BC Natal Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu and Hospital Clínic, Passeig Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain.
Occupational and Environmental Medicine, Lund University, Scheelevägen 2, 223 63 Lund, Sweden.
Alcohol. 2018 Aug;70:43-49. doi: 10.1016/j.alcohol.2018.01.001. Epub 2018 Jan 4.
Maternal exposure to tobacco and alcohol is a known cause, among others, for fetal growth restriction (FGR). Clinically, FGR can be subclassified into two forms: intrauterine growth restriction (IUGR) and small for gestational age (SGA), based on the severity of the growth retardation, and abnormal uterine artery Doppler or cerebro-placental ratio. This study aimed at investigating any differential correlation between maternal exposures to these toxins with the two clinical forms of FGR. Therefore, a case-control study was conducted in Barcelona, Spain. Sixty-four FGR subjects, who were further subclassified into IUGR (n = 36) and SGA (n = 28), and 89 subjects matched appropriate-for-gestational age (AGA), were included. The levels of nicotine (NIC) and ethyl glucuronide (EtG), biomarkers of tobacco and alcohol exposure, respectively, were assessed in the maternal hair in the third trimester. Our analysis showed 65% of the pregnant women consumed alcohol, 25% smoked, and 19% did both. The odds ratios (ORs) of IUGR were 21 times versus 14 times for being SGA with maternal heavy smoking, while with alcohol consumption the ORs for IUGR were 22 times versus 37 times for the SGA group. The differential correlations between these toxins with the two subtypes of FGR suggest different mechanisms influencing fetal weight. Our alarming data of alcohol consumption during pregnancy should be considered for further confirmation among Spanish women.
母体暴露于烟草和酒精等物质是胎儿生长受限（FGR）的已知原因之一。临床上，FGR 可根据生长迟缓的严重程度进一步分为宫内生长受限（IUGR）和小于胎龄儿（SGA）两种类型，并伴有子宫动脉多普勒或脑胎盘比异常。本研究旨在探讨母体接触这些毒素与两种临床类型的 FGR 之间是否存在差异相关性。因此，在西班牙巴塞罗那进行了一项病例对照研究。共纳入 64 例 FGR 患者，进一步分为 IUGR（n=36）和 SGA（n=28），并纳入 89 例与胎龄相匹配的正常大小儿（AGA）作为对照组。在妊娠晚期，评估了母体头发中尼古丁（NIC）和乙基葡萄糖醛酸苷（EtG）的水平，这两种标志物分别代表烟草和酒精暴露的水平。我们的分析显示，65%的孕妇饮酒，25%吸烟，19%既饮酒又吸烟。与 SGA 相比，母体重度吸烟与 IUGR 的比值比（OR）分别为 21 倍和 14 倍，而与酒精摄入相比，IUGR 与 SGA 组的 OR 分别为 22 倍和 37 倍。这些毒素与 FGR 两种亚型之间的差异相关性表明，不同的机制会影响胎儿体重。我们发现妊娠期间饮酒的数据令人震惊，应在西班牙女性中进一步证实。
