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意大利某省胎儿酒精谱系障碍的母亲风险因素

Maternal risk factors for fetal alcohol spectrum disorders in a province in Italy.

作者信息

Ceccanti Mauro, Fiorentino Daniela, Coriale Giovanna, Kalberg Wendy O, Buckley David, Hoyme H Eugene, Gossage J Phillip, Robinson Luther K, Manning Melanie, Romeo Marina, Hasken Julie M, Tabachnick Barbara, Blankenship Jason, May Philip A

机构信息

Center on Alcoholism, Alcohol Addiction Program, The University of Rome, Sapienza, Plazzale Aldo Moro 5, Rome 00186, Italy.

Center on Alcoholism, Substance Abuse, and Addictions (CASAA), The University of New Mexico, Albuquerque, NM 87106, USA.

出版信息

Drug Alcohol Depend. 2014 Dec 1;145:201-8. doi: 10.1016/j.drugalcdep.2014.10.017. Epub 2014 Oct 25.

Abstract

BACKGROUND

Maternal risk factors for fetal alcohol spectrum disorders (FASD) in Italy and Mediterranean cultures need clarification, as there are few studies and most are plagued by inaccurate reporting of antenatal alcohol use.

METHODS

Maternal interviews (n = 905) were carried out in a population-based study of the prevalence and characteristics of FASD in the Lazio region of Italy which provided data for multivariate case control comparisons and multiple correlation models.

RESULTS

Case control findings from interviews seven years post-partum indicate that mothers of children with FASD are significantly more likely than randomly-selected controls or community mothers to: be shorter; have higher body mass indexes (BMI); be married to a man with legal problems; report more drinking three months pre-pregnancy; engage in more current drinking and drinking alone; and have alcohol problems in her family. Logistic regression analysis of multiple candidate predictors of a FASD diagnosis indicates that alcohol problems in the child's family is the most significant risk factor, making a diagnosis within the continuum of FASD 9 times more likely (95%C.I. = 1.6 to 50.7). Sequential multiple regression analysis of the child's neuropsychological performance also identifies alcohol problems in the child's family as the only significant maternal risk variable (p < .001) when controlling for other potential risk factors.

CONCLUSIONS

Underreporting of prenatal alcohol use has been demonstrated among Italian and other Mediterranean antenatal samples, and it was suspected in this sample. Nevertheless, several significant maternal risk factors for FASD have been identified.

摘要

背景

在意大利及地中海文化中,胎儿酒精谱系障碍(FASD)的母体风险因素尚需明确,因为相关研究较少,且多数研究存在产前酒精使用报告不准确的问题。

方法

在一项基于人群的意大利拉齐奥地区FASD患病率及特征研究中,开展了对905名母亲的访谈,为多变量病例对照比较和多重相关模型提供数据。

结果

产后七年访谈的病例对照研究结果表明,与随机选择的对照组或社区母亲相比,FASD患儿的母亲更有可能:身材较矮;体重指数(BMI)较高;丈夫有法律问题;报告在怀孕前三个月饮酒较多;当前饮酒量更多且独自饮酒;其家族存在酒精问题。对FASD诊断的多个候选预测因素进行逻辑回归分析表明,患儿家族中的酒精问题是最显著的风险因素,使FASD连续谱内的诊断可能性增加9倍(95%置信区间=1.6至50.7)。对患儿神经心理表现进行的逐步多元回归分析也表明,在控制其他潜在风险因素时,患儿家族中的酒精问题是唯一显著的母体风险变量(p<.001)。

结论

在意大利及其他地中海地区的产前样本中已证实存在产前酒精使用报告不足的情况,本样本中也存在这种怀疑。尽管如此,已确定了几个FASD的重要母体风险因素。

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