Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
Alcohol Clin Exp Res. 2013 Jul;37(7):1171-8. doi: 10.1111/acer.12073. Epub 2013 Feb 26.
Prenatal alcohol exposure (PAE) affects central nervous system development, growth, and morphology at higher exposure levels. Little is known about the effects of PAE at lower exposure levels or in young adults. Research on children with higher levels of PAE has shown that PAE predicts behavior problems. The question remains whether these effects are permanent or ameliorated by maturation into adulthood.
These data are from a longitudinal study of PAE. Mothers were recruited from a prenatal clinic and interviewed during their fourth prenatal month, seventh month, and delivery. In the postpartum, mothers and offspring were seen at 8 and 18 months, and 3, 6, 10, 14, 16, and 22 years.
At 22 years, PAE significantly predicted behavior as measured with the adult self-report. These findings were significant controlling for covariates. Exposure at each trimester predicted increased behavior problems on the Total Score, Internalizing, Externalizing, Attention, and Critical Items scales. Use across pregnancy predicted a higher rate of behavior problems compared to no use and use in the first trimester only.
The effects were dose-response and significant at each trimester of pregnancy. However, duration across pregnancy was a better predictor than drinking during the first trimester only. Binge drinking was not a better predictor of outcome compared to average daily volume (ADV), and within categories of ADV, binge drinking did not predict more problems than nonbinge drinking. Thus, there is no safe level or safe time during pregnancy for women to drink. These data demonstrate that the effects of PAE, even at low to moderate levels, extend into young adulthood and are most likely permanent.
产前酒精暴露 (PAE) 在更高的暴露水平下会影响中枢神经系统的发育、生长和形态。对于低水平暴露或在年轻成年人中的影响知之甚少。对高水平 PAE 的儿童进行的研究表明，PAE 可预测行为问题。问题仍然是这些影响是永久性的，还是随着成年期的成熟而改善。
这些数据来自一项关于 PAE 的纵向研究。母亲是从产前诊所招募的，并在第四个孕期、第七个月和分娩期间接受了访谈。在产后，母亲和子女在 8 个月、18 个月、3 岁、6 岁、10 岁、14 岁、16 岁和 22 岁时进行了随访。
在 22 岁时，PAE 显著预测了成年自评时的行为。这些发现在校正协变量后仍然显著。每个孕期的暴露预测了总分、内化、外化、注意力和关键项目量表上更多的行为问题。与无使用或仅在第一个孕期使用相比，整个孕期使用预测了更高的行为问题发生率。
这些影响是剂量反应，在每个孕期都有显著意义。然而，整个孕期的持续时间比仅在第一个孕期饮酒更能预测结果。与平均日量（ADV）相比， binge drinking 并不能更好地预测结果，而在 ADV 的类别内， binge drinking 并不比非 binge drinking 预测更多的问题。因此，对于女性来说，怀孕期间没有安全的饮酒水平或时间。这些数据表明，即使在低至中度水平，PAE 的影响也会持续到成年早期，而且很可能是永久性的。
