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[酒精与妊娠——胚胎病及酒精影响]

[Alcohol and pregnancy--embryopathy and alcohol effects].

作者信息

Löser H

机构信息

Universitätskinderklinik, Münster.

出版信息

Ther Umsch. 2000 Apr;57(4):246-52. doi: 10.1024/0040-5930.57.4.246.

Abstract

Fetal alcohol syndrome (FAS) is a specific polydystrophic pattern of malformations with the following diagnostic criteria: 1. Maternal alcohol dependence or alcohol abuse during pregnancy. 2. Pre- and postnatal deficiency of growth in weight, height and head circumference. 3. Multiple minor and major anomalies recognizable mainly at a typical face. 4. Structural injuries and changes at the central nervous system with complex brain dysfunction combining elements of cognitive impairments, behavioral disturbance and neurological damage. Fetal alcohol effects (FAE) or so-called "alcohol-related neurodevelopmental disorders" (ARND) with predominant neurotoxic effects and a large spectrum of cerebral dysfunctions are manifold more frequent than the full-blown FAS. These remain mostly unrecognized, overlooked and they are difficult to be diagnosed, the symptoms being unspecific. Alcohol in pregnancy is nowadays the most important and the most frequent toxic substance for the embryo and the fetus and one of the most frequent causes of mental retardation. The longlasting and irreversible consequences refer to school development, social maturation, social behaviour and later life-style. The diagnosis is based on the careful maternal history and on the clinical findings; there are no biochemical parameters of assessment. The risk of addiction development in these children is assumed to be more than 20 percent.

摘要

胎儿酒精综合征(FAS)是一种具有特定多系统发育不良模式的畸形病症,其诊断标准如下:1. 孕期母亲存在酒精依赖或酒精滥用情况。2. 出生前和出生后体重、身高及头围生长不足。3. 主要在典型面部可识别出多种轻微和严重畸形。4. 中枢神经系统存在结构损伤和变化,伴有复杂的脑功能障碍,包括认知障碍、行为紊乱和神经损伤等因素。胎儿酒精影响(FAE)或所谓的“酒精相关神经发育障碍”(ARND),主要具有神经毒性作用且脑功能障碍范围广泛,其发生频率比典型的胎儿酒精综合征要高得多。这些情况大多未被识别、被忽视,且难以诊断,因为症状不具特异性。如今,孕期饮酒是胚胎和胎儿最重要且最常见的有毒物质,也是智力发育迟缓最常见的原因之一。其后果持久且不可逆,涉及学业发展、社交成熟度、社会行为及后期生活方式。诊断基于详尽的母亲病史和临床检查结果;不存在用于评估的生化指标。据推测,这些儿童成瘾的风险超过20%。

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