Prenatal alcohol exposure prevalence as measured by direct ethanol metabolites in meconium in a Native American tribe of the southwest.

Background: Although fetal alcohol spectrum disorders represent a significant public health problem, Native Americans are underrepresented in population and targeted screening programs. Prior reports suggest that Native American tribal communities may have a higher prevalence of alcohol use during pregnancy; however, systematic examination using ethanol biomarkers is lacking.

Methods: This study utilized data collected through the Navajo Birth Cohort Study (NBCS)-a birth cohort study of a Southwestern tribal community. Prevalence of prenatal alcohol exposure (PAE) was assessed by a battery of meconium biomarkers among 333 NBCS participants. Meconium samples were analyzed for nine individual fatty acid ethyl ester (FAEE) species, ethyl glucuronide (EtG), and ethyl sulfate (EtS) by LC-MS/MS.

Results: Participants were recruited from five hospitals at the Navajo Nation located in Arizona (Chinle, Tséhootsooí, Tuba City) and New Mexico (Gallup, Shiprock). All participants identified as Native American; most reported a personal income of <$20,000 per year (71.3%), and ≤high school education (55.3%). The most prevalent biomarker was EtS (7.8%) followed by ethyl oleate (6.9%); 5.4% of the sample were positive for at least two biomarkers.

Conclusions: Results of this study on the prevalence of PAE in the Navajo Nation, obtained for the first time with an objective comprehensive panel of meconium biomarkers, indicate that the rates in the NBCS may be comparable to the general U.S. population and are in accord with recent U.S. national survey estimates. Our findings emphasize that drinking behaviors among Native American communities in the United States can vary, and generalization across all Native American populations is not warranted.