Racial/Ethnic Disparity in Association Between Fetal Alcohol Syndrome and Alcohol Intake During Pregnancy: Multisite Retrospective Cohort Study.
Racial/Ethnic Disparity in Association Between Fetal Alcohol Syndrome and Alcohol Intake During Pregnancy: Multisite Retrospective Cohort Study.
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DOI：
10.2196/45358
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发表时间：
2023-04-21
影响因子：
8.5
通讯作者：
Kawachi, Ichiro
中科院分区：
文献类型：
--
作者：
Oh, Sarah Soyeon;Kang, Bada;Park, Jewel;Kim, SangMin;Park, Eun-Cheol;Lee, Seung Hee;Kawachi, Ichiro
关键词：
妊娠期间饮酒与一系列不良出生相关结局相关，包括死胎、低出生体重、早产和胎儿酒精综合征（FAS）。由于全球超过10%的女性在怀孕期间饮酒，了解种族/民族差异如何影响FAS发病变得越来越重要。然而，当每日乙醇摄入量受到控制时，人种和种族是否会影响FAS风险评估仍然未知。本研究旨在评估与妊娠期间饮酒相关的FAS风险的种族/民族差异。我们使用了一项纵向队列研究（胎儿酒精谱系障碍合作倡议）的数据，该研究在美国5家医院进行，共有595名妇女在2007年至2017年期间在怀孕期间饮酒。通过问卷、面对面访谈以及对医疗、法律的和社会服务记录的审查，收集了怀孕期间平均酒精含量（AAC）的数据。使用母亲人种（美洲印第安人/阿拉斯加原住民[AI/AN]、亚洲人、夏威夷原住民或其他太平洋岛民、黑人或非裔美国人、白色、多个人种和其他）和种族（西班牙裔/拉丁裔或非西班牙裔/拉丁裔）的自我报告以及基于标准化畸形标准的FAS诊断进行分析。采用对数二项回归分析与妊娠期间乙醇摄入量每增加1 g相关的FAS风险，按人种/种族分层。共有3.4%（20/595）的妇女报告在怀孕期间饮酒，生下了患有FAS的婴儿。产下FAS患儿的母亲AAC均值为32.06 g（SD 9.09），高于未产FAS患儿的母亲AAC均值12.07 g（SD 15.87）。FAS婴儿的AI/AN母亲的AAC最高（平均42.62，SD 8.35克），其次是白色（平均30.13，SD 4.88克）和黑人母亲（平均27.05，SD 12.78克）。白色（患病率比[PR] 1.10，95% CI 1.03-1.19）、黑人（PR 1.13，95% CI 1.04-1.23）和AI/AN（PR 1.10，95% CI 1.00-1.21）母亲在妊娠期酒精暴露相同的情况下，产下FAS婴儿的几率增加10%至13%。不考虑种族，AAC增加1克导致增加4%（PR 1.04，95% CI 1.02-1.07）在分娩婴儿时有≥2个面部畸形的几率方面（即睑裂短，上唇薄朱红缘，人中光滑）和增加4%（PR 1.04，95% CI 1.01-1.07）在脑生长不足的机会。分娩FAS婴儿的风险在白色、黑人和AI/AN妇女之间是相当的，在怀孕期间饮酒水平相似。无论种族如何，AAC每增加1克，就会增加生下面部畸形或大脑发育不足的婴儿的几率。
Alcohol consumption during pregnancy is associated with a range of adverse birth-related outcomes, including stillbirth, low birth weight, preterm birth, and fetal alcohol syndrome (FAS). With more than 10% of women consuming alcohol during pregnancy worldwide, it is increasingly important to understand how racial/ethnic variations affect FAS onset. However, whether race and ethnicity inform FAS risk assessment when daily ethanol intake is controlled for remains unknown. This study aimed to assess racial/ethnic disparities in FAS risk associated with alcohol consumption during pregnancy. We used data from a longitudinal cohort study (the Collaborative Initiative on Fetal Alcohol Spectrum Disorders) at 5 hospital sites around the United States of 595 women who consumed alcohol during pregnancy from 2007 to 2017. Questionnaires, in-person interviews, and reviews of medical, legal, and social service records were used to gather data on average alcoholic content (AAC) during pregnancy. Self-reports of maternal race (American Indian/Alaska Native [AI/AN], Asian, Native Hawaiian or other Pacific Islander, Black or African American, White, more than one race, and other) and ethnicity (Hispanic/Latino or not Hispanic/Latino), as well as FAS diagnoses based on standardized dysmorphological criteria, were used for analysis. Log-binomial regression was used to examine the risk of FAS associated with each 1-gram increase in ethanol consumption during pregnancy, stratified by race/ethnicity. A total of 3.4% (20/595) of women who reported consuming alcohol during pregnancy gave birth to a baby with FAS. Women who gave birth to a baby with FAS had a mean AAC of 32.06 (SD 9.09) grams, which was higher than that of women who did not give birth to a baby with FAS (mean 12.07, SD 15.87 grams). AI/AN mothers with FAS babies had the highest AAC (mean 42.62, SD 8.35 grams), followed by White (mean 30.13, SD 4.88 grams) and Black mothers (mean 27.05, SD 12.78 grams). White (prevalence ratio [PR] 1.10, 95% CI 1.03-1.19), Black (PR 1.13, 95% CI 1.04-1.23), and AI/AN (PR 1.10, 95% CI 1.00-1.21) mothers had 10% to 13% increased odds of giving birth to a baby with FAS given the same exposure to alcohol during pregnancy. Regardless of race, a 1-gram increase in AAC resulted in a 4% increase (PR 1.04, 95% CI 1.02-1.07) in the chance of giving birth to a baby with ≥2 facial anomalies (ie, short palpebral fissures, thin vermilion border of the upper lip, and smooth philtrum) and a 4% increase (PR 1.04, 95% CI 1.01-1.07) in the chance of deficient brain growth. The risk of delivering a baby with FAS was comparable among White, Black, and AI/AN women at similar levels of drinking during pregnancy. Regardless of race, a 1-gram increase in AAC resulted in increased odds of giving birth to a baby with facial anomalies or deficient brain growth.
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影响因子：
1
作者：
Elek, Elvira;Harris, Shelly L.;Mitchell, Betsy
通讯作者：
Mitchell, Betsy
DOI：
10.1111/j.1530-0277.2008.00802.x
发表时间：
2008-12-01
影响因子：
3.2
作者：
Aragon, Alfredo S.;Kalberg, Wendy O.;May, Philip A.
通讯作者：
May, Philip A.
DOI：
10.1002/ajmg.a.37023
发表时间：
2015-04
期刊：
American journal of medical genetics. Part A
影响因子：
--
作者：
Hoyme HE;Hoyme DB;Elliott AJ;Blankenship J;Kalberg WO;Buckley D;Abdul-Rahman O;Adam MP;Robinson LK;Manning M;Bezuidenhout H;Jones KL;May PA
通讯作者：
May PA
DOI：
10.1111/acer.14970
发表时间：
2022-11-16
期刊：
ALCOHOL-CLINICAL AND EXPERIMENTAL RESEARCH
影响因子：
--
作者：
Kable, Julie A.;Mehta, Puja K.;Coles, Claire D.
通讯作者：
Coles, Claire D.
影响因子：
--
作者：
Gampa, Vikas;Bernard, Kenneth;Oldani, Michael J
通讯作者：
Oldani, Michael J