Coles C D, Brown R T, Smith I E, Platzman K A, Erickson S, Falek A
Department of Psychiatry, Emory University School of Medicine, Atlanta, GA.
Neurotoxicol Teratol. 1991 Jul-Aug;13(4):357-67. doi: 10.1016/0892-0362(91)90084-a.
Alcohol is a potent teratogen associated with dysmorphology, growth retardation, and neurological damage in children with the full fetal alcohol syndrome (FAS); alcohol is also associated with growth retardation and behavioral alterations in neonates prenatally exposed to various dosages. Questions remain about the long-term consequences of prenatal alcohol exposure. This study reports on the follow-up of a subsample of 68 children, the majority of whom were low income and black (mean age: 5 years, 10 months) who were first evaluated as neonates. Physical and cognitive outcomes of 25 children of women who drank throughout pregnancy [absolute alcohol (AA)/week: mean = 11.80 oz), even after receiving an educational intervention to stop drinking, were compared with outcomes of children in two contrast groups: a) women (n = 22) who stopped drinking (AA/week: mean = 11.46 oz) in the second trimester after an educational intervention but resumed postpartum; and b) women who did not drink during pregnancy and who drank little postnatally (n = 21). Children were compared for alcohol-related birth defects (ARBDs), growth (height, weight, and head circumference), and cognitive, academic, and adaptive measures. Neonatal and current physical measures were correlated to determine predictability of neonatal status. When the effects of age and gender were controlled, children in the continued-to-drink group showed significantly more ARBDs and had smaller head circumferences than those in the other two groups. When current drinking reported by caretakers was controlled, the children who were exposed throughout pregnancy also showed significant and consistent deficits in several areas of intellectual functioning including sequential processing (short-term memory and encoding) and overall mental processing. Alcohol-exposed children displayed significant deficits in preacademic skills when compared with children of nondrinkers, with both alcohol groups deficient in premath and reading skills. There were no differences in adaptive behavior at follow-up. These data suggest that alcohol exposure throughout pregnancy is correlated with persistent physical differences as well as identifiable deficits in sequential memory processes and specific academic skills. However, even when alcohol use is limited to the first part of pregnancy, significant deficits in academic skills and growth parameters are measurable.
酒精是一种强效致畸剂，与患有完全型胎儿酒精综合征（FAS）的儿童的形态异常、生长发育迟缓及神经损伤有关；酒精还与产前接触不同剂量酒精的新生儿的生长发育迟缓和行为改变有关。产前酒精暴露的长期后果仍存在疑问。本研究报告了对68名儿童的一个子样本的随访情况，这些儿童大多为低收入黑人（平均年龄：5岁10个月），他们在新生儿期首次接受评估。将25名母亲在整个孕期饮酒的儿童（绝对酒精摄入量/周：平均 = 11.80盎司）的身体和认知结果进行比较，这些母亲即便在接受了戒酒教育干预后仍继续饮酒，同时与两个对照组儿童的结果进行比较：a）22名母亲在接受教育干预后于孕中期戒酒（绝对酒精摄入量/周：平均 = 11.46盎司），但产后又恢复饮酒；b）孕期不饮酒且产后少量饮酒的母亲（21名）。对儿童的酒精相关出生缺陷（ARBDs）、生长发育情况（身高、体重和头围）以及认知、学业和适应性指标进行了比较。对新生儿期和当前的身体指标进行相关性分析以确定新生儿状况的可预测性。在控制了年龄和性别的影响后，持续饮酒组的儿童比其他两组儿童表现出更多的酒精相关出生缺陷，且头围更小。在控制了照料者报告的当前饮酒情况后，整个孕期暴露于酒精的儿童在包括序列加工（短期记忆和编码）和整体心理加工在内的几个智力功能领域也表现出显著且持续的缺陷。与不饮酒母亲的孩子相比，暴露于酒精的儿童在学前技能方面存在显著缺陷，两个酒精暴露组在数学前技能和阅读技能方面均有不足。随访时适应性行为方面没有差异。这些数据表明，整个孕期暴露于酒精与持续的身体差异以及序列记忆过程和特定学业技能方面可识别的缺陷相关。然而，即使酒精使用仅限于孕期的前半段，学业技能和生长参数方面的显著缺陷也是可测量的。
