Das Sumon K, McIntyre Harold D, Alati Rosa, Al Mamun Abdullah
Institute for Social Science Research, School of Social Science, The University of Queensland, Brisbane, Queensland, Australia.
Nutrition and Clinical Services Devision, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
Nephrology (Carlton). 2019 Jan;24(1):21-27. doi: 10.1111/nep.13206.
Prenatal exposure to alcohol has adverse ramifications on foetal development resulting in developmental abnormalities and major congenital anomalies. Experimental studies have documented effects on kidney structure and function among offspring exposed to alcohol during foetal life; however, human evidence is scarce. Thus, the present study aimed to determine the development of CKD among a cohort of 30-year-old Australian offspring whose mothers reported consumption of alcohol during pregnancy.
The study sample comprised 1626 offspring of the Australia cohort study (MUSP) whose serum creatinine was assessed at 30 years of age and CKD was categorized from stage 1 to stage 5 based on their level of eGFR following the CKD-EPI definition.
Seven percent (n = 111) of offspring had mild (stage 2) CKD at 30 years. The overall adjusted odds of CKD were 2.10 (95% CI 1.02 to 4.33) for offspring of moderate to heavy drinking mothers in late pregnancy, 1.59 (0.69 to 3.66) for early pregnancy and 1.23 (0.75 to 2.04) for pre-pregnancy. The association was higher for female offspring-2.84 (1.07 to 7.54) for late pregnancy and 2.94 (1.10 to 7.88) for early pregnancy. Higher but insignificant odds were found for male offspring at late pregnancy 1.51 (0.49 to 4.73) only.
Maternal alcohol exposure during early and late pregnancy is associated with development of mild CKD in their offspring at 30 years. This association is stronger for female than male offspring.
孕期暴露于酒精会对胎儿发育产生不良影响，导致发育异常和主要先天性畸形。实验研究已证明胎儿期暴露于酒精的后代肾脏结构和功能会受到影响；然而，人类相关证据却很稀少。因此，本研究旨在确定一组30岁澳大利亚后代中慢性肾脏病（CKD）的发病情况，这些后代的母亲报告在孕期饮酒。
研究样本包括澳大利亚队列研究（MUSP）的1626名后代，在他们30岁时评估其血清肌酐，并根据CKD-EPI定义，依据估算肾小球滤过率（eGFR）水平将CKD分为1期至5期。
7%（n = 111）的后代在30岁时患有轻度（2期）CKD。妊娠晚期中度至重度饮酒母亲所生后代患CKD的总体校正比值比为2.10（95%可信区间1.02至4.33），妊娠早期为1.59（0.69至3.66），孕前为1.23（0.75至2.04）。女性后代的关联度更高——妊娠晚期为2.84（1.07至7.54），妊娠早期为2.94（1.10至7.88）。仅在妊娠晚期发现男性后代的比值比更高但无统计学意义，为1.51（0.49至4.73）。
孕期早期和晚期母亲暴露于酒精与后代30岁时患轻度CKD有关。这种关联在女性后代中比男性后代更强。
