May Philip A, Hasken Julie M, Stegall Julie M, Mastro Heather A, Baete Amy, Russo Jaymi, Bozeman Rosemary, Burns Mary Kay, Jones Jo-Viviane, Kalberg Wendy O, Buckley David, Abdul-Rahman Omar, Adam Margaret P, Jewett Tamison, Robinson Luther K, Manning Melanie A, Hoyme H Eugene
Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC, USA.
Center on Alcohol, Substance Use, and Addictions, University of New Mexico, Albuquerque, NM, USA.
Alcohol Clin Exp Res (Hoboken). 2025 Jan;49(1):185-204. doi: 10.1111/acer.15501. Epub 2024 Dec 12.
We sought to determine risk factors for fetal alcohol spectrum disorders (FASD) in the United States.
Mothers of first-grade children participating in the Collaboration on FASD Prevalence (CoFASP) in three regional sites were interviewed. Maternal and paternal data were reported by mothers of children with an FASD diagnosis and controls.
Interviews were conducted with mothers of children with an FASD (n = 114) and controls (n = 753). Fifty-seven percent of control mothers usually drank 2.7 drinks per drinking day (DDD) once per month prior to pregnancy, and 79% of mothers of children with FASD reported drinking 4.2 drinks 1-2 times per week. Mothers of children with alcohol-related neurodevelopmental disorder reported the most alcohol consumption overall: bingeing, drinking frequency, drinking in each trimester, and other drug use. Mothers of children with fetal alcohol syndrome (FAS) and partial FAS (PFAS) underreported consumption. Distal maternal risk factors were liver problems, depression, later pregnancy recognition and first prenatal visit, lower frequency of marriage, and lower spirituality. Postnatal risk indicators were low birthweight and gestational age. Regression analysis indicated that maternal reports of three DDD before pregnancy were associated with a diagnosis within the FASD continuum (p < 0.001, OR = 9.92). First-trimester exposure (p < 0.001, OR = 7.64) and all three trimesters (p < 0.001, OR = 7.77) were associated with a child's FASD diagnosis. An independent association was found between paternal DDD during pregnancy and FASD diagnoses (p = 0.002, OR = 1.08); but, once maternal drinking was a covariate, paternal influence was not significant. Stepwise models indicated that combined maternal alcohol use measures (p < 0.001, χ = 61.09), later pregnancy recognition (p = 0.032, χ = 4.58), later prenatal visits (p = 0.036, χ = 4.38), and depression in lifetime (p = 0.002, χ = 9.47) were significant FASD predictors. The final 10-step model explained 27.4% of the variance in FASD risk.
While multiple, significant maternal risk factors for FASD were identified, paternal drinking was not a statistically significant, independent risk factor.
我们试图确定美国胎儿酒精谱系障碍（FASD）的风险因素。
对参与三个地区性FASD患病率协作研究（CoFASP）的一年级儿童的母亲进行了访谈。患有FASD诊断的儿童和对照儿童的母亲报告了母亲和父亲的数据。
对患有FASD的儿童（n = 114）和对照儿童（n = 753）的母亲进行了访谈。57%的对照儿童母亲在怀孕前每月通常饮酒一次，每次饮酒日饮酒量为2.7杯，而79%的患有FASD的儿童母亲报告每周饮酒1 - 2次，每次饮酒量为4.2杯。患有酒精相关神经发育障碍的儿童母亲报告的总体饮酒量最高：暴饮、饮酒频率、孕期各阶段饮酒情况以及其他药物使用情况。患有胎儿酒精综合征（FAS）和部分FAS（PFAS）的儿童母亲少报了饮酒量。母亲的远期风险因素包括肝脏问题、抑郁症、怀孕确认和首次产前检查较晚、结婚频率较低以及精神信仰较低。产后风险指标包括低出生体重和孕周。回归分析表明，母亲报告怀孕前每日饮酒量达到三杯与FASD连续谱内的诊断相关（p < 0.001，OR = 9.92）。孕早期暴露（p < 0.001，OR = 7.64）和孕期三个阶段均暴露（p < 0.001，OR = 7.77）与儿童FASD诊断相关。发现孕期父亲每日饮酒量与FASD诊断之间存在独立关联（p = 0.002，OR = 1.08）；但是，一旦将母亲饮酒作为协变量纳入，父亲的影响就不显著了。逐步模型表明，母亲饮酒综合测量指标（p < 0.001，χ = 6
