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产前酒精使用与注意缺陷多动障碍的风险。

Prenatal alcohol use as a risk for attention-deficit/hyperactivity disorder.

机构信息

Department of Neurosciences and Behavior, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.

Department of Psychiatry and Mental Health, Fluminense Federal University, Rua Marques do Paraná, 303 Prédio Anexo, Niterói, Rio de Janeiro, CEP 24030-215, Brazil.

出版信息

Eur Arch Psychiatry Clin Neurosci. 2019 Sep;269(6):681-687. doi: 10.1007/s00406-018-0946-7. Epub 2018 Oct 23.

Abstract

The objective of the study was to investigate the association between alcohol use during pregnancy and mental disorders in childhood, controlling for confounding risk factors by a longitudinal study of pregnant women and their offspring. The initial cohort comprised pregnant women attending an obstetric service. From the initial sample of 449 pregnant women, 81 mother-child pairs agreed to participate. After 12 years, mother-child pairs were assessed through self-administered questionnaires and semi-structured interviews. The Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL) was used to assess the presence of any mental disorders in the children. The mothers were assessed by the Self-Reporting Questionnaire (SRQ) and the Alcohol Use Disorders Identification Test (AUDIT). Furthermore, data on the mother's alcohol use collected during pregnancy were analysed. A logistic regression tested the influence of alcohol consumption in all trimesters and binge drinking on the occurrence of attention-deficit/hyperactivity disorder (ADHD), controlling for covariates. Binge drinking at any time during pregnancy or low-moderate alcohol consumption in all trimesters of pregnancy was associated with a fivefold increased odds of child ADHD. The combination of both patterns of alcohol use added an increase of 19% in the variance of ADHD's occurrence. The episodic use of at least four drinks or the regular use of low-moderate alcohol doses during pregnancy was associated with significantly increased odds of subsequent child ADHD. Reducing binge drinking and regular alcohol use of pregnant women may lead to a significant decrease in their children developing ADHD.

摘要

本研究旨在通过对孕妇及其子女进行纵向研究,控制混杂风险因素,探讨孕期饮酒与儿童期精神障碍之间的关联。最初的队列包括在产科就诊的孕妇。在最初的 449 名孕妇中,有 81 对母婴同意参与。12 年后,通过自我管理问卷和半结构化访谈对母婴对进行评估。使用儿童期情感障碍和精神分裂症定式检查表-现病和终生版本(K-SADS-PL)评估儿童是否存在任何精神障碍。通过自我报告问卷(SRQ)和酒精使用障碍识别测试(AUDIT)评估母亲。此外,还分析了孕期母亲饮酒的数据。使用逻辑回归检验了所有孕期和 binge drinking 对注意缺陷多动障碍(ADHD)发生的影响,控制了协变量。在任何孕期或低-中度孕期饮酒与儿童 ADHD 的发生几率增加五倍相关。这两种饮酒模式的结合使 ADHD 发生的方差增加了 19%。在孕期至少饮用四杯或定期饮用低-中度酒精剂量与儿童 ADHD 的发生几率显著增加相关。减少孕妇 binge drinking 和定期饮酒可能会显著降低其子女患 ADHD 的风险。

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