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胎粪中脂肪酸乙酯与新生儿出生时生长缺陷的相关性:一项前瞻性、单中心队列研究。

Association of Fatty Acid Ethyl Esters in Meconium of Neonates with Growth Deficits at Birth: a Prospective, Single-Centre Cohort Study.

机构信息

Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

出版信息

J Korean Med Sci. 2018 Nov 15;33(50):e318. doi: 10.3346/jkms.2018.33.e318. eCollection 2018 Dec 10.

Abstract

BACKGROUND

In this prospective cohort study, we investigated the association between fatty acid ethyl esters (FAEEs) in meconium as biomarkers of prenatal ethanol exposure and growth deficits, as birth outcomes, that constitute several of the key cardinal features of fetal alcohol syndrome.

METHODS

A total of 157 meconium samples were collected from enrolled infants within 24 hours of birth, and nine FAEEs were quantified using liquid chromatography/tandem mass spectrometry. The relationships between cumulative concentrations of nine species of FAEEs in meconium and birth parameters of growth (age-sex-specific centiles of head circumference [HC], weight, and length) and respective and combined birth outcomes of growth deficits (HC ≤ 10th centile, weight ≤ 10th centile, and length ≤ 10th centile) were determined.

RESULTS

Multivariate logistic regression analysis demonstrated that higher cumulative concentrations of meconium FAEEs correlated with elevated risks for HC and length, both, 10th percentile or less (adjusted odds ratio [aOR], 2.94; 95% confidence interval [CI], 1.12-7.74; = 0.029) and HC and weight and length, all of them, 10th percentile or less (aOR, 3.27; 95% CI, 1.12-9.59; = 0.031).

CONCLUSION

The elevated cumulative FAEEs in meconium were associated with combined growth deficits at birth, specifically HC and length, both, 10th percentile or less, which might be correlated with detrimental alcohol effects on fetal brain and bone development, suggesting a plausible alcohol-specific pattern of intrauterine growth restriction.

摘要

背景

在这项前瞻性队列研究中,我们研究了胎粪中脂肪酸乙酯(FAEE)作为产前乙醇暴露生物标志物与生长缺陷的关系,而生长缺陷是胎儿酒精综合征的几个关键特征之一。

方法

共收集了 157 例出生后 24 小时内的婴儿胎粪样本,并使用液相色谱/串联质谱法定量了 9 种 FAEE。采用多元逻辑回归分析,确定胎粪中 9 种 FAEE 累积浓度与生长参数(头围[HC]、体重和长度的年龄性别特定百分位数)以及各自和联合的生长缺陷(HC≤第 10 百分位数、体重≤第 10 百分位数和长度≤第 10 百分位数)的出生结果之间的关系。

结果

多元逻辑回归分析表明,胎粪 FAEE 累积浓度越高,HC 和长度均<第 10 百分位数(调整比值比[aOR],2.94;95%置信区间[CI],1.12-7.74;P=0.029)和 HC、体重和长度均<第 10 百分位数(aOR,3.27;95%CI,1.12-9.59;P=0.031)的风险增加。

结论

胎粪中 FAEE 累积浓度升高与出生时联合生长缺陷有关,特别是 HC 和长度均<第 10 百分位数,这可能与酒精对胎儿大脑和骨骼发育的有害影响有关,提示宫内生长受限存在一种可能与酒精有关的特定模式。

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本文引用的文献

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Fetal Alcohol Exposure: The Common Toll.胎儿酒精暴露:共同的危害。
J Alcohol Drug Depend. 2017 Feb;5(1). doi: 10.4172/2329-6488.1000257. Epub 2017 Feb 28.
9
Fetal Alcohol Growth Restriction and Cognitive Impairment.胎儿酒精性生长受限与认知障碍。
Pediatrics. 2016 Aug;138(2). doi: 10.1542/peds.2016-0775. Epub 2016 Jul 8.

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