Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, California.
Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, La Jolla, California.
Alcohol Clin Exp Res. 2019 Dec;43(12):2578-2590. doi: 10.1111/acer.14213. Epub 2019 Nov 5.
There are limited data on the characteristics of children with fetal alcohol spectrum disorders (FASD) and their mothers from the general population in the United States.
During the 2012 and 2013 academic years, first-grade children in a large urban Pacific Southwest city were invited to participate in a study to estimate the prevalence of FASD. Children who screened positive on weight, height, or head circumference ≤25th centile or on parental report of developmental concerns were selected for evaluation, along with a random sample of those who screened negative. These children were examined for dysmorphology and neurobehavior and their mothers or collateral sources were interviewed. Children were classified as fetal alcohol syndrome (FAS), partial fetal alcohol syndrome (pFAS), alcohol-related neurodevelopmental disorder (ARND), or No FASD.
A total of 854 children were evaluated; 5 FAS, 44 pFAS, 44 ARND, and 761 No FASD. Children with FAS or pFAS were more likely to have dysmorphic features, and 32/49 (65.3%) of those met criteria for neurobehavioral impairment on cognitive measures with or without behavioral deficits. In contrast, 28/44 (63.6%) of children with ARND met criteria on behavioral measures alone. Mothers of FASD children were more likely to recognize pregnancy later, be unmarried, and report other substance use or psychiatric disorders, but did not differ on age, socioeconomic status, education, or parity. Mothers of FASD children reported more drinks/drinking day each trimester. The risk of FASD was elevated with increasing number of drinks/drinking day prior to pregnancy recognition, even at the level of 1 drink per day (adjusted odds ratio 3.802, 95% confidence interval 1.634, 8.374).
Data from this general population sample in a large urban region in the United States demonstrate the variability of expression of FASD and point to risk and protective factors for mothers in this setting.
在美国，关于一般人群中胎儿酒精谱系障碍（FASD）患儿及其母亲的特征，数据有限。
在 2012 年和 2013 学年期间，邀请美国太平洋西南部一个大城市的一年级儿童参加一项研究，以估计 FASD 的患病率。对体重、身高或头围≤第 25 百分位数筛查阳性或父母报告有发育问题的儿童进行评估，并对筛查阴性的随机样本进行评估。对这些儿童进行了畸形和神经行为检查，并对其母亲或旁证进行了访谈。将儿童分为胎儿酒精综合征（FAS）、部分胎儿酒精综合征（pFAS）、酒精相关神经发育障碍（ARND）或无 FASD。
共评估了 854 名儿童；5 名 FAS、44 名 pFAS、44 名 ARND 和 761 名无 FASD。FAS 或 pFAS 患儿更有可能出现畸形特征，其中 32/49（65.3%）名患儿在认知测试中存在神经行为损伤，无论是否存在行为缺陷。相比之下，44 名 ARND 患儿中有 28 名仅在行为测量中符合标准。FASD 患儿的母亲更有可能在妊娠后期才意识到怀孕，未婚，且报告有其他物质使用或精神疾病，但在年龄、社会经济地位、教育程度或产次方面没有差异。FASD 患儿的母亲报告每妊娠三期中的饮酒量/饮酒天数更多。在妊娠前识别妊娠前饮酒量/饮酒天数增加，即使每天 1 份（调整后的比值比 3.802，95%置信区间 1.634，8.374），FASD 的风险也会升高。
来自美国一个大城市的一般人群样本中的数据显示了 FASD 的表现多样性，并指出了这种环境中母亲的风险和保护因素。
