A newborn’s first stool can signal the child may struggle with persistent
cognitive problems, according to Case Western Reserve University Project Newborn
In particular, high levels of fatty acid ethyl esters (FAEE) found in the
meconium (a newborn’s first stool) from a mother’s alcohol use during pregnancy
can alert doctors that a child is at risk for problems with intelligence and
Left untreated, such problems persist into the teen years, the research team
from the Jack, Joseph and Morton Mandel School of Applied Social Sciences found.
“We wanted to see if there was a connection between FAEE level and their
cognitive development during childhood and adolescence–and there was,” said
Meeyoung O. Min, PhD, research assistant professor at the Mandel School and the
study’s lead researcher. “FAEE can serve as a marker for fetal alcohol exposure
and developmental issues ahead.”
Detecting prenatal exposure to alcohol at birth could lead to early
interventions that help reduce the effects later, Min said.
The research is part of the ongoing Project Newborn study, a longitudinal
research project funded by the National Institutes of Health’s National
Institute on Drug Abuse that has followed the physical, social and cognitive
developments of babies born to mothers who used cocaine, alcohol and other drugs
during their pregnancies.
Project Newborn has studied nearly 400 children for 20 years since their births
in the mid-1990s.
For this study, researchers analyzed the meconium of 216 subjects for levels of
FAEE. (FAEE are composed of a group of products from metabolizing alcohol; this
study examined ethyl myristate, ethyl oleate ethyl linoleateand
They then gave intelligence tests at ages 9, 11 and 15.
The conclusion: There was a link between those with high levels of FAEE at birth
and lower IQ scores.
“Although we already knew a mother’s alcohol use during her pregnancy may cause
cognitive deficits, what is significant is that the early marker, not previously
available, predicted this, establishing the predictive validity of FAEEs for
determining alcohol exposure in utero” Min said.
The study was among the first to examine an association between FAEEs in
meconium and cognitive development during childhood and adolescence.
Newborns with distinctive fetal alcohol facial characteristics–such as a
smaller head and eyes, thin upper lip and a smooth ridge between upper lip
and nose–are more easily identifiable. But many babies exposed to alcohol
can still appear normal. And many mothers are reluctant to reveal how much
they drank while pregnant because of the stigma. So prenatal alcohol
exposure is often missed. Thus, clinical biomarkers are instrumental for
identifying alcohol-exposed neonates, regardless of mothers’ report of
alcohol use or not during pregnancy.
It is estimated that as many as 2 to 5 percent of younger school children in
the United States and Western Europe are affected by developmental
disabilities resulting from alcohol exposure in utero, with a much higher
prevalence (17 percent) reported in the child welfare system.
Previously, Project Newborn researchers found associations between high
levels of FAEE and mental and psychomotor development problems during the
first two years. The new study is an extension of the previous findings. In
the current study researchers
- 60 percent of the 191 mothers reported drinking while pregnant, with an
average of 6.5 standard drinks weekly (one standard drink equals to 0.5
oz. of absolute alcohol).
- Of those women, 63 percent engaged in risk drinking.
- 15 mothers (13 percent) had at least 12 drinks per week.