Prenatal alcohol exposure (PAE) continues to be a serious public health problem, yet no reliable clinical tools are available for assessing levels of drinking during pregnancy. Fatty acid ethyl esters (FAEEs), the nonoxidative metabolites of ethanol measured in meconium, are potential biomarkers to quantify the level of PAE. The association between the concentrations of FAEEs from meconium and adolescent substance use and related problems was examined in a prospective birth-cohort of adolescents exposed to alcohol and drugs in utero. FAEEs were quantified with gas chromatography via a flame ionization detector. Meconium was analyzed for FAEEs in 216 newborns; 183 of them (81 boys, 102 girls) were assessed at age 15 for alcohol, tobacco, and marijuana use using biologic assays and self-report. Substance use problems were assessed using the Problem Oriented Screening Instrument for Teenagers. Findings from multivariable logistic regression analyses indicated that, after controlling for other prenatal drug exposure and covariates, higher concentrations of FAEEs (ethyl myristate, ethyl palmitate, ethyl oleate, ethyl linoleate, ethyl linolenate, and ethyl arachidonate) were related to a greater likelihood of marijuana use and experiencing substance use problems, but not tobacco or alcohol use, at age 15. Elevated levels of FAEEs in meconium may be promising markers for PAE, identifying newborns at risk for early substance use and developing substance use problems.

产前酒精暴露 (PAE) 仍然是一个严重的公共卫生问题，但尚无可靠的临床工具可用于评估怀孕期间的饮酒水平。脂肪酸乙酯 (FAEE) 是在胎粪中测得的乙醇的非氧化代谢物，是量化 PAE 水平的潜在生物标志物。在子宫内暴露于酒精和药物的青少年的前瞻性出生队列中，研究了来自胎粪的 FAEE 浓度与青少年物质使用和相关问题之间的关联。通过火焰离子化检测器用气相色谱法对 FAEE 进行量化。对 216 名新生儿的胎粪进行了 FAEE 分析；其中 183 人（81 名男孩，102 名女孩）在 15 岁时使用生物测定和自我报告评估了酒精、烟草和大麻的使用情况。使用面向青少年的问题导向筛选工具评估物质使用问题。多变量逻辑回归分析的结果表明，在控制其他产前药物暴露和协变量后，较高浓度的 FAEE（肉豆蔻酸乙酯、棕榈酸乙酯、油酸乙酯、亚油酸乙酯、亚麻酸乙酯和花生四烯酸乙酯）与更大的可能性相关15 岁时吸食大麻并出现物质使用问题，但未吸食烟草或酒精。胎粪中 FAEE 水平升高可能是 PAE 的有前途的标记，可识别有早期物质使用风险和出现物质使用问题的新生儿。