Handmaker Nancy S, Rayburn William F, Meng Chen, Bell Jordan B, Rayburn Brittany B, Rappaport Valerie J
Department of Psychology, University of New Mexico, Abuquerque, New Mexico 87131, USA.
Alcohol Clin Exp Res. 2006 May;30(5):892-8. doi: 10.1111/j.1530-0277.2006.00104.x.
More than 3 decades after Jones and Smith (1973) reported on the devastation caused by alcohol exposure on fetal development, the rates of heavy drinking during pregnancy remain relatively unchanged. Early identification of fetal alcohol exposure and maternal abstinence led to better infant outcomes. This study examined the utility of biometry for detecting alcohol-related fetal growth impairment.
We obtained fetal ultrasound measures from routine ultrasound examinations for 167 pregnant hazardous drinkers who were enrolled in a brief alcohol intervention study. The fetal measures for women who quit after learning of their pregnancies were compared with measures for women who continued some drinking throughout the course of their pregnancies. Because intensity of alcohol consumption is associated with poorer fetal outcomes, separate analyses were conducted for the heavy (average of >or=5 drinks per drinking day) alcohol consumers. Fetal measures from the heavy-exposed fetuses were also compared with measures from a nondrinking group that was representative of normal, uncomplicated pregnancies from our clinics. Analyses of covariance were used to determine whether there were differences between groups after controlling for influences of gestational age and drug abuse.
Nearly half of the pregnant drinkers abstained after learning of their pregnancies. When women reportedly quit drinking early in their pregnancies, fetal growth measures were not significantly different from a non-alcohol-exposed group, regardless of prior drinking patterns. Any alcohol consumption postpregnancy recognition among the heavy drinkers resulted in reduced cerebellar growth as well as decreased cranial to body growth in comparison with women who either quit drinking or who were nondrinkers. Amphetamine abuse was predictive of larger cranial to body growth ratios.
Alterations in fetal biometric measurements were observed among the heavy drinkers only when they continued drinking after becoming aware of their pregnancies. Although the reliance on self-reported drinking is a limitation in this study, these findings support the benefits of early abstinence and the potential for ultrasound examinations in the detection of fetal alcohol effects.
在琼斯和史密斯（1973年）报道酒精暴露对胎儿发育造成的破坏30多年后，孕期大量饮酒的比例仍相对未变。早期识别胎儿酒精暴露并使母亲戒酒可带来更好的婴儿结局。本研究探讨了生物测量法在检测与酒精相关的胎儿生长受损方面的效用。
我们从167名参与一项简短酒精干预研究的孕期高危饮酒者的常规超声检查中获取了胎儿超声测量数据。将怀孕后戒酒的女性的胎儿测量数据与孕期全程持续饮酒的女性的测量数据进行比较。由于酒精摄入量与较差的胎儿结局相关，因此对重度（平均每个饮酒日饮酒≥5杯）饮酒者进行了单独分析。还将重度暴露胎儿的测量数据与来自我们诊所代表正常、无并发症妊娠的非饮酒组的测量数据进行了比较。采用协方差分析来确定在控制了孕周和药物滥用的影响后，各组之间是否存在差异。
近一半的孕期饮酒者在得知怀孕后戒酒。当据报道女性在孕期早期戒酒时，无论其先前的饮酒模式如何，胎儿生长指标与未暴露于酒精的组无显著差异。与戒酒或不饮酒的女性相比，重度饮酒者在怀孕被确认后仍有任何酒精摄入都会导致小脑生长减缓以及头身生长比例降低。滥用安非他命可预测头身生长比例增大。
仅在重度饮酒者意识到怀孕后仍继续饮酒时，才观察到其胎儿生物测量指标有变化。尽管本研究存在依赖自我报告饮酒情况这一局限性，但这些发现支持了早期戒酒的益处以及超声检查在检测胎儿酒精影响方面的潜力。
