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减少美国的胎儿酒精暴露。

Reducing fetal alcohol exposure in the United States.

机构信息

Department of Family Medicine, School of Medicine, Oregon Health and Science University, Portland, OR 97239, USA.

出版信息

Obstet Gynecol Surv. 2013 May;68(5):367-78. doi: 10.1097/OGX.0b013e31828736d5.

DOI:10.1097/OGX.0b013e31828736d5
PMID:23624962
Abstract

UNLABELLED

Fetal alcohol exposure is the leading preventable cause of birth and developmental defects in the United States. Despite a growing body of knowledge about the spectrum of disorders resulting from fetal alcohol exposure, 1 in 9 pregnant women continues to drink alcohol during pregnancy, and a small percentage of pregnant women continues to binge drink. Health care providers do not consistently screen pregnant women for alcohol use, nor do health professionals necessarily know how to counsel pregnant women effectively about the risks of fetal alcohol exposure. In this article, we review the epidemiology of fetal alcohol exposure and discuss current strategies for screening and prevention of fetal alcohol exposure. We also explore the multiple barriers that exist toward reducing alcohol-exposed pregnancies from the patient, provider, and systems perspectives. Finally, we make recommendations for improved clinical and public health strategies to eliminate fetal alcohol exposure in the United States.

TARGET AUDIENCE

Obstetricians and gynecologists, family physicians.

LEARNING OBJECTIVES

After completing this CME activity, physicians should be better able to describe rates of fetal alcohol exposure in the United States, describe the demographic characteristics of women at highest risk for fetal alcohol exposure, counsel patients appropriately regarding the risk of poor fetal outcomes in association with fetal alcohol exposure, and understand the barriers to effective counseling about fetal alcohol exposure.

摘要

未加标签

在美国,胎儿酒精暴露是导致出生缺陷和发育缺陷的主要可预防原因。尽管人们对胎儿酒精暴露导致的一系列疾病有了越来越多的了解,但仍有 1/9 的孕妇在怀孕期间继续饮酒,还有一小部分孕妇继续狂饮。医疗保健提供者并未始终对孕妇进行酒精使用筛查,卫生专业人员也不一定知道如何有效地就胎儿酒精暴露的风险对孕妇进行咨询。在本文中,我们回顾了胎儿酒精暴露的流行病学,并讨论了目前筛查和预防胎儿酒精暴露的策略。我们还探讨了从患者、提供者和系统角度来看,存在着多种减少酒精暴露妊娠的障碍。最后,我们提出了改进临床和公共卫生策略的建议,以消除美国的胎儿酒精暴露。

目标受众

妇产科医生、家庭医生。

学习目标

完成这项 CME 活动后,医生应能够更好地描述美国胎儿酒精暴露的发生率,描述面临胎儿酒精暴露风险最高的妇女的人口统计学特征,就与胎儿酒精暴露相关的不良胎儿结局风险向患者进行适当咨询,并了解有效咨询胎儿酒精暴露的障碍。

相似文献

1
Reducing fetal alcohol exposure in the United States.减少美国的胎儿酒精暴露。
Obstet Gynecol Surv. 2013 May;68(5):367-78. doi: 10.1097/OGX.0b013e31828736d5.
2
Alcohol use and pregnancy consensus clinical guidelines.酒精使用与妊娠共识临床指南。
J Obstet Gynaecol Can. 2010 Aug;32(8 Suppl 3):S1-31. doi: 10.1016/s1701-2163(16)34633-3.
3
Midwives and pregnant women talk about alcohol: what advice do we give and what do they receive?助产士和孕妇谈论酒精:我们提供什么建议,她们接受什么建议?
Midwifery. 2011 Aug;27(4):489-96. doi: 10.1016/j.midw.2010.03.009. Epub 2010 May 14.
4
Strategies to reduce alcohol-exposed pregnancies.减少酒精暴露妊娠的策略。
Matern Child Health J. 2006 Sep;10(5 Suppl):S149-51. doi: 10.1007/s10995-006-0116-9.
5
Alcohol and pregnancy: a clinical perspective.酒精与妊娠:临床视角
Annu Rev Med. 1985;36:73-80. doi: 10.1146/annurev.me.36.020185.000445.
6
Alcohol use among pregnant and nonpregnant women of childbearing age - United States, 1991-2005.1991 - 2005年美国育龄孕妇和非孕妇的酒精使用情况
MMWR Morb Mortal Wkly Rep. 2009 May 22;58(19):529-32.
7
Managing persistent preventable threats to safer pregnancies and infant health in the United States: beyond silos and into integration, early intervention, and prevention.应对美国安全怀孕和婴儿健康面临的持续性可预防威胁:超越各自为政,实现整合、早期干预和预防。
J Womens Health (Larchmt). 2006 Nov;15(9):1090-2. doi: 10.1089/jwh.2006.15.1090.
8
Make your office alcohol-exposed pregnancy prevention friendly.让你的办公室成为预防酒精暴露致孕的友好场所。
J Ark Med Soc. 2011 Sep;108(4):62-4.
9
Prevention of fetal alcohol spectrum disorders.胎儿酒精谱系障碍的预防
Dev Disabil Res Rev. 2009;15(3):193-9. doi: 10.1002/ddrr.75.
10
Fetal alcohol spectrum disorders: knowledge and screening practices of university hospital medical students and residents.胎儿酒精谱系障碍:大学医院医学生和住院医师的知识与筛查实践
J Popul Ther Clin Pharmacol. 2013;20(1):e18-25. Epub 2013 Jan 23.

引用本文的文献

1
Reducing Prenatal Alcohol Exposure and the Incidence of FASD: Is the Past Prologue?减少产前酒精暴露和 FASD 的发生率:过去是序幕吗?
Alcohol Res. 2023 Apr 20;43(1):02. doi: 10.35946/arcr.v43.1.02. eCollection 2023.
2
Forty Years of Assessing Neurodevelopmental and Behavioral Effects of Prenatal Alcohol Exposure in Infants: What Have We Learned?四十年来评估婴儿期产前酒精暴露对神经发育和行为的影响:我们学到了什么?
Alcohol Clin Exp Res. 2019 Aug;43(8):1632-1642. doi: 10.1111/acer.14127. Epub 2019 Jul 3.
3
Risk factors for alcohol use among pregnant women, ages 15-44, in the United States, 2002 to 2017.
美国 2002 年至 2017 年间,15-44 岁孕妇饮酒的风险因素。
Prev Med. 2019 Jul;124:75-83. doi: 10.1016/j.ypmed.2019.04.027. Epub 2019 May 1.
4
Substance use during pregnancy.孕期物质使用。
F1000Res. 2016 May 13;5. doi: 10.12688/f1000research.7645.1. eCollection 2016.
5
Substance Use in the Perinatal Period.围产期物质使用
Curr Psychiatry Rep. 2015 Nov;17(11):91. doi: 10.1007/s11920-015-0626-5.
6
Characteristics of Low-income Racial/Ethnic Minority Pregnant Women Screening Positive for Alcohol Risk.酒精风险筛查呈阳性的低收入种族/族裔少数族裔孕妇的特征。
J Immigr Minor Health. 2016 Aug;18(4):850-855. doi: 10.1007/s10903-015-0238-5.
7
Prenatal ethanol exposure disrupts intraneocortical circuitry, cortical gene expression, and behavior in a mouse model of FASD.产前乙醇暴露破坏了 FASD 小鼠模型的皮质内皮层回路、皮质基因表达和行为。
J Neurosci. 2013 Nov 27;33(48):18893-905. doi: 10.1523/JNEUROSCI.3721-13.2013.