Pyman Philippa, Collins Simonne E, Muggli Evelyne, Testa Renee, Anderson Peter J
Monash University, Turner Institute for Brain and Mental Health, Melbourne, VIC, Australia.
Murdoch Children's Research Institute, Melbourne, VIC, Australia.
Neuropsychol Rev. 2021 Dec;31(4):610-627. doi: 10.1007/s11065-021-09490-8. Epub 2021 Mar 3.
Attention problems are thought to be a hallmark feature of prenatal alcohol exposure (PAE). Despite decades of research however, these findings have never been pooled to assess the association between PAE and the different domains of attention functioning. This systematic review and meta-analysis aimed to examine the relationships between low-moderate, binge and heavy PAE with domains of attention functioning (encode, focus, shift, sustain and behavioural) in children. Thirteen studies compared children with PAE to abstinent controls. A significant adverse effect of any PAE on shifting attention (Cohen's d = -0.61), and a trend towards an adverse effect of heavy PAE on encoding attention (Cohen's d = -0.79) were identified. Compared to controls, there were trends showing that low-moderate PAE (odds ratio = 1.21) was associated with greater odds of behavioural attention problems. Remaining analyses were limited by insufficient studies or were non-significant. In summary, a vulnerability of higher-level attention skills to PAE was found. Urgent investigation into the effects of low to moderate PAE is needed given the prevalence of this drinking pattern, trends towards behavioural attention problems, the lack of comprehensive and high-quality research and the known impacts of attention difficulties on academic and social development in children.
注意力问题被认为是产前酒精暴露（PAE）的一个标志性特征。然而，尽管经过了数十年的研究，但这些研究结果从未被汇总起来以评估PAE与注意力功能不同领域之间的关联。这项系统综述和荟萃分析旨在研究低中度、暴饮和重度PAE与儿童注意力功能领域（编码、聚焦、转移、维持和行为）之间的关系。13项研究将有PAE的儿童与戒酒的对照组进行了比较。研究发现，任何PAE对注意力转移均有显著不良影响（科恩d值=-0.61），重度PAE对注意力编码有不良影响的趋势（科恩d值=-0.79）。与对照组相比，有趋势表明低中度PAE（优势比=1.21）与行为注意力问题的更高几率相关。其余分析因研究不足而受限或无统计学意义。总之，发现了高级注意力技能对PAE的易损性。鉴于这种饮酒模式的普遍性、行为注意力问题的趋势、缺乏全面和高质量的研究以及注意力困难对儿童学业和社交发展的已知影响，需要对低至中度PAE的影响进行紧急调查。
