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[饮酒、妊娠与胎儿酒精综合征:对公共卫生的影响及预防策略]

[Alcohol consumption, pregnancy and fetal alcohol syndrome: implications in public health and preventive strategies].

作者信息

Ripabelli G, Cimmino L, Grasso G M

机构信息

Cattedra di Igiene, Dipartimento di Scienze per la Salute, Facoltà di Medicina e Chirurgia, Università degli Studi del Molise, Campobasso.

出版信息

Ann Ig. 2006 Sep-Oct;18(5):391-406.

Abstract

Alcohol consumption during pregnancy is a significant public health problem and is an established cause of serious birth defects and developmental delay collectively described as fetal alcohol syndrome (FAS). FAS is caused by congenital alcohol-induced damages and is a cause of mental retardation. It is characterised by facial abnormalities and growth deficiency. Infants affected by the syndrome show intellectual impairment, and difficulties in learning, memory, problem-solving, and attention as well as experiencing additional problems with mental health and social interactions. However, an absence of the characteristic facial defects and growth deficiency may result in a failure to identify children with prenatal alcohol exposure, which can further present as alcohol-related neurodevelopment disorder (ARND) or alcohol-related birth defects (ARBD). Estimates of prevalence of FAS in U.S.A. range between 0.3 to 2.2 per 1,000 live births, but much higher rates occurring in some communities. Harmonisation of the methodology used for epidemiological studies, with research activities that establishes real baseline prevalence of FAS and identification of women who are at highest risk of bearing a FAS-affected child, are an essential prerequisite to prevention. In addition, it is essential to assess different FAS preventive approaches through carefully controlled studies. Universal, selected, and indicated preventive strategies have been identified, targeting different kind of populations. Since FAS and other adverse effects of drinking during pregnancy are theoretically completely preventable, it is vital to make more efforts to improve the application of the most appropriate interventions. Although in Italy alcohol consumption has constantly increased, mainly amongst the young (including women of childbearing age), knowledge on FAS and alcohol-related effects is completely lacking. Because of the high cost for care of individuals with this syndrome, it is essential to apply appropriate interventions to prevent this problem.

摘要

孕期饮酒是一个重大的公共卫生问题,是导致严重出生缺陷和发育迟缓的既定原因,这些情况统称为胎儿酒精谱系障碍(FAS)。FAS由先天性酒精诱导损伤引起,是智力发育迟缓的一个原因。其特征为面部异常和生长发育不足。受该综合征影响的婴儿表现出智力障碍,在学习、记忆、解决问题和注意力方面存在困难,以及在心理健康和社交互动方面还存在其他问题。然而,缺乏典型的面部缺陷和生长发育不足可能导致无法识别产前有酒精暴露的儿童,这些儿童可能进一步表现为酒精相关神经发育障碍(ARND)或酒精相关出生缺陷(ARBD)。美国FAS的患病率估计为每1000例活产中有0.3至2.2例,但在一些社区发生率要高得多。统一用于流行病学研究的方法,开展确定FAS实际基线患病率以及识别生育FAS患儿风险最高的女性的研究活动,是预防的必要前提。此外,通过严格对照研究评估不同的FAS预防方法至关重要。已确定针对不同人群的普遍、选择性和针对性预防策略。由于FAS和孕期饮酒的其他不良影响理论上完全可以预防,加大力度改进最合适干预措施的应用至关重要。尽管在意大利,酒精消费量持续增加,主要是在年轻人(包括育龄妇女)中,但对FAS及酒精相关影响的了解完全缺失。由于护理该综合征患者成本高昂,应用适当干预措施预防这一问题至关重要。

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