{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T17:58:44Z","timestamp":1789063124517,"version":"build-2803163510"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2019,4,26]],"date-time":"2019-04-26T00:00:00Z","timestamp":1556236800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Northumbria Healthcare NHS Foundation Trust Research and Development department"},{"name":"Helena Biosciences Europe"},{"name":"Northumbria Healthcare NHS Foundation Trust"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,2,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>We previously investigated the prevalence of alcohol consumption in early pregnancy in Northumbria Healthcare NHS Foundation Trust, a locality of north-east England. The prevalence was 1.4% based on blood sample biomarker analysis using carbohydrate deficient transferrin (CDT) and 3.5% for gamma-glutamyltransferase (GGT).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>To supplement this research by investigating the prevalence of alcohol use using identical methods in a different locality of the same region.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Six-hundred random blood samples taken at the antenatal booking appointment were anonymously analysed for the presence of CDT, a validated marker of chronic alcohol exposure (normalizing 2\u20133 weeks from abstinence) and GGT, a liver enzyme elevated for up to 8 weeks after alcohol exposure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The North Tees and Hartlepool NHS Foundation Trust data revealed a CDT prevalence rate of 1.7% (95% CI: 0.7\u20132.9) and GGT prevalence rate of 4.2% (95% CI: 2.6\u20135.9). However, these measures are not sensitive to low levels of alcohol; and no overlapping cases were identified or a significant correlation demonstrated between CDT or GGT.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>These data support our earlier work. Prevalence rates according to CDT and GGT analysis were similar in both areas, suggesting similar patterns of sustained alcohol use in pregnancy across the region.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/pubmed\/fdz039","type":"journal-article","created":{"date-parts":[[2019,3,19]],"date-time":"2019-03-19T13:25:24Z","timestamp":1553001924000},"page":"e74-e80","source":"Crossref","is-referenced-by-count":2,"title":["Assessing the prevalence of alcohol consumption in early pregnancy using blood biomarker analysis: a consistent pattern across north-east England?"],"prefix":"10.1093","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5557-8358","authenticated-orcid":false,"given":"Helen","family":"Howlett","sequence":"first","affiliation":[{"name":"Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shonag","family":"Mackenzie","sequence":"first","affiliation":[{"name":"Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William K","family":"Gray","sequence":"first","affiliation":[{"name":"Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Rankin","sequence":"first","affiliation":[{"name":"Institute of Health & Society, Newcastle University, Newcastle Upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leanne","family":"Nixon","sequence":"first","affiliation":[{"name":"Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigel W","family":"Brown","sequence":"first","affiliation":[{"name":"Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,4,26]]},"reference":[{"issue":"12","key":"2020022702315117600_fdz039C1","doi-asserted-by":"crossref","first-page":"2168","DOI":"10.1111\/j.1530-0277.2012.01832.x","article-title":"Fetal brain function in response to maternal alcohol consumption: early evidence of damage","volume":"36","author":"Hepper","year":"2012","journal-title":"Alcohol Clin Exp Res"},{"key":"2020022702315117600_fdz039C2","author":"Department of Health."},{"issue":"10","key":"2020022702315117600_fdz039C3","doi-asserted-by":"crossref","first-page":"1779","DOI":"10.1111\/j.1530-0277.2012.01783.x","article-title":"Alcohol consumption among pregnant women in a Swedish sample and its effects on the newborn outcomes","volume":"36","author":"Comasco","year":"2012","journal-title":"Alcohol Clin Exp Res"},{"key":"2020022702315117600_fdz039C4","volume-title":"Alcohol and Pregnancy: Preventing and Managing Fetal Alcohol Spectrum Disorders","author":"British Medical Association Board of Science","year":"2016"},{"issue":"5","key":"2020022702315117600_fdz039C5","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1542\/peds.2013-3319","article-title":"Prevalence and characteristics of fetal alcohol spectrum disorders","volume":"134","author":"May","year":"2014","journal-title":"Pediatrics"},{"issue":"1","key":"2020022702315117600_fdz039C6","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1111\/acer.12214","article-title":"The association of mild, moderate, and binge prenatal alcohol exposure and child neuropsychological outcomes: a meta-analysis","volume":"38","author":"Flak","year":"2014","journal-title":"Alcohol Clin Exp Res"},{"issue":"9","key":"2020022702315117600_fdz039C7","doi-asserted-by":"crossref","first-page":"e0138611","DOI":"10.1371\/journal.pone.0138611","article-title":"Low to moderate average alcohol consumption and binge drinking in early pregnancy: effects on choice reaction time and information processing time in five-year-old children","volume":"10","author":"Kilburn","year":"2015","journal-title":"PLoS One"},{"issue":"6","key":"2020022702315117600_fdz039C8","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1136\/jech-2013-202934","article-title":"Maternal alcohol intake prior to and during pregnancy and risk of adverse birth outcomes: evidence from a British cohort","volume":"68","author":"Nykjaer","year":"2014","journal-title":"J Epidemiol Community Health"},{"issue":"9","key":"2020022702315117600_fdz039C9","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1111\/1471-0528.12208","article-title":"The effects of low to moderate alcohol consumption and binge drinking in early pregnancy on behaviour in 5-year-old children: a prospective cohort study on 1628 children","volume":"120","author":"Skogerbo","year":"2013","journal-title":"BJOG"},{"issue":"11","key":"2020022702315117600_fdz039C10","doi-asserted-by":"crossref","first-page":"e49407","DOI":"10.1371\/journal.pone.0049407","article-title":"Fetal alcohol exposure and IQ at age 8: evidence from a population-based birth-cohort study","volume":"7","author":"Lewis","year":"2012","journal-title":"PLoS One"},{"key":"2020022702315117600_fdz039C11","volume-title":"Better Births: Improving Outcomes of Maternity Services in England","author":"National Maternity Review","year":"2016"},{"key":"2020022702315117600_fdz039C12","author":"Health, D.o.","year":"2017"},{"key":"2020022702315117600_fdz039C13","first-page":"143","article-title":"FASD is it something we should be more aware of?","volume":"42","author":"Mukherjee","year":"2012","journal-title":"J R Soc Med"},{"key":"2020022702315117600_fdz039C14","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1186\/1471-2393-14-127","article-title":"A comparison of the prevalence of prenatal alcohol exposure obtained via maternal self-reports versus meconium testing: a systematic literature review and meta-analysis","volume":"14","author":"Lange","year":"2014","journal-title":"BMC Pregnancy Childbirth"},{"issue":"1","key":"2020022702315117600_fdz039C15","first-page":"56","article-title":"Focus on: biomarkers of fetal alcohol exposure and fetal alcohol effects","volume":"34","author":"Bakhireva","year":"2011","journal-title":"Alcohol Res Health"},{"issue":"4","key":"2020022702315117600_fdz039C16","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1080\/08897070209511493","article-title":"Measurement of maternal alcohol consumption in a pregnant population","volume":"23","author":"Savage","year":"2002","journal-title":"Subst Abus"},{"issue":"2","key":"2020022702315117600_fdz039C17","doi-asserted-by":"crossref","first-page":"157","DOI":"10.15288\/jsa.2005.66.157","article-title":"Unexpectedly high prevalence of alcohol use among pregnant Swedish women: failed detection by antenatal care and simple tools that improve detection","volume":"66","author":"Magnusson","year":"2005","journal-title":"J Stud Alcohol"},{"key":"2020022702315117600_fdz039C18","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.ejogrb.2017.04.005","article-title":"How strong is the evidence for using blood biomarkers alone to screen for alcohol consumption during pregnancy? A systematic review","volume":"213","author":"Howlett","year":"2017","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"9","key":"2020022702315117600_fdz039C19","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/j.ejmg.2018.05.009","article-title":"Assessing prevalence of alcohol consumption in early pregnancy: self-report compared to blood biomarker analysis","volume":"61","author":"Howlett","year":"2018","journal-title":"Eur J Med Genet"},{"key":"2020022702315117600_fdz039C20","volume-title":"Alcohol-Related Deaths in the UK, Registered in 2014","author":"Office for National Statistics","year":"2016"},{"key":"2020022702315117600_fdz039C21","volume-title":"Local Alcohol Profiles for England: March 2017","author":"Public Health England","year":"2017"},{"issue":"8","key":"2020022702315117600_fdz039C22","doi-asserted-by":"crossref","first-page":"569","DOI":"10.3109\/10826084.2013.786730","article-title":"Monitoring population levels of alcohol consumption in pregnant women: a case for using biomarkers","volume":"48","author":"Shipton","year":"2013","journal-title":"Subst Use Misuse"},{"issue":"10","key":"2020022702315117600_fdz039C23","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1111\/j.1360-0443.2005.01216.x","article-title":"Validity of carbohydrate-deficient transferrin (%CDT), gamma-glutamyltransferase (gamma-GT) and mean corpuscular erythrocyte volume (MCV) as biomarkers for chronic alcohol abuse: a study in patients with alcohol dependence and liver disorders of non-alcoholic and alcoholic origin","volume":"100","author":"Hock","year":"2005","journal-title":"Addiction"},{"issue":"3","key":"2020022702315117600_fdz039C24","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1016\/S0022-3476(98)70267-7","article-title":"The prenatal detection of significant alcohol exposure with maternal blood markers","volume":"133","author":"Stoler","year":"1998","journal-title":"J Pediatr"},{"issue":"5","key":"2020022702315117600_fdz039C25","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1515\/cclm-2012-0767","article-title":"Toward standardization of carbohydrate-deficient transferrin (CDT) measurements: III. Performance of native serum and serum spiked with disialotransferrin proves that harmonization of CDT assays is possible","volume":"51","author":"Weykamp","year":"2013","journal-title":"Clin Chem Lab Med"},{"issue":"1","key":"2020022702315117600_fdz039C26","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1093\/clinchem\/47.1.13","article-title":"Carbohydrate-deficient transferrin as a marker of chronic alcohol abuse: a critical review of preanalysis, analysis, and interpretation","volume":"47","author":"Arndt","year":"2001","journal-title":"Clin Chem"},{"issue":"6","key":"2020022702315117600_fdz039C27","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1373\/clinchem.2007.102145","article-title":"Insufficient standardization of a direct carbohydrate-deficient transferrin immunoassay","volume":"54","author":"Helander","year":"2008","journal-title":"Clin Chem"},{"issue":"4","key":"2020022702315117600_fdz039C28","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1007\/s00414-012-0812-5","article-title":"Comparison of direct and indirect alcohol markers with PEth in blood and urine in alcohol dependent inpatients during detoxication","volume":"127","author":"Winkler","year":"2013","journal-title":"Int J Legal Med"},{"issue":"5","key":"2020022702315117600_fdz039C29","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1093\/alcalc\/ags065","article-title":"Monitoring of the alcohol biomarkers PEth, CDT and EtG\/EtS in an outpatient treatment setting","volume":"47","author":"Helander","year":"2012","journal-title":"Alcohol Alcohol"},{"issue":"4","key":"2020022702315117600_fdz039C30","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1093\/alcalc\/agv038","article-title":"Phosphatidylethanol compared with other blood tests as a biomarker of moderate alcohol consumption in healthy volunteers: a prospective randomized study","volume":"50","author":"Kechagias","year":"2015","journal-title":"Alcohol Alcohol"},{"issue":"6","key":"2020022702315117600_fdz039C31","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1016\/0002-9378(83)90444-1","article-title":"Evaluation of serum gamma-glutamyl transferase as a screening method for excessive alcohol consumption during pregnancy","volume":"147","author":"Larsson","year":"1983","journal-title":"Am J Obstet Gynecol"},{"issue":"3","key":"2020022702315117600_fdz039C32","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1093\/alcalc\/agv117","article-title":"The economic burden of fetal alcohol spectrum disorder in Canada in 2013","volume":"51","author":"Popova","year":"2016","journal-title":"Alcohol Alcohol"},{"issue":"2","key":"2020022702315117600_fdz039C33","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1159\/000263460","article-title":"Can prenatal screening for fetal alcohol spectrum disorder be justified? A commentary","volume":"69","author":"Mizejewski","year":"2010","journal-title":"Gynecol Obstet Invest"},{"key":"2020022702315117600_fdz039C34","doi-asserted-by":"crossref","DOI":"10.1093\/oxfordhb\/9780199935291.013.78","volume-title":"Burden and Social Cost of Fetal Alcohol Spectrum Disorders","author":"Popova","year":"2016"},{"key":"2020022702315117600_fdz039C35","volume-title":"Guidelines for the Identification and Management of Substance Use and Substance Use Disorders in Pregnancy","author":"World Health Organization","year":"2014"},{"key":"2020022702315117600_fdz039C36","author":"National Institute for Health and Care Excellence","year":"2008"},{"issue":"8","key":"2020022702315117600_fdz039C37","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1177\/1744987117745579","article-title":"A survey of attitudes, beliefs and practice regarding alcohol use and screening in pregnancy: an opportunity for support and education?","volume":"22","author":"Howlett","year":"2017","journal-title":"J Res Nursing"},{"key":"2020022702315117600_fdz039C38","author":"NOFAS-UK"},{"key":"2020022702315117600_fdz039C39","author":"Statistics, O.f.N.","year":"2018"},{"issue":"3","key":"2020022702315117600_fdz039C40","doi-asserted-by":"crossref","first-page":"e290","DOI":"10.1016\/S2214-109X(17)30021-9","article-title":"Estimation of national, regional, and global prevalence of alcohol use during pregnancy and fetal alcohol syndrome: a systematic review and meta-analysis","volume":"5","author":"Popova","year":"2017","journal-title":"Lancet Glob Health"},{"key":"2020022702315117600_fdz039C41","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.ypmed.2018.10.013","article-title":"Screening prevalence of fetal alcohol spectrum disorders in a region of the United Kingdom: a population-based birth-cohort study","volume":"118","author":"McQuire","year":"2019","journal-title":"Prev Med"},{"key":"2020022702315117600_fdz039C42","author":"Office for National Statistics","year":"2015"},{"issue":"3","key":"2020022702315117600_fdz039C43","doi-asserted-by":"crossref","first-page":"e232","DOI":"10.1016\/S2214-109X(17)30008-6","article-title":"High global prevalence of alcohol use during pregnancy and fetal alcohol syndrome indicates need for urgent action","volume":"5","author":"Tsang","year":"2017","journal-title":"Lancet Glob Health"}],"container-title":["Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jpubhealth\/article-pdf\/42\/1\/e74\/32650816\/fdz039.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jpubhealth\/article-pdf\/42\/1\/e74\/32650816\/fdz039.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,2,27]],"date-time":"2020-02-27T02:35:05Z","timestamp":1582770905000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jpubhealth\/article\/42\/1\/e74\/5480292"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4,26]]},"references-count":43,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,4,26]]},"published-print":{"date-parts":[[2020,2,28]]}},"URL":"https:\/\/doi.org\/10.1093\/pubmed\/fdz039","relation":{},"ISSN":["1741-3842","1741-3850"],"issn-type":[{"value":"1741-3842","type":"print"},{"value":"1741-3850","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,3]]},"published":{"date-parts":[[2019,4,26]]}}}