A utilitarian comparison of two alcohol use biomarkers with self-reported drinking history collected in antenatal clinics.

Background Alcohol use is reported accurately among pregnant women in some populations. Methods Self-reported alcohol use via the AUDIT and 90-day recall for 193 women from antenatal clinics was compared to biomarker results: phosphatidylethanol (PEth) from bloodspots and ethyl glucuronide (EtG) in fingernails. Results AUDIT was positive for 67.9% of respondents, and 65.3% directly reported drinking. Individual biomarkers detected less drinking (PEth = 57.0%, EtG = 38.9%) than self-report. But 64.8% had drinking-positive values (>8 ng) on one or both biomarkers, which was not significantly different from self-report. Biomarkers indicated that 3.1% −6.8% of drinkers denied drinking. Combined biomarker sensitivity was 95% −80% and specificity 49% −76% for drinking in the previous 7–90 days. Combined biomarker results have their best yield (89.6%) and accuracy (78.8%) when measuring 90 day drinking. Conclusions Women reported their alcohol use accurately, and the combined use of PEth and EtG is supported. [ABSTRACT FROM AUTHOR]