Study examines the effectiveness of urine testing as a screening tool for alcohol use in pregnancy

Previous reports have indicated that between 20 and 60 per cent of pregnant women in Ireland consume alcohol during pregnancy.

Data on alcohol consumption by pregnant women in Ireland has previously only been collected through self-reporting in questionnaires, which may give an incomplete picture of consumption. Based on the available data, some medical research has extrapolated that Ireland could have the third highest prevalence of foetal alcohol syndrome in the world.

The study, entitled 'Urinary alcohol and ethyl glucuronide as a screening tool for alcohol use in pregnancy: a multicentre prospective study,' is the first study in Ireland to use objective laboratory methods to detect alcohol use in early pregnancy and was published today in the journal Acta Obstetricia et Gynecologica Scandinavica.

Researchers conducted the study to obtain objective evidence of alcohol consumption in early pregnancy by testing urine, with a view to offering support and treatment for women.

The study tested the effectiveness and acceptability of urine testing to screen for alcohol use by pregnant women, in order to gain a better understanding of consumption during pregnancy using objective measures.

Senior co-author, Full Professor of Obstetrics and Gynaecology at UCD Perinatal Research Centre, UCD School of Medicine and the National Maternity Hospital, and leading expert in perinatal health research, Prof Fionnuala McAuliffe said: "The findings showed that alcohol intake during early pregnancy is very low. This is an objective measure of alcohol intake and testing was very acceptable to women. Alcohol intake during pregnancy is a concern and it is important that women have information to enable them to take healthy decisions during pregnancy."

She said: "There is no safe limit of alcohol in pregnancy and the findings of low levels of alcohol in this large multicentre study show that the majority of women are heeding public health advice in early pregnancy. Our ongoing research aims to develop early identification, feedback and support systems to prevent fetal alcohol spectrum disorder."

The study was conducted at one urban hospital and two semi-rural hospitals in Ireland, and included expectant mothers over 18 years of age, attending for visits at around 13 weeks of pregnancy. Some 84 per cent of women consented to participate, yielding 1,053 urine samples, with none testing positive for ethanol (a metabolite of just consumed alcohol).

Just four samples (0.4 per cent) tested positive for ethyl glucuronide which is a long lasting metabolite of alcohol that can be detected from 24 to 80 hours after consuming alcohol.

Fetal alcohol spectrum disorder is believed to be a leading cause of preventable neurodevelopmental disorder. It may cause learning, emotional or behavioural abnormalities with life-long consequences. It is very encouraging that our results show that alcohol use in pregnancy is less common than expected in Ireland."

Prof Aiden McCormick, liver specialist at St Vincent's University Hospital and co-author

The study was conducted by researchers at UCD Perinatal Research Centre at the National Maternity Hospital, the National Drug Treatment Centre, Wexford General Hospital, St Lukes's Hospital, Kilkenny, and the Liver Unit, St Vincent's University Hospital.