Fetal Watch: Unlocking Early Alcohol Detection in Pregnancy Through Urine Analysis

Previous assessments have suggested that a significant proportion of expectant mothers in Ireland, ranging from 20% to 60%, engage in alcohol consumption during their pregnancies.

Historically, information regarding the consumption of alcohol by pregnant women in Ireland has been confined to self-reported data gathered through questionnaires, a method that may not fully represent the actual consumption patterns. Based on the limited existing data, some medical investigations have projected that Ireland might exhibit the third-highest incidence of Fetal Alcohol Syndrome globally.
This scholarly inquiry, identified by the title ‘Urinary alcohol and ethyl glucuronide as a screening tool for alcohol use in pregnancy: a multicentre prospective study,’ marks the inaugural investigation in Ireland to employ objective laboratory methodologies for the detection of alcohol consumption in the early stages of pregnancy. Its findings were disseminated today within the esteemed journal Acta Obstetricia et Gynecologica Scandinavica.
The researchers embarked on this study with the objective of acquiring empirical evidence of alcohol consumption during the initial phases of pregnancy by analyzing urine samples. The ultimate aim was to facilitate the provision of support and therapeutic interventions for affected women.
The investigation assessed the efficacy and the degree of acceptance associated with employing urine testing as a screening mechanism for alcohol consumption among pregnant individuals. This was undertaken to cultivate a more profound comprehension of consumption habits during gestation through the application of objective evaluative techniques.
Professor Fionnuala McAuliffe, a senior co-author and a distinguished Full Professor of Obstetrics and Gynaecology at the UCD Perinatal Research Centre, UCD School of Medicine, and the National Maternity Hospital, who also holds prominence as a leading authority in perinatal health research, commented: “The outcomes revealed that alcohol intake during the early stages of pregnancy is remarkably low. This represents an objective indicator of alcohol consumption, and the testing process was highly well-received by the participants. Alcohol consumption during pregnancy is a matter of considerable concern, and it is imperative that women are furnished with information that empowers them to make healthful choices throughout their pregnancy.”
She further elaborated: “There is no ascertainable safe threshold for alcohol consumption during pregnancy, and the findings of minimal alcohol levels in this extensive, multicenter study indicate that the predominant majority of women are adhering to public health guidance during early gestation. Our ongoing research endeavors are directed towards the development of early identification, feedback, and support frameworks designed to mitigate the occurrence of fetal alcohol spectrum disorder.”
The research was executed across one urban hospital and two semi-rural healthcare facilities in Ireland, enrolling expectant mothers aged 18 years and above who attended appointments around the 13-week gestation mark. A substantial 84% of the women provided consent to participate, resulting in the collection of 1,053 urine specimens. Notably, none of these samples yielded a positive result for ethanol (an immediate metabolite of recently consumed alcohol).
In contrast, a mere four samples, representing 0.4% of the total, tested positive for ethyl glucuronide, a persistent metabolite of alcohol that can be detected within a timeframe of 24 to 80 hours following alcohol ingestion.

Fetal alcohol spectrum disorder is recognized as a primary contributor to preventable neurodevelopmental impairments. It possesses the potential to manifest as learning difficulties, emotional disturbances, or behavioral anomalies, with ramifications that can persist throughout an individual’s lifetime. It is immensely encouraging that our findings suggest alcohol consumption during pregnancy is less prevalent in Ireland than previously anticipated.”

Prof Aiden McCormick, a liver specialist affiliated with St Vincent’s University Hospital and a co-author of the study

The investigative work was undertaken by researchers associated with the UCD Perinatal Research Centre at the National Maternity Hospital, the National Drug Treatment Centre, Wexford General Hospital, St Luke’s Hospital in Kilkenny, and the Liver Unit at St Vincent’s University Hospital.