Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa.
Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
Alcohol Clin Exp Res. 2018 Feb;42(2):369-377. doi: 10.1111/acer.13566. Epub 2017 Dec 28.
Cohort studies have noted associations between hazardous alcohol use during pregnancy and infant growth outcomes, but many have not controlled for potential psychosocial confounders. To assess the unique contribution of hazardous alcohol use, we examined its effect on infant growth outcomes while controlling for maternal psychosocial stressors and hazardous tobacco and drug use in a cohort of 986 pregnant South African women enrolled into the Drakenstein Child Health Study between 2012 and 2015.
Data on psychosocial stressors and maternal risk behaviors were collected between 28 and 32 weeks of gestation. Participants were categorized as hazardous alcohol users if they obtained moderate or high scores (>10) on the Alcohol, Smoking and Substance Involvement Screening Test at this assessment or retrospectively reported drinking at least 2 drinks weekly during any trimester of pregnancy. Infant growth outcomes were recorded at delivery. Multivariable regression models examined correlates of hazardous alcohol use and associations between hazardous alcohol use and birth outcomes.
Overall, 13% of mothers reported hazardous alcohol use. Recent exposure to intimate partner violence (adjusted odds ratio (aOR) = 2.08; 95% confidence interval (CI): 1.37, 3.18) and hazardous tobacco use (aOR = 5.03; 95% CI: 2.97, 8.52) were significant correlates of hazardous alcohol use. After controlling for potential psychosocial confounders, hazardous alcohol use remained associated with lower infant weight-for-age (B = -0.35, 95% CI: -0.56, -0.14), height-for-age (B = -0.46, 95% CI: -0.76, -0.17), and head-circumference-for-age z-scores (B = -0.43, 95% CI: -0.69, -0.17).
Interventions to reduce hazardous alcohol use among pregnant women in South Africa are needed to prevent alcohol-related infant growth restrictions. As these growth deficits may lead to neurodevelopmental consequences, it is critical to identify alcohol-related growth restrictions at birth and link exposed infants to early interventions for neurodevelopment.
队列研究表明，怀孕期间危险饮酒与婴儿生长结局有关，但许多研究并未控制潜在的心理社会混杂因素。为了评估危险饮酒的独特作用，我们在 2012 年至 2015 年间参加德肯斯坦儿童健康研究的 986 名南非孕妇队列中，在控制产妇心理社会压力源和危险烟草及药物使用的情况下，检查了危险饮酒对婴儿生长结局的影响。
在妊娠 28-32 周期间收集心理社会压力源和产妇危险行为的数据。如果在该评估中获得酒精、吸烟和物质参与筛查测试的中或高评分（>10），或在妊娠任何一个季度每周至少饮用 2 杯，则将参与者归类为危险饮酒者。在分娩时记录婴儿生长结局。多变量回归模型检查了危险饮酒的相关因素以及危险饮酒与出生结局之间的关联。
总体而言，13%的母亲报告有危险饮酒。最近接触亲密伴侣暴力（调整后的优势比（aOR）=2.08；95%置信区间（CI）：1.37，3.18）和危险烟草使用（aOR=5.03；95%CI：2.97，8.52）是危险饮酒的显著相关因素。在控制潜在的心理社会混杂因素后，危险饮酒与婴儿体重-年龄（B=-0.35，95%CI：-0.56，-0.14）、身高-年龄（B=-0.46，95%CI：-0.76，-0.17）和头围-年龄 z 评分（B=-0.43，95%CI：-0.69，-0.17）均有关联。
南非需要采取干预措施减少孕妇的危险饮酒，以防止与酒精相关的婴儿生长受限。由于这些生长缺陷可能导致神经发育后果，因此在出生时识别与酒精相关的生长受限并将暴露的婴儿与早期神经发育干预措施联系起来至关重要。
