Bakhireva Ludmila N, Ma Xingya, Wiesel Alexandria, Wohrer Fiona E, DiDomenico Jared, Jacobson Sandra W, Roberts Melissa H
College of Pharmacy Substance Use Research and Education Center, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA.
Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan, USA.
Alcohol Clin Exp Res (Hoboken). 2024 Apr;48(4):703-714. doi: 10.1111/acer.15284. Epub 2024 Mar 30.
A better understanding of the effects of lower levels of prenatal alcohol exposure (PAE), as a common exposure, is needed. The goal of this study was to examine the effects of mild-moderate PAE and episodic binge drinking on perinatal outcomes.
The data were obtained from three prospective cohorts with a combined sample of 281 participants: 125 with PAE and 156 without PAE. Alcohol-related measures included the Alcohol Use Disorders Identification Test, timeline follow-back questionnaires (covering the periconceptional period, mid-gestation, and late gestation), and biomarkers. Absolute alcohol per day (AAD) and per drinking day (AADD), number of binge episodes, and maximum number of drinks in a 24-h period were estimated. Perinatal outcomes included gestational age and anthropometric measures. Data were analyzed using correlation and multivariable regression analysis.
Among women with PAE, average alcohol consumption across the periconceptional period and pregnancy was 0.37 oz ± 0.74 AA/day (~5 drinks/week). After adjusting for tobacco co-exposure and sociodemographic characteristics, significant associations between all alcohol measures and gestational age at delivery were observed, including cumulative measures of AAD (β = -0.58; 95% CI: -0.98; -0.17) and AADD (β = -0.58; 95% CI: -0.90; -0.26) during pregnancy and the periconceptional period. A significant association between the maximum number of drinks in a 24-h period and birth length percentile (β = -0.70; 95% CI: -1.36; -0.04) was observed in the final model. PAE was associated with lower birth weight percentile in univariate analyses only.
Results of this study demonstrate a negative association between mild-moderate PAE and episodic binge drinking with gestational age at delivery and birth length percentile after controlling for other factors. Robust negative effects of PAE, including in the periconceptional period before pregnancy recognition, on duration of gestation highlight the need for primary prevention efforts aimed at PAE in persons of reproductive age.
需要更好地了解较低水平的产前酒精暴露（PAE）这种常见暴露的影响。本研究的目的是检验轻度至中度PAE和间歇性暴饮对围产期结局的影响。
数据来自三个前瞻性队列，合并样本为281名参与者：125名有PAE者和156名无PAE者。与酒精相关的测量指标包括酒精使用障碍识别测试、时间线追溯问卷（涵盖受孕前期、妊娠中期和妊娠晚期）以及生物标志物。估计每日绝对酒精摄入量（AAD）和每次饮酒日酒精摄入量（AADD）、暴饮次数以及24小时内最大饮酒量。围产期结局包括孕周和人体测量指标。使用相关性分析和多变量回归分析对数据进行分析。
在有PAE的女性中，受孕前期和孕期的平均酒精摄入量为0.37盎司±0.74酒精单位/天（约每周5杯）。在调整了烟草共同暴露和社会人口学特征后，观察到所有酒精测量指标与分娩时孕周之间存在显著关联，包括孕期和受孕前期的AAD累积测量值（β = -0.58；95%置信区间：-0.98；-0.17）和AADD（β = -0.58；95%置信区间：-0.90；-0.26）。在最终模型中观察到24小时内最大饮酒量与出生身长百分位数之间存在显著关联（β = -0.70；95%置信区间：-1.36；-0.04）。仅在单变量分析中，PAE与较低的出生体重百分位数相关。
本研究结果表明，在控制其他因素后，轻度至中度PAE和间歇性暴饮与分娩时孕周和出生身长百分位数之间存在负相关。PAE的强烈负面影响，包括在确认怀孕前的受孕前期，对妊娠期的影响凸显了针对育龄人群PAE进行一级预防的必要性。
