identified for inclusion and evaluated for methodological quality. Using fatty acid ethyl esters (FAEEs) meconium biomarkers, PAU prevalence varied from 2.4% to 44%. Rates based on EtG (ethyl glucuronide) analysis ranged from 0% to 16.3%, and EtS (ethyl sulfate) analysis from 7.8% to 16.7%. Studies were of moderate quality with high heterogeneity. Prevalence rates based on self-report data ranged from 0% to 46.4%. When reported, none of the reviewed studies identified agreement between meconium-based and self-report-based PAU prevalence rates. Using both self-reports to detect early pregnancy alcohol use, and meconium biomarkers to detect the occurrence of alcohol use later in pregnancy, may provide a more complete picture of PAU prevalence. Furthermore, research is warranted to develop stringent guidance on the ascertainment, storage, analysis, and reporting required in this field.
摘要：
胎儿酒精暴露是一个日益严重的公共卫生问题。然而,由于母亲的自我报告可能缺乏有效性，因此确定其真实程度仍然具有挑战性。越来越多,兴趣转向了更客观的产前饮酒(PAU)衡量标准，胎粪,被认为是一种有价值的工具。这篇综述评估了在一般产妇人群中使用胎粪生物标志物获得的PAU的国际患病率，在可行的情况下，胎粪生物标志物与自我报告PAU之间的一致性水平。对报告PAU患病率的研究进行系统的文献检索，通过胎粪生物标志物测试确定，从1990年到2023年，使用多个电子数据库进行。确定了17项研究纳入并评估了方法学质量。使用脂肪酸乙酯（FAEEs）胎粪生物标志物，PAU患病率从2.4%到44%不等。基于EtG（乙基葡糖苷酸）分析的比率范围为0％至16.3％，和EtS(硫酸乙酯)分析从7.8%至16.7%。研究质量中等，异质性高。基于自我报告数据的患病率范围为0%至46.4%。报告时，审查的研究没有发现基于胎粪和基于自我报告的PAU患病率之间的一致性。使用两个自我报告来检测怀孕早期饮酒，和胎粪生物标志物来检测怀孕后期饮酒的发生，可以提供更完整的PAU患病率图片。此外，有必要进行研究，以制定严格的确定指导，storage,分析,以及该领域所需的报告。
