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Gimenez PV, Lichtenberger A, Cremonte M, Cherpitel CJ, Peltzer RI, Conde K. Efficacy of Brief Intervention for Alcohol Consumption during Pregnancy in Argentinean Women: A Randomized Controlled Trial. Subst Use Misuse 2022; 57:674-683. [PMID: 35258400 PMCID: PMC8967783 DOI: 10.1080/10826084.2022.2026967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Although Brief Intervention (BI) has proven to reduce alcohol consumption during pregnancy in high income countries, there is no evidence from the Southern Cone of America. Thus, we conducted a study to assess BI efficacy among Argentinean pregnant women. METHOD AND MATERIALS We collected data on pregnant women receiving prenatal care at the public health system in Mar del Plata, Argentina. Women with less than 26 weeks of gestation (n = 486) were randomized to brief advice (BA) or BI. Three months later they were re-assessed; women with more than 26 weeks of gestation constituted a screening only control group (SC) (n = 154). Self-reported quantity and frequency of alcohol consumption, frequency of binge drinking, and related problems after three months were used as outcomes. We performed generalized estimating equations and clinical significance analyses. Also, we obtained newborn health indicators from the city's health system database to use as objective outcomes. Women who did not participate in any of the three former conditions were randomly selected to constitute a non-screening control group (NSC) (n = 150). We compared objective outcomes among BI, BA, and NSC groups using the Wilcoxon rank test. RESULTS In comparison with SC, BI and BA reduced alcohol consumption, without differences between the latter two. Newborns of women who received BI and BA had better health indicators compared with the NSC group. CONCLUSIONS performing either a BI or BA reduces alcohol consumption among Argentinean pregnant women and might lead to healthier newborns.
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Affiliation(s)
- Paula Victoria Gimenez
- Institute of Basic, Applied Psychology and Technology (IPSIBAT), National Scientific and Technical Research Council (CONICET), National University of Mar del Plata (UNMdP), Mar del Plata, Argentina
| | - Aldana Lichtenberger
- Institute of Basic, Applied Psychology and Technology (IPSIBAT), National Scientific and Technical Research Council (CONICET), National University of Mar del Plata (UNMdP), Mar del Plata, Argentina
| | - Mariana Cremonte
- Institute of Basic, Applied Psychology and Technology (IPSIBAT), National Scientific and Technical Research Council (CONICET), National University of Mar del Plata (UNMdP), Mar del Plata, Argentina
| | | | - Raquel Inés Peltzer
- Institute of Basic, Applied Psychology and Technology (IPSIBAT), National Scientific and Technical Research Council (CONICET), National University of Mar del Plata (UNMdP), Mar del Plata, Argentina
| | - Karina Conde
- Institute of Basic, Applied Psychology and Technology (IPSIBAT), National Scientific and Technical Research Council (CONICET), National University of Mar del Plata (UNMdP), Mar del Plata, Argentina
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De La Fuente-Ortega E, Plaza-Briceño W, Vargas-Robert S, Haeger P. Prenatal Ethanol Exposure Misregulates Genes Involved in Iron Homeostasis Promoting a Maladaptation of Iron Dependent Hippocampal Synaptic Transmission and Plasticity. Front Pharmacol 2019; 10:1312. [PMID: 31787896 PMCID: PMC6855190 DOI: 10.3389/fphar.2019.01312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 10/15/2019] [Indexed: 01/05/2023] Open
Abstract
Prenatal ethanol exposure (PAE) induces behavioral maladptations in offspring, including a deficit in memory formation which is part of the umbrella sign of fetal alcohol spectrum disorder. Clinical and preclinical studies have shown that iron depletion exacerbates cognitive problems in offspring exposed to ethanol in utero and that PAE promotes dysregulation in brain iron homeostasis. However, the mechanisms underlying brain iron dysregulation and neuronal activity defects in adolescent offspring of PAE are unclear and poorly understand. Here, we used a PAE rat model to analyze messenger RNA (mRNA) and protein expression of iron homeostasis genes such as transferrin receptor (TfR), divalent metal transporter (DMT1), ferroportin (FPN1), and ferritin (FT) in brain areas associated with memory formation such as the prefrontal cortex (PFC), ventral tegmental area, and hippocampus. Interestingly, we found that 21 day old PAE rats have higher mRNA expression of DMT1 in the PFC, and TfR in the hippocampus, compared to control animals. In contrast FPN has lower mRNA expression in the PFC, and FT and FPN1 have lower expression in the hippocampus. In agreement with these results, we found a 1.5–2 fold increase of TfR and DMT1 protein levels both in the hippocampus and the PFC. Additionally, using an electrophysiological approach, we found that in hippocampal slices from PAE rats, iron treatment decreased long-term potentiation (LTP), but not AMPAR basal transmission (AMPAR fEPSP). In contrast, in control slices Fe-NTA did not affect LTP but decreased significantly the AMPAR fEPSP. Meanwhile, iron chelation with deferiprone decreased AMPAR transmission in PAE and control slices and decreased LTP only in controls slices. These results suggest that PAE affects iron homeostasis of specific brain areas—PFC and hippocampus—which could be involved in maladaptive cognition observed in this animal model.
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Affiliation(s)
- Erwin De La Fuente-Ortega
- Departamento de Ciencias Biomédicas, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
| | - Wladimir Plaza-Briceño
- Departamento de Ciencias Biomédicas, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
| | - Sofía Vargas-Robert
- Departamento de Ciencias Biomédicas, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
| | - Paola Haeger
- Departamento de Ciencias Biomédicas, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
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Lange S, Probst C, Heer N, Roerecke M, Rehm J, Monteiro MG, Shield K, de Oliveira C, Popova S. Actual and predicted prevalence of alcohol consumption during pregnancy in Latin America and the Caribbean: systematic literature review and meta-analysis. Rev Panam Salud Publica 2017. [PMID: 28614487 PMCID: PMC6645189 DOI: 10.26633/rpsp.2017.89] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective To estimate the prevalence of alcohol consumption during pregnancy among the general population of Latin America and the Caribbean, by country, in 2012. Methods Three steps were taken: a comprehensive, systematic literature search; meta-analyses, assuming a random-effects model for countries with published studies; and regression modelling (data prediction) for countries with either no published studies or too few to obtain an estimate. Results Based on 24 existing studies, the pooled prevalence of alcohol consumption during pregnancy among the general population was estimated for Brazil (15.2%; 95% confidence interval [95%CI]: 10.4%–20.8%) and Mexico (1.2%; 95%CI: 0.0%–2.7%). The prevalence of alcohol consumption during pregnancy among the general population was predicted for 31 countries and ranged from 4.8% (95%CI: 4.2%–5.4%) in Cuba to 23.3% (95%CI: 20.1%–26.5%) in Grenada. Conclusions Greater prevention efforts and measures are needed in the countries of Latin America and the Caribbean to prevent pregnant women from consuming alcohol during pregnancy and decrease the rates of Fetal Alcohol Spectrum Disorder. Additional high quality studies on the prevalence of alcohol consumption during pregnancy in Latin America and the Caribbean are also needed.
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Affiliation(s)
- Shannon Lange
- Institute for Mental Health Policy Research, Center for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Charlotte Probst
- Institute for Mental Health Policy Research, Center for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Navrose Heer
- Institute for Mental Health Policy Research, Center for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Michael Roerecke
- Institute for Mental Health Policy Research, Center for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Center for Addiction and Mental Health, Toronto, Ontario, Canada
| | | | - Kevin Shield
- Institute for Mental Health Policy Research, Center for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Claire de Oliveira
- Institute for Mental Health Policy Research, Center for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Svetlana Popova
- Institute for Mental Health Policy Research, Center for Addiction and Mental Health, Toronto, Ontario, Canada
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Yazici AB, Uslu Yuvaci H, Yazici E, Halimoglu Caliskan E, Cevrioglu AS, Erol A. Smoking, alcohol, and substance use and rates of quitting during pregnancy: is it hard to quit? Int J Womens Health 2016; 8:549-556. [PMID: 27785104 PMCID: PMC5063552 DOI: 10.2147/ijwh.s116170] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background Alcohol and substance use is a major health challenge in Turkey, as it is worldwide. Recently, there has been a rapid increase in the number of females using substances and although usage tends to reduce during pregnancy, it is of critical importance to determine its exact level as substance use negatively impacts on the health of both the mother and infant. Aim The aim of the present study was to investigate the frequency of smoking, alcohol, and substance use, and quitting rates during pregnancy. Method This study was conducted on pregnant females in Sakarya, Turkey. A total of 1,082 consecutively presenting females who agreed to participate in the study were evaluated. The study team prepared a sociodemographic data form and adapted the “Introduction” section, derived from the Addiction Profile Index, to cover substance use during pregnancy. Results The substances most frequently used by pregnant females in their previous pregnancies and current pregnancies were cigarettes/tobacco products (11% and 11.8%, respectively), alcohol (0.6% and 0.4%, respectively), and rarely, synthetic cannabinoids (0.3% and 0.2%, respectively). Daily tobacco smokers continued to smoke during pregnancy, with a rate of 42.5%. Based on research into predictors of smoking (cigarettes) in pregnancy, a correlation was found between lifetime smoking and smoking during a previous pregnancy. A similar link was found with respect to alcohol. Conclusion Cigarettes are the most frequently used substance in pregnancy, and to a lesser extent, alcohol and synthetic cannabinoids, also considered to be risky substances. A high incidence of smoking regularly during pregnancy was found in daily smokers. It is recommended that physicians should sensitively ask pregnant females presenting at clinics about all forms of substance use, including alcohol and synthetic cannabinoids, and to include such questions in their routine enquiries.
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Affiliation(s)
| | | | - Esra Yazici
- Faculty of Medicine, Department of Psychiatry
| | - Ebru Halimoglu Caliskan
- Department of Obstetrics and Gynaecology, Training and Research Hospital, Sakarya University, Sakarya, Turkey
| | | | - Atila Erol
- Faculty of Medicine, Department of Psychiatry
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Kuehn D, Aros S, Cassorla F, Avaria M, Unanue N, Henriquez C, Kleinsteuber K, Conca B, Avila A, Carter TC, Conley MR, Troendle J, Mills JL. A prospective cohort study of the prevalence of growth, facial, and central nervous system abnormalities in children with heavy prenatal alcohol exposure. Alcohol Clin Exp Res 2012; 36:1811-9. [PMID: 22823161 DOI: 10.1111/j.1530-0277.2012.01794.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Accepted: 01/19/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Most children who are exposed to large quantities of alcohol in utero do not develop fetal alcohol syndrome (FAS). Population-based prospective data on the risk of developing components of fetal alcohol spectrum disorders (FASD), however, are limited. METHODS This was a prospective cohort study of 9,628 women screened during their first prenatal appointment in Chile, which identified 101 who consumed at least 4 drinks/d (exposed) matched with 101 women with no reported alcohol consumption during pregnancy (unexposed). Detailed alcohol consumption data were collected during the pregnancy. Children were evaluated up to 8.5 years of age by clinicians masked to exposure status. RESULTS One or more functional central nervous system abnormalities were present in 44.0% (22/50) of the exposed children compared to 13.6% (6/44) of the unexposed (p = 0.002). Growth restriction was present in 27.2% (25/92) of the exposed and 12.5% (12/96) of the unexposed (p = 0.02). Abnormal facial features were present in 17.3% (14/81) of the exposed children compared to 1.1% (1/89) of the unexposed children (p = 0.0002) by direct examination. Of the 59 exposed children with data available to detect at least 1 abnormality, 12 (20.3%) had no abnormalities. Binge drinking from conception to recognition of pregnancy (OR = 1.48 per day, 95% CI: 1.15 to 1.91, p = 0.002) and after recognition of pregnancy (OR= 1.41 per day, 95% CI: 1.01 to 1.95, p = 0.04) and total number of drinks consumed per week from conception to recognition of pregnancy (OR = 1.02 per drink, 95% CI: 1.01 to 1.04, p = 0.0009) were significantly associated with abnormal child outcome. CONCLUSIONS After exposure to heavy alcohol consumption during pregnancy, 80% of children had 1 or more abnormalities associated with alcohol exposure. Patterns of alcohol use that posed the greatest risk of adverse outcomes were binge drinking and high total weekly intake. Functional neurologic impairment occurred most frequently and may be the only sign to alert physicians to prenatal alcohol exposure.
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Affiliation(s)
- Devon Kuehn
- Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute for Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
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Cornman-Homonoff J, Kuehn D, Aros S, Carter TC, Conley MR, Troendle J, Cassorla F, Mills JL. Heavy prenatal alcohol exposure and risk of stillbirth and preterm delivery. J Matern Fetal Neonatal Med 2011; 25:860-3. [PMID: 21728738 DOI: 10.3109/14767058.2011.587559] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
We prospectively identified 96 women consuming at least 4 drinks/day during pregnancy by screening 9628 pregnant women. In these women with heavy prenatal alcohol use, there were three stillbirths and one preterm delivery; 98 matched nondrinking women had no stillbirths and two preterm births. Preterm rates did not differ significantly. The stillbirth rate was higher in the exposed group (p = 0.06). Additional investigation showed the stillbirth rate in the exposed population (3.1%) was significantly higher (p = 0.019) than the reported Chilean population rate (0.45%). Our data suggest that heavy alcohol consumption may increase the risk for stillbirth but not preterm delivery.
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Affiliation(s)
- Joshua Cornman-Homonoff
- Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute for Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA
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Aros S, Mills JL, Iñiguez G, Avila A, Conley MR, Troendle J, Cox C, Cassorla F. Effects of prenatal ethanol exposure on postnatal growth and the insulin-like growth factor axis. Horm Res Paediatr 2011; 75:166-73. [PMID: 20847545 PMCID: PMC3068754 DOI: 10.1159/000319706] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2009] [Accepted: 07/23/2010] [Indexed: 11/19/2022] Open
Abstract
AIMS To study the effect of in-utero alcohol exposure on the insulin-like growth factor axis (IGF) and leptin during infancy and childhood, considering that exposed children may exhibit pre- and postnatal growth retardation. METHODS We prospectively identified heavily drinking pregnant women who consumed on average 4 or more drinks of ethanol per day (≥ 48 g/day) and assessed growth in 69 of their offspring and an unexposed control group of 83 children, measuring serum IGF-I (radioimmunoassay), IGF-II (immunoradiometric assay, IRMA), insulin-like growth factor-binding protein 3 (IGFBP-3) (IRMA) and leptin (IRMA) at 1 month and 1, 2, 3, 4, and 5 years of age. RESULTS IGF-II levels increased with age in both groups, but the rate of increase was significantly higher in exposed children, and levels were significantly higher in ethanol-exposed children at 3, 4, and 5 years of age. In exposed children, IGF-I levels were higher at 3 and 4 years and leptin levels were significantly lower at 1 and 2 years. Exposed subjects showed a much lower correlation between IGF-I and growth parameters than unexposed subjects. CONCLUSION Exposure to ethanol during pregnancy increases IGF-I and IGF-II and decreases leptin during early childhood. The increase in serum IGF-II concentrations in ethanol-exposed children suggests that this hormone should be explored as a potential marker for prenatal alcohol exposure.
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Affiliation(s)
- Sofía Aros
- Department of Pediatrics, Faculty of Medicine, University of Chile, San Borja Arriarán Clinical Hospital, Santiago, Chile
| | - James L. Mills
- Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Md., USA,*James L. Mills, MD, MS, 6100 Bldg. Room 7 B03. NICHD, NIH, DHHS, Bethesda, MD 20892 (USA), Tel. +1 301 496 5394, Fax +1 301 402 2084, E-Mail
| | - Germán Iñiguez
- Institute of Maternal and Child Research, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Alejandra Avila
- Institute of Maternal and Child Research, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Mary R. Conley
- Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Md., USA
| | - James Troendle
- Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Md., USA
| | - Christopher Cox
- Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Md., USA
| | - Fernando Cassorla
- Institute of Maternal and Child Research, Faculty of Medicine, University of Chile, Santiago, Chile
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Abstract
This study examines the role that self-esteem plays in HIV-related risk taking among users of the drug, Ecstasy. The first part of the analysis focuses on the relationship of self-esteem to HIV risk-taking. The second part examines predictors of self-esteem in this population. Conducted between 2002 and 2004, the research is based on a sample of 283 young adult Ecstasy users who completed approximately two-hour-long, face-to-face interviews via computer-assisted structured interviews. Study participants were recruited in the Atlanta, Georgia metropolitan area using targeted sampling and ethnographic mapping. Results indicated that self-esteem is associated with a variety of risky practices, including: the number of sex partners that people had, individuals' likelihood of having multiple sex partners, the number of different illegal drugs people used, and their condom use self-efficacy. The multivariate analysis conducted to ascertain the factors that impact participants' levels of self-esteem yielded six factors: educational attainment (positive), coming from a family-of-origin whose members got along well (positive), the extent of alcohol problems (negative), the number of positive effects experienced as a result of Ecstasy use (positive), the number of negative effects experienced as a result of Ecstasy use (negative), and the extent of experiencing symptoms of post-traumatic stress disorder (negative).
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Affiliation(s)
- Hugh Klein
- Kensington Research Institute, Emory University, Atlanta, GA, USA.
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Chiodo LM, Sokol RJ, Delaney-Black V, Janisse J, Hannigan JH. Validity of the T-ACE in pregnancy in predicting child outcome and risk drinking. Alcohol 2010; 44:595-603. [PMID: 20053522 PMCID: PMC2891940 DOI: 10.1016/j.alcohol.2009.08.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2009] [Revised: 07/31/2009] [Accepted: 08/07/2009] [Indexed: 10/20/2022]
Abstract
Preventing fetal alcohol spectrum disorders (FASDs) requires detection of in-pregnancy maternal risk drinking. The widely used T-ACE screen has been applied in various ways, although the impact of those different uses on effectiveness is uncertain. We examined relations among different T-ACE scoring criteria, maternal drinking, and child outcome. Self-reported across-pregnancy maternal drinking was assessed in 75 African-American women. The different T-ACE criteria used varied the level of drinking that defined tolerance (two or three drinks) and the total T-ACE score cut-points (two or three). Receiver operator curves and regression analysis assessed the significance of relations. Increasing the total T-ACE score cut-point to 3 almost doubled specificity in detecting risk drinking whereas maintaining adequate sensitivity, equivalent to that in the original report, and identified substantially more neurobehavioral deficits in children. Redefining tolerance at three drinks did not improve T-ACE effectiveness in predicting outcomes. This study is among the first to show the ability of an in-pregnancy T-ACE assessment to predict child neurodevelopmental outcome. In addition, increasing the total T-ACE score criterion (from 2 to 3) improved identification of non-drinking mothers and unaffected children with little loss in detection of drinkers and affected children. Efficient in-pregnancy screens for risk drinking afford greater opportunities for intervention that could prevent/limit FASDs.
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Affiliation(s)
- Lisa M Chiodo
- College of Nursing, Wayne State University, Detroit, MI 48202, USA.
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État des lieux de la consommation de substances psychoactives par les femmes enceintes. Encephale 2010; 36:33-8. [DOI: 10.1016/j.encep.2008.12.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2007] [Accepted: 12/01/2008] [Indexed: 01/18/2023]
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Chou FH, Yang YH, Kuo SH, Chan TF, Yang MS. Relationships among smoking, drinking, betel quid chewing and pregnancy-related nausea and vomiting in Taiwanese aboriginal women. Kaohsiung J Med Sci 2009; 25:62-9. [PMID: 19321408 DOI: 10.1016/s1607-551x(09)70042-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
A cross-sectional survey was conducted to investigate the associations among smoking, drinking, betel quid chewing and pregnancy-related nausea and vomiting (N/V) in Taiwanese aboriginal women. A total of 901 aboriginal women from 11 hospitals were recruited into this study. A structured questionnaire on demographic and obstetric information, smoking history, alcohol consumption, betel quid chewing habits, and N/V by checklist was used to collect data. The findings of this study indicated that the prevalence of N/V, maternal smoking, drinking, and betel quid chewing were 75.6% (n = 682), 22.8% (n = 201), 31.9% (n = 287), and 34.7% (n = 313) respectively. Multiple logistic regression with adjustment for age, body mass index and antiemetics use revealed significant relationships between smoking habits and N/V before confirmation of pregnancy and during pregnancy. In comparison with those who did not smoke, women smoking in excess of 10 cigarettes a day before pregnancy were 1.65 times more likely to develop N/V; and women smoking in excess of 10 cigarettes a day during pregnancy were 2.79 times more likely to develop N/V. Based on the findings of this study, smoking was associated, with a dose-response effect, with pregnancy-related N/V. Reducing the intake of cigarettes could decrease the risk of pregnancy-related N/V. Health care providers should help these women decrease their uncomfortable symptoms and improve their experiences of pregnancy and birth outcome during critical times.
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Affiliation(s)
- Fan-Hao Chou
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
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12
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Chiodo LM, Janisse J, Delaney-Black V, Sokol RJ, Hannigan JH. A Metric of Maternal Prenatal Risk Drinking Predicts Neurobehavioral Outcomes in Preschool Children. Alcohol Clin Exp Res 2009; 33:634-44. [PMID: 19183137 DOI: 10.1111/j.1530-0277.2008.00878.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Lisa M Chiodo
- Carman and Ann Adams Department of Pediatrics, School of Medicine, Wayne State University, Detroit, Michigan 48201, USA.
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13
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Flanigan EY, Aros S, Bueno MF, Conley M, Troendle JF, Cassorla F, Mills JL. Eye malformations in children with heavy alcohol exposure in utero. J Pediatr 2008; 153:391-5. [PMID: 18571671 PMCID: PMC2570183 DOI: 10.1016/j.jpeds.2008.04.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2007] [Revised: 03/19/2008] [Accepted: 04/04/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To determine whether children who do not develop fetal alcohol syndrome (FAS) despite heavy alcohol exposure are at risk for eye abnormalities. STUDY DESIGN We screened 9628 pregnant women and identified 101 women who were drinking >/= 2 oz of absolute alcohol per day and 101 nondrinking control women. We followed 43 exposed and 55 control offspring between age 4 and 9 years, performing masked standardized ophthalomologic examinations. RESULTS The groups did not differ in their rates of impaired visual acuity, refractory errors, ptosis, epicanthal folds, or short palpebral fissures. Biomicroscopy examination was normal in all exposed subjects; cataracts were detected in 2 control subjects (4%) but in no exposed subjects. Arterial tortuosity was seen in 7 exposed subjects (16%) and in 8 control subjects (15%). Optic nerve hypoplasia was not detected in any subject. CONCLUSIONS Previous research has found that children with FAS have a high incidence of serious ophthalmologic defects; our data indicate that the risk is limited to children with FAS and does not extend to children exposed to high levels of alcohol prenatally who do not develop FAS. Eye examinations are unlikely to clarify the diagnosis in children suspected of having alcohol-related damage.
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Affiliation(s)
- Elizabeth Y. Flanigan
- Division of Epidemiology, Statistics, and Prevention Research, National Institute of Child Health and Human Development (NICHD), National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA,Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA and Department of Pediatrics, Walter Reed Army Medical Center, Washington, DC
| | - Sofia Aros
- Department of Pediatrics, School of Medicine, University of Chile, San Borja Arriaran Clinical Hospital, Santiago, Chile
| | | | - Mary Conley
- Division of Epidemiology, Statistics, and Prevention Research, National Institute of Child Health and Human Development (NICHD), National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
| | - James F. Troendle
- Division of Epidemiology, Statistics, and Prevention Research, National Institute of Child Health and Human Development (NICHD), National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
| | - Fernando Cassorla
- Institute of Maternal and Child Research (IDIMI), School of Medicine, University of Chile, Santiago, Chile
| | - James L. Mills
- Division of Epidemiology, Statistics, and Prevention Research, National Institute of Child Health and Human Development (NICHD), National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
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Signore C, Aros S, Morrow JD, Troendle J, Conley MR, Flanigan EY, Cassorla F, Mills JL. Markers of oxidative stress and systemic vasoconstriction in pregnant women drinking > or =48 g of alcohol per day. Alcohol Clin Exp Res 2008; 32:1893-8. [PMID: 18715278 DOI: 10.1111/j.1530-0277.2008.00773.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The precise pathway by which alcohol causes the characteristic features of fetal alcohol spectrum disorders is unknown. Proposed mechanisms for fetal injury from maternal alcohol use include cellular damage from oxidative stress and impaired fetal oxygenation related to maternal systemic vasoconstriction. Our objective was to compare the levels of urinary markers of oxidative stress and systemic vasoconstriction between women consuming large amounts of alcohol during pregnancy and women who did not drink alcohol during pregnancy. METHODS Pregnant women consuming > or =48 g alcohol per day (n = 29) on average and pregnant women who abstained from alcohol use (n = 39) were identified using detailed interviews and home visits. Random maternal urine specimens were collected. Urinary levels of the oxidative stress marker, 8-isoprostane F2alpha, and of the vasoactive prostaglandin metabolites, 2,3-dinor-6-keto-prostaglandin F1alpha (a vasodilator) and 11-dehydro-thromboxane B2 (a vasoconstrictor), were measured using mass spectrometric methods. All analyte levels were corrected for urinary creatinine. RESULTS In crude analyses, there was no significant difference in 8-isoprostane F2alpha between pregnant drinkers and nondrinkers (2.16 vs. 2.08 ng/mg creatinine, respectively, p = 0.87). There were no significant differences between the drinking and nondrinking groups in levels of 2,3-dinor-6-keto-prostaglandin F1alpha (1.03 vs. 1.17 ng/mg creatinine, respectively, p = 0.50), 11-dehydro-thromboxane B2 (0.72 vs. 0.59 ng/mg creatinine, respectively, p = 0.21), or the ratio of vasodilatory metabolite to vasoconstrictive metabolite (1.73 vs. 2.72, respectively, p = 0.14). Adjusting for maternal age, marital status, smoking, and gestational age at sampling did not substantially alter the results. CONCLUSION Our results show no difference in levels of urinary eicosanoid markers of oxidative stress and systemic vasoconstriction between pregnant women who drink heavily and pregnant women who abstain. These findings speak against a role for maternal oxidative stress or systemic vasoconstriction in the pathogenesis of alcohol damage to the fetus.
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Affiliation(s)
- Caroline Signore
- Epidemiology Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892, USA
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