Center for Maternal Substance Abuse and Child Development, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Drive NE, Suite 200, Atlanta, GA 30329, United States..
Neurotoxicol Teratol. 2017 Nov;64:50-62. doi: 10.1016/j.ntt.2017.10.001. Epub 2017 Oct 3.
Few studies have focused on the transition to adulthood in adults with prenatal alcohol exposure (PAE). In this study, we examine the occurrence of problem behavior at this transition, including mental health problems, substance use, and difficulties with the legal system. The sample is prospective and provides an opportunity to examine effects of a wide range of prenatal exposure. Adults with PAE were expected to show more problem behavior; the impact of level of exposure was examined as well.
The sample was drawn from a predominantly low-income, African-American population. Mothers of the alcohol-exposed participants (n=123) and those in the non-exposed SES-Control group (CONT) (n=59) were recruited at a prenatal visit when information on alcohol and drug use during pregnancy was collected. A disability contrast group (n=54) was recruited at adolescence. The adults with PAE were assigned to three groups varying in physical and cognitive effects of exposure. This report is based on the adults' responses to interviews or questionnaires on problem behavior and laboratory tests related to substance use.
Adults with PAE showed more problem behavior in all three areas than adults from the CONT group. For mental health problems, the exposed group showing cognitive, but not physical effects, had the highest scores; their scores were similar, however, to those of the disability contrast group on several scales. Results for outcomes on substance use and legal difficulties were less consistent, but, when significant effects occurred, the group that was exposed, but neither physically nor cognitively affected, was more likely to show negative outcomes. Males in this group were most involved in these behaviors.
Effects of PAE continue into early adulthood and affect mental health problems, substance use, and interactions with the legal system. Adults who are exposed, but less physically affected, seem to be the most involved in problem behavior. More research is necessary to examine environmental effects in conjunction with PAE on these outcomes and to provide a basis for developing potential interventions.
很少有研究关注产前酒精暴露(PAE)成年人向成年期的过渡。在这项研究中,我们研究了这一过渡时期出现的问题行为,包括心理健康问题、物质使用和与法律系统的困难。该样本是前瞻性的,有机会检查广泛的产前暴露的影响。预计 PAE 成年人会表现出更多的问题行为;还检查了暴露水平的影响。
该样本来自一个以低收入、非裔美国人为主的人群。酒精暴露参与者的母亲(n=123)和非暴露 SES 对照组(CONT)(n=59)的母亲在产前就诊时被招募,当时收集了有关怀孕期间酒精和药物使用的信息。一个残疾对照组(n=54)在青春期被招募。PAE 成年人被分配到三个不同的组,这些组的暴露程度在身体和认知方面有所不同。本报告基于成年人对问题行为的访谈或问卷调查以及与物质使用相关的实验室测试的回答。
与 CONT 组相比,PAE 成年人在所有三个领域都表现出更多的问题行为。对于心理健康问题,表现出认知但没有身体影响的暴露组得分最高;然而,在几个量表上,他们的得分与残疾对照组相似。物质使用和法律困难的结果不太一致,但当出现显著影响时,暴露但既没有身体也没有认知影响的组更有可能表现出负面结果。该组中的男性最容易参与这些行为。
PAE 的影响持续到成年早期,并影响心理健康问题、物质使用和与法律系统的互动。暴露但身体受影响较小的成年人似乎更容易出现问题行为。需要进一步研究,以检查环境影响与 PAE 对这些结果的综合影响,并为制定潜在干预措施提供依据。