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，但没有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) 是在胎粪中测量的乙醇非氧化代谢物，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，研究了胎便中 FAEE 浓度与青少年药物使用及相关问题之间的关联。 FAEE 通过火焰离子化检测器通过气相色谱法进行定量。对 216 名新生儿的胎便进行了 FAEE 分析；其中 183 人（81 名男孩，102 名女孩）在 15 岁时接受了生物检测和自我报告的酒精、烟草和大麻使用情况评估。使用青少年问题导向筛查工具评估药物使用问题。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）与较高的可能性相关。 15 岁时吸食大麻并出现物质使用问题，但不使用烟草或酒精。胎便中 FAEE 水平升高可能是 PAE 的有希望的标志物，可识别处于早期物质使用和出现物质使用问题风险的新生儿。