Department of Nutrition, Nutrition Research Institute, University of North Carolina, Chapel Hill, North Carolina.
Center on Alcoholism, Substance Abuse and Addictions (CASAA), The University of New Mexico, Albuquerque, New Mexico.
Alcohol Clin Exp Res. 2020 Apr;44(4):900-918. doi: 10.1111/acer.14315. Epub 2020 Apr 15.
To document prevalence and traits of children with fetal alcohol spectrum disorders (FASD) and maternal risk factors in a Rocky Mountain city.
Variations on active case ascertainment methods were used in 2 first-grade cohorts in all city schools. The consent rate was 59.2%. Children were assessed for physical growth, dysmorphology, and neurobehavior and their mothers interviewed.
Thirty-eight children were diagnosed with FASD and compared with 278 typically developing controls. Total dysmorphology scores summarized well the key physical indicators of FASD and defined specific diagnostic groups. On average, children with FASD performed significantly poorer than controls on intellectual, adaptive, learning, attention, and behavioral tasks. More mothers of children with FASD reported drinking prior to pregnancy and in the first and second trimesters, and had partners with drinking problems than mothers of controls; however, reports of comorbid alcohol use and 6 other drugs were similar for mothers of children with FASD and mothers of controls. Mothers of children with FASD were significantly younger at pregnancy, had lower average weight before pregnancy and less education, initiated prenatal clinic visits later, and reported more health problems (e.g., stomach ulcers and accidents). Children with FASD had significantly lower birth weight and more problems at birth, and were less likely to be living with biological mother and father. Controlling for other drug and tobacco use, a FASD diagnosis is 6.7 times (OR = 6.720, 95% CI = 1.6 to 28.0) more likely among children of women reporting prepregnancy drinking of 3 drinks per drinking day (DDD) and 7.6 times (OR = 7.590, 95% CI = 2.0 to 31.5) more likely at 5 DDD. Prevalence of FAS was 2.9-5.8 per 1,000 children, and total FASD was 34.9 to 82.5 per 1,000 children or 3.5 to 8.3% at this site.
This site had the second highest prevalence of FASD of the 4 Collaboration on FASD Prevalence sites and clearly identifiable child and maternal risk traits.
记录在落基山城市中患有胎儿酒精谱系障碍（FASD）的儿童及其母亲的风险因素的患病率和特征。
在所有城市学校的两个一年级队列中使用了主动病例发现方法的变化。同意率为 59.2%。对儿童进行身体生长、畸形和神经行为评估，并对其母亲进行访谈。
38 名儿童被诊断为 FASD，并与 278 名典型发育对照组进行比较。总的畸形评分很好地总结了 FASD 的关键身体指标，并定义了特定的诊断组。平均而言，FASD 患儿在智力、适应、学习、注意力和行为任务上的表现明显差于对照组。更多的 FASD 患儿母亲报告在怀孕前和前三个月和第二个三个月饮酒，并且其伴侣有饮酒问题，而对照组母亲则没有；然而，FASD 患儿母亲和对照组母亲报告的其他共病酒精使用和其他 6 种药物的报告相似。FASD 患儿的母亲在怀孕时明显更年轻，怀孕前平均体重较低，教育程度较低，开始产前就诊较晚，报告的健康问题（如胃溃疡和事故）更多。FASD 患儿的出生体重明显较低，出生时问题更多，与亲生母亲和父亲一起生活的可能性较小。在控制其他药物和烟草使用的情况下，报告怀孕前每天饮酒 3 杯（DDD）的女性所生儿童的 FASD 诊断的可能性是其他儿童的 6.7 倍（OR=6.720，95%CI=1.6 至 28.0），每天饮酒 5 杯（DDD）的女性所生儿童的可能性是其他儿童的 7.6 倍（OR=7.590，95%CI=2.0 至 31.5）。FAS 的患病率为每 1000 名儿童 2.9-5.8 例，总 FASD 为每 1000 名儿童 34.9-82.5 例，或该地点的 3.5-8.3%。
该地点是 FASD 合作研究的 4 个患病率地点中 FAS 患病率第二高的地点，并且具有明显可识别的儿童和产妇风险特征。
