1
|
Wainstock T, Walfisch A, Sergienko R, Sheiner E. Maternal anemia and pediatric neurological morbidity in the offspring - Results from a population based cohort study. Early Hum Dev 2019; 128:15-20. [PMID: 30445347 DOI: 10.1016/j.earlhumdev.2018.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/17/2018] [Accepted: 11/01/2018] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Maternal anemia (Hemoglobin, <11 mg/dl) has been shown to affect fetal growth and pregnancy outcome. We aimed to study a possible association between maternal anemia and the risk for neurological morbidity in the offspring, during a follow-up period of up to 18 years. STUDY DESIGN A population-based cohort analysis was performed at the Soroka University Medical Center (SUMC), a single regional tertiary center comparing total and specific subtypes of neurological morbidities associated with hospitalizations among children stratified by three maternal post-partum hemoglobin categories: ≥11 mg/dl (no anemia); 11.0 mg/dl > Hb ≥ 7 mg/dl (mild-to-moderate anemia) and <7 mg/dl (severe anemia). Data on pregnancy course and outcome, and later offspring hospitalizations, were compared between the three study groups. All singleton deliveries between the years 1991-2014 were included in the analysis, and congenital malformations were excluded. A Kaplan-Meier survival curve was used to compare cumulative hospitalization incidence based on maternal anemia status, and a Weibull survival multivariable hazard model was constructed to adjust for confounding variables. RESULTS The study population included 217,358 deliveries of which 50.6% were in mothers who were not anemic, 49.0% in mothers with moderate anemia and 0.4% in mothers with severe anemia. During the follow up period (0-18 years, median 10.22 years), 2.1% of offspring were hospitalized with a neurological diagnoses. Neurological hospitalization incidence decreased from 2.95/1000 person years, in the severe anemia group, to 2.32/1000 person years and 2.01/1000 person years, among the mild-to-moderate and no anemia groups, respectively (p = 0.007). The association between maternal anemia and offspring long-term pediatric neurological morbidity remained significant in a Weibull hazards model controlled for gestational age, delivery mode, SGA and insufficient prenatal care (adjusted HR 1.55; 1.05-2.31 and adjusted HR 1.13; 1.06-1.20; among the severe and mild-to-moderate anemia, vs. no anemia, respectively). CONCLUSION Children born to anemic mothers are at an increased risk for pediatric neurological-related hospitalizations.
Collapse
Affiliation(s)
- Tamar Wainstock
- The Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Asnat Walfisch
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ruslan Sergienko
- The Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Eyal Sheiner
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| |
Collapse
|
2
|
Lucas BR, Latimer J, Fitzpatrick JP, Doney R, Watkins RE, Tsang TW, Jirikowic T, Carmichael Olson H, Oscar J, Carter M, Elliott EJ. Soft neurological signs and prenatal alcohol exposure: a population-based study in remote Australia. Dev Med Child Neurol 2016; 58:861-7. [PMID: 26991727 DOI: 10.1111/dmcn.13071] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/17/2015] [Indexed: 11/29/2022]
Abstract
AIM To identify soft neurological signs (SNS) in a population-based study of children living in remote Aboriginal communities in the Fitzroy Valley, Western Australia, born between 2002 and 2003 and explore the relationship between SNS, prenatal alcohol exposure (PAE), and fetal alcohol spectrum disorders (FASD). METHOD The presence of SNS was assessed using the Quick Neurological Screening Test, 2nd edition (QNST-2), which has a total maximum score of 140. Higher scores indicated more SNS. 'Severe discrepancy' was defined as scores less than or equal to the fifth centile while 'moderate discrepancy' represented scores from the sixth to the 24th centile. Children were assigned FASD diagnoses using modified Canadian FASD diagnostic guidelines. RESULTS A total of 108 of 134 (80.6%) eligible children (mean age 8y 9mo, SD=6mo, 53% male) were assessed. The median QNST-2 Total Score for all participants was within the normal category (19.0, range 4-66). However, the median QNST-2 Total Score was higher in children with than without (1) PAE (r=0.2, p=0.045) and (2) FASD (r=0.3, p=0.004). Half (8/16) of children scoring 'moderate discrepancy' and all (2/2) children scoring 'severe discrepancy' had at least three domains of central nervous system impairment. INTERPRETATION SNS were more common in children with PAE or FASD, consistent with the known neurotoxic effect of PAE. The QNST-2 is a useful screen for subtle neurological dysfunction indicating the need for more comprehensive assessment in children with PAE or FASD.
Collapse
Affiliation(s)
- Barbara R Lucas
- Discipline of Paediatrics and Child Health, The Children's Hospital at Westmead, Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Jane Latimer
- The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - James P Fitzpatrick
- Discipline of Paediatrics and Child Health, The Children's Hospital at Westmead, Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Robyn Doney
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Rochelle E Watkins
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Tracey W Tsang
- Discipline of Paediatrics and Child Health, The Children's Hospital at Westmead, Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Tracy Jirikowic
- Division of Occupational Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Heather Carmichael Olson
- Seattle Children's Research Institute and University of Washington School of Medicine, Seattle, WA, USA
| | - June Oscar
- Marninwarntikura Women's Resource Centre, Fitzroy Crossing, WA, Australia
| | - Maureen Carter
- Nindilingarri Cultural Health Services, Fitzroy Crossing, WA, Australia
| | - Elizabeth J Elliott
- Discipline of Paediatrics and Child Health, The Children's Hospital at Westmead, Clinical School, University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
3
|
Golding J, Emmett P, Iles-Caven Y, Steer C, Lingam R. A review of environmental contributions to childhood motor skills. J Child Neurol 2014; 29:1531-47. [PMID: 24170258 PMCID: PMC4004720 DOI: 10.1177/0883073813507483] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Although much of children's motor skills have a heredity component, at least half of the variance is likely to be influenced by the environment. It is important to ascertain features of the environment that are responsible so that toxins can be avoided, children at risk can be identified, and beneficial interventions initiated. This review outlines the results of published studies and recommends the areas where further research is required. We found much confusion with little comparability concerning the ages or measures used. Few studies had sufficient power and few allowed for confounders. We found that research to date implicates associations with prenatal drinking ≥4 drinks of alcohol per day; diabetes; taking antidepressant drugs; being deficient in iodine or iron; dietary fish; and postnatal depression. The child appearing to be most at risk was born of low birth weight (but not due to preterm delivery) or with neonatal problems.
Collapse
Affiliation(s)
- Jean Golding
- Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | | | | | | | | |
Collapse
|
4
|
Lucas BR, Latimer J, Pinto RZ, Ferreira ML, Doney R, Lau M, Jones T, Dries D, Elliott EJ. Gross motor deficits in children prenatally exposed to alcohol: a meta-analysis. Pediatrics 2014; 134:e192-209. [PMID: 24913787 DOI: 10.1542/peds.2013-3733] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Gross motor (GM) deficits are often reported in children with prenatal alcohol exposure (PAE), but their prevalence and the domains affected are not clear. The objective of this review was to characterize GM impairment in children with a diagnosis of fetal alcohol spectrum disorder (FASD) or "moderate" to "heavy" maternal alcohol intake. METHODS A systematic review with meta-analysis was conducted. Medline, Embase, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, PEDro, and Google Scholar databases were searched. Published observational studies including children aged 0 to ≤18 years with (1) an FASD diagnosis or moderate to heavy PAE, or a mother with confirmed alcohol dependency or binge drinking during pregnancy, and (2) GM outcomes obtained by using a standardized assessment tool. Data were extracted regarding participants, exposure, diagnosis, and outcomes by using a standardized protocol. Methodological quality was evaluated by using Strengthening the Reporting of Observational Studies in Epidemiology guidelines. RESULTS The search recovered 2881 articles of which 14 met the systematic review inclusion criteria. The subjects' mean age ranged from 3 days to 13 years. Study limitations included failure to report cutoffs for impairment, nonstandardized reporting of PAE, and small sample sizes. The meta-analysis pooled results (n = 10) revealed a significant association between a diagnosis of FASD or moderate to heavy PAE and GM impairment (odds ratio: 2.9; 95% confidence interval: 2.1-4.0). GM deficits were found in balance, coordination, and ball skills. There was insufficient data to determine prevalence. CONCLUSIONS The significant results suggest evaluation of GM proficiency should be a standard component of multidisciplinary FASD diagnostic services.
Collapse
Affiliation(s)
- Barbara R Lucas
- Discipline of Paediatrics and Child Health, The University of Sydney, The Children's Hospital at Westmead, Westmead, Australia;The George Institute for Global Health, Sydney Medical School, andPoche Centre for Indigenous Health, Sydney Medical School, The University of Sydney, Sydney, Australia;Physiotherapy Department, and
| | - Jane Latimer
- The George Institute for Global Health, Sydney Medical School, and
| | - Rafael Z Pinto
- Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, Sydney, Australia;Departamento de Fisioterapia, Faculdade de Ciências e Tecnologia, UNESP - Univ Estadual Paulista, Presidente Prudente, Brazil
| | | | - Robyn Doney
- School of Public Health, Curtin University, Western Australia, Australia
| | - Mandy Lau
- The George Institute for Global Health, Sydney Medical School, and
| | - Taryn Jones
- Department of Health Professions, Faculty of Human Sciences, Macquarie University, Sydney, Australia; and
| | | | - Elizabeth J Elliott
- Discipline of Paediatrics and Child Health, The University of Sydney, The Children's Hospital at Westmead, Westmead, Australia;The George Institute for Global Health, Sydney Medical School, andThe Sydney Children's Hospital Networks (Westmead), Westmead, Australia
| |
Collapse
|
5
|
Flak AL, Su S, Bertrand J, Denny CH, Kesmodel US, Cogswell ME. The association of mild, moderate, and binge prenatal alcohol exposure and child neuropsychological outcomes: a meta-analysis. Alcohol Clin Exp Res 2013; 38:214-26. [PMID: 23905882 DOI: 10.1111/acer.12214] [Citation(s) in RCA: 227] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 05/15/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND The objective of this review is to evaluate the literature on the association between mild, moderate, and binge prenatal alcohol exposure and child neurodevelopment. METHODS Meta-analysis with systematic searches of MEDLINE (1970 through August 2012), EMBASE (1988 through August 2012), and PsycINFO(®) (1970 through August 2012) and examination of selected references. RESULTS From 1,593 articles, we identified 34 presenting data from cohort studies that met our inclusion criteria. Information on study population, outcomes, measurement instruments, timing and quantification of alcohol exposure, covariates, and results was abstracted. Outcomes included academic performance, attention, behavior, cognition, language skills, memory, and visual and motor development. The quality of each article was assessed by 2 researchers using the Newcastle-Ottawa Scale. Based on 8 studies of 10,000 children aged 6 months through 14 years, we observed a significant detrimental association between any binge prenatal alcohol exposure and child cognition (Cohen's d [a standardized mean difference score] -0.13; 95% confidence interval [CI], -0.21, -0.05). Based on 3 high-quality studies of 11,900 children aged 9 months to 5 years, we observed a statistically significant detrimental association between moderate prenatal alcohol exposure and child behavior (Cohen's d -0.15; 95% CI, -0.28, -0.03). We observed a significant, albeit small, positive association between mild-to-moderate prenatal alcohol exposure and child cognition (Cohen's d 0.04; 95% CI, 0.00, 0.08), but the association was not significant after post hoc exclusion of 1 large study that assessed mild consumption nor was it significant when including only studies that assessed moderate alcohol consumption. None of the other completed meta-analyses resulted in statistically significant associations between mild, moderate, or binge prenatal alcohol exposure and child neuropsychological outcomes. CONCLUSIONS Our findings support previous findings suggesting the detrimental effects of prenatal binge drinking on child cognition. Prenatal alcohol exposure at levels less than daily drinking might be detrimentally associated with child behavior. The results of this review highlight the importance of abstaining from binge drinking during pregnancy and provide evidence that there is no known safe amount of alcohol to consume while pregnant.
Collapse
Affiliation(s)
- Audrey L Flak
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia; Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee; National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | | | | |
Collapse
|
6
|
Humphriss R, Hall A, May M, Zuccolo L, Macleod J. Prenatal alcohol exposure and childhood balance ability: findings from a UK birth cohort study. BMJ Open 2013; 3:bmjopen-2013-002718. [PMID: 23794556 PMCID: PMC3686236 DOI: 10.1136/bmjopen-2013-002718] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To investigate the association of prenatal alcohol exposure with balance in10-year-old children. DESIGN Population-based prospective longitudinal study. SETTING Former Avon region of UK (Southwest England). PARTICIPANTS 6915 children from the Avon Longitudinal Study of Parents and Children who had a balance assessment at age 10 and had data on maternal alcohol consumption. OUTCOME MEASURES 3 composite balance scores: dynamic balance (beam-walking), static balance eyes open, static balance eyes closed (heel-to-toe balance on a beam and standing on one leg, eyes open or closed). RESULTS Most mothers (95.5%) consumed no-to-moderate amounts (3-7 glasses/week) of alcohol during pregnancy. Higher total-alcohol consumption was associated with maternal-social advantage, whereas binge drinking (≥4 units/day) and abstinence were associated with maternal social disadvantage. No evidence was found of an adverse effect of maternal-alcohol consumption on childhood balance. Higher maternal-alcohol use during pregnancy was generally associated with better offspring outcomes, with some specific effects appearing strong (static balance eyes open and moderate total alcohol exposure at 18 weeks, adjusted OR 1.23 (95% CI 1.01 to 1.49); static balance eyes closed and moderate total alcohol exposure at 18 weeks, adjusted OR 1.25 (95% CI 1.06 to 1.48). Similar results were found for both paternal and postnatal maternal alcohol exposure. A Mendelian-randomization approach was used to estimate the association between maternal genotype and offspring balance using the non-synonymous variant rs1229984*A (ADH1B) to proxy for lower maternal alcohol consumption; no strong associations were found between this genotype/proxy and offspring balance. CONCLUSIONS No evidence was found to indicate that moderate maternal alcohol consumption in this population sample had an adverse effect on offspring balance at age 10. An apparent beneficial effect of higher total maternal alcohol consumption on offspring balance appeared likely to reflect residual confounding.
Collapse
Affiliation(s)
- Rachel Humphriss
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- Children's Hearing Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Amanda Hall
- Children's Hearing Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Centre for Hearing and Balance Studies, University of Bristol, Bristol, UK
| | - Margaret May
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Luisa Zuccolo
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- MRC Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - John Macleod
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| |
Collapse
|
7
|
Kikkert HK, de Jong C, Hadders-Algra M. Minor neurological dysfunction and cognition in 9-year-olds born at term. Early Hum Dev 2013; 89:263-70. [PMID: 23123256 DOI: 10.1016/j.earlhumdev.2012.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Revised: 09/26/2012] [Accepted: 10/02/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND In children with developmental disorders, motor problems often co-occur with cognitive difficulties. Associations between specific cognitive deficits underlying learning problems and minor neurological dysfunction (MND) are still unknown. AIMS To assess associations between specific types of MND as clinical markers of non-optimal brain function and performance in specific cognitive domains. STUDY DESIGN Part of a randomized controlled trial. SUBJECTS Three hundred and forty one 9-year-old children born at term (177 boys, 164 girls). OUTCOME MEASURES Children were neurologically assessed to detect eight types of MND: mild dysfunction in posture and muscle tone, reflexes, coordination, fine manipulative ability, sensory function, cranial nerve function, choreiform dyskinesia and excessive associated movements. Cognitive function in the domains of attention, memory and language was evaluated using the Test of Everyday Attention for Children (TEA-Ch), a developmental neuropsychological assessment (NEPSY) and the Children's Memory Scale. RESULTS Fine manipulative disability and coordination problems were associated with lower scores on attention, memory and learning and language, other types of MND were not. Girls with coordination problems performed significantly worse on attention/executive function than those without this dysfunction; however, in boys, such association was absent. CONCLUSION Particularly, fine manipulative disability and coordination problems were associated with worse cognitive function in the domains of attention, learning and memory and language. Previous and present data suggest a minor sex difference in neurocognitive associations: in girls dysfunction of the cerebello-thalamo-cortical pathways may be associated with cognitive deficits, while in boys cognitive impairment may be associated with dysfunction of cortico-striato-thalamo-cortical pathways.
Collapse
Affiliation(s)
- Hedwig K Kikkert
- Department of Paediatrics-Developmental Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | | |
Collapse
|
8
|
Landgren M, Svensson L, Strömland K, Andersson Grönlund M. Prenatal alcohol exposure and neurodevelopmental disorders in children adopted from eastern Europe. Pediatrics 2010; 125:e1178-85. [PMID: 20385628 DOI: 10.1542/peds.2009-0712] [Citation(s) in RCA: 130] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The purposes of this investigation were to determine the frequencies of and associations between different neurodevelopmental disorders and to study the potential lasting effects of alcohol on children adopted from eastern Europe. METHODS In a population-based, prospective, observational, multidisciplinary, cross-sectional, cohort study of 71 children adopted from eastern Europe, children were assessed 5 years after adoption, from pediatric, neuropsychological, and ophthalmologic perspectives. RESULTS Fetal alcohol spectrum disorders, that is, fetal alcohol syndrome (FAS), partial FAS, and alcohol-related neurodevelopmental disorders, were identified for 52% of children; FAS was found for 30%, partial FAS for 14%, and alcohol-related neurodevelopmental disorders for 9%. Alcohol-related birth defects were found for 11% of children, all of whom also were diagnosed as having FAS. Mental retardation or significant cognitive impairment was found for 23% of children, autism for 9%, attention-deficit/hyperactivity disorder for 51%, and developmental coordination disorder for 34%. CONCLUSIONS Fetal alcohol spectrum disorders and neurodevelopmental disorders were common in this long-term follow-up study of children adopted from orphanages in eastern Europe. Maternal alcohol consumption during pregnancy has long-lasting adverse effects, causing structural, behavioral, and cognitive damage despite a radically improved environment.
Collapse
Affiliation(s)
- Magnus Landgren
- Department of Pediatrics, Developmental Neurology, Mariestad, Skaraborg Hospital, Skövde, Sweden.
| | | | | | | |
Collapse
|
9
|
Humphriss R, Hall A, Macleod J. Prenatal alcohol exposure and childhood balance: a systematic review. Paediatr Perinat Epidemiol 2010; 24:156-65. [PMID: 20415772 DOI: 10.1111/j.1365-3016.2009.01084.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Balance problems in childhood have known adverse psychosocial associations such as poorer quality of life and lower educational achievement. Previous longitudinal studies have documented an adverse effect of prenatal alcohol exposure on a variety of neurodevelopmental outcomes and so an effect on balance would seem plausible. This is supported by a previous laboratory study that found that rats exposed to ethanol in utero have dysfunctional balance and gait. The present study is a systematic review of the current evidence on the effects of maternal alcohol use during pregnancy on offspring balance in childhood. A search strategy was devised and applied in the CENTRAL database (Cochrane Collaboration). Prospective longitudinal studies were then sought using databases including Medline, EMBASE, PsychInfo, CINAHL and AMED. In addition, citations in relevant published papers and books were followed up and experts in the field were contacted. No relevant human experimental studies were found. Four longitudinal studies were found to have assessed balance in preschool children. Only one of these studies suggested strong or substantial effects of alcohol exposure on balance-related outcomes. However, this study appeared the most methodologically robust. In conclusion, at present, there is limited evidence on the possible effects of alcohol exposure on childhood balance.
Collapse
Affiliation(s)
- Rachel Humphriss
- Centre for Hearing and Balance Studies, University of Bristol, Bristol, UK.
| | | | | |
Collapse
|
10
|
Évaluation de l’imprégnation en éthanol lors de dégustations professionnelles de boissons alcoolisées. ARCH MAL PROF ENVIRO 2009. [DOI: 10.1016/j.admp.2008.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
11
|
Seror E, Chapelon E, Bué M, Garnier-Lengliné H, Lebeaux-Legras C, Loudenot A, Lejeune C. [Alcohol and pregnancy]. Arch Pediatr 2009; 16:1364-73. [PMID: 19683904 DOI: 10.1016/j.arcped.2009.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2009] [Revised: 04/24/2009] [Accepted: 07/04/2009] [Indexed: 11/29/2022]
Abstract
Alcohol consumption during pregnancy is a major cause of mental retardation in Western countries. Fetal alcohol syndrome (FAS) is mainly characterized by pre- and postnatal stunted growth, neurocognitive disorders, and facial dysmorphism. It compromises the intellectual and behavioral prognosis of the child. Prevention tools exist, through better information of health professionals, for optimal care of high-risk women before, during, and after pregnancy, which would decrease the incidence of SAF in the future.
Collapse
Affiliation(s)
- E Seror
- Service d'hématologie pédiatrique, hôpital Saint-Louis, Assistance publique-Hôpitaux de Paris, 1 avenue Claude-Vellefaux, Paris cedex 10, France.
| | | | | | | | | | | | | |
Collapse
|
12
|
Aros S, Mills JL, Torres C, Henriquez C, Fuentes A, Capurro T, Mena M, Conley M, Cox C, Signore C, Klebanoff M, Cassorla F. Prospective identification of pregnant women drinking four or more standard drinks (> or = 48 g) of alcohol per day. Subst Use Misuse 2006; 41:183-97. [PMID: 16479683 DOI: 10.1080/10826080500391779] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We aimed to identify drinking rates in a prospectively identified cohort of pregnant women, and subsequently, to identify the drinkers of 48 g or more alcohol/day among them, by using complementary methods for verifying self-reported drinking habits. A research team of social workers and health professionals at the Maipú Clinic, located in a lower middle class neighborhood of Santiago, Chile, conducted interviews of women attending a prenatal clinic between August 1995 and July 2000. Women whose interview responses met predefined criteria (identified in the text) were further evaluated by home visits. We interviewed 9,628 of 10,917 (88%) women receiving prenatal care. By initial interview, 42.6% of women reported no drinking, 57.4% some alcohol consumption, and 3.7% consuming at least one standard drink (15 mL of absolute alcohol) per day. Of the 887 women who had home visits, 101 were identified as consuming on average at least 4 drinks/day (48 g). To determine the best home visit questionnaire items for identifying those drinking at least 4 drinks per day, 48 women who openly admitted drinking this amount were compared with 786 women who were not considered drinkers after the home visit. The 48 self-reported 48 g/day drinkers were significantly more likely to get tipsy when drinking before (p = 0.01) or during (p < 0.0001) pregnancy, to have started drinking at a younger age (p = 0.007), or to exhibit signs of low self-esteem (p < 0.0001), sleep or appetite problems (p < 0.0001), bad interpersonal relationships (p < 0.0001) or having family members with fetal alcohol syndrome features (p < 0.009). In conclusion, using complementary methods of alcohol misuse ascertainment during pregnancy, we found that at least 1% of pregnant women in a Santiago, Chile, clinic population were drinking at levels that are clearly dangerous to the fetus (48 g/day or more). We identified specific interview questions that may help screen for alcohol use of 48 g/day or more in pregnant women.
Collapse
Affiliation(s)
- Sofia Aros
- Department of Pediatrics, School of Medicine, University of Chile, San Borja Arriarán Clinical Hospital, Santiago, Chile
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Millichap JG. Prenatal Alcohol and Neurologic Dysfunction. Pediatr Neurol Briefs 2000. [DOI: 10.15844/pedneurbriefs-14-9-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|