Low alcohol consumption and pregnancy and childhood outcomes: time to change guidelines indicating apparently 'safe' levels of alcohol during pregnancy? A systematic review and meta-analyses.
Low alcohol consumption and pregnancy and childhood outcomes: time to change guidelines indicating apparently 'safe' levels of alcohol during pregnancy? A systematic review and meta-analyses.
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DOI：
10.1136/bmjopen-2016-015410
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发表时间：
2017-08-03
期刊：
影响因子：
2.9
通讯作者：
Zuccolo L
中科院分区：
文献类型：
--
作者：
Mamluk L;Edwards HB;Savović J;Leach V;Jones T;Moore THM;Ijaz S;Lewis SJ;Donovan JL;Lawlor D;Smith GD;Fraser A;Zuccolo L
确定母亲在怀孕期间低至中等水平的饮酒对怀孕和长期后代结局的影响。Medline，Embase，Web of Science和Psychinfo从成立到2016年7月11日。对孕妇进行的前瞻性观察性研究、阴性对照和准实验性研究，评估妊娠期轻度饮酒（≤32 g/周）与戒酒的影响。妊娠结局，如出生体重和胎儿酒精综合征的特点进行了检查。一名评审员提取数据，另一名评审员检查提取的数据。如适用，进行随机效应荟萃分析，否则进行结果的叙述性总结。纳入24项队列研究和2项准实验研究。除了出生大小和胎龄外，没有足够的数据进行荟萃分析或得出可靠的结论。小于胎龄儿（SGA）和早产的几率更高的婴儿，其母亲消耗高达32克/周与没有，但早产的估计也与没有关联：总结OR 1.08，95% CI（1.02 ~ 1.14），I2 0%，（7项研究，所有估计值均已校正）OR 1.10，95% CI（0.95 - 1.28），I2 60%，（9项研究，包括1项未校正估计值）。分析中使用了最早的暴露时间点。怀孕期间饮酒≤32 g/周的影响的证据很少。由于有一些证据表明，即使是轻微的产前饮酒也与SGA和早产有关，指南可以建议将饮酒作为预防原则，但应该解释证据的缺乏。
To determine the effects of low-to-moderate levels of maternal alcohol consumption in pregnancy on pregnancy and longer-term offspring outcomes. Medline, Embase, Web of Science and Psychinfo from inception to 11 July 2016. Prospective observational studies, negative control and quasiexperimental studies of pregnant women estimating effects of light drinking in pregnancy (≤32 g/week) versus abstaining. Pregnancy outcomes such as birth weight and features of fetal alcohol syndrome were examined. One reviewer extracted data and another checked extracted data. Random effects meta-analyses were performed where applicable, and a narrative summary of findings was carried out otherwise. 24 cohort and two quasiexperimental studies were included. With the exception of birth size and gestational age, there was insufficient data to meta-analyse or make robust conclusions. Odds of small for gestational age (SGA) and preterm birth were higher for babies whose mothers consumed up to 32 g/week versus none, but estimates for preterm birth were also compatible with no association: summary OR 1.08, 95% CI (1.02 to 1.14), I2 0%, (seven studies, all estimates were adjusted) OR 1.10, 95% CI (0.95 to 1.28), I2 60%, (nine studies, includes one unadjusted estimates), respectively. The earliest time points of exposure were used in the analysis. Evidence of the effects of drinking ≤32 g/week in pregnancy is sparse. As there was some evidence that even light prenatal alcohol consumption is associated with being SGA and preterm delivery, guidance could advise abstention as a precautionary principle but should explain the paucity of evidence.
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DOI：
10.1097/ede.0b013e3181d61eeb
发表时间：
2010-05
期刊：
Epidemiology (Cambridge, Mass.)
影响因子：
--
作者：
Lipsitch M;Tchetgen Tchetgen E;Cohen T
通讯作者：
Cohen T
影响因子：
3.6
作者：
Alati, Rosa;Macleod, John;Lawlor, Debbie A.
通讯作者：
Lawlor, Debbie A.
DOI：
10.1097/ede.0000000000000161
发表时间：
2014-11
期刊：
Epidemiology (Cambridge, Mass.)
影响因子：
--
作者：
Burgess S;Davies NM;Thompson SG;EPIC-InterAct Consortium
通讯作者：
EPIC-InterAct Consortium
影响因子：
3.8
作者：
Larsen, Rikke Faebo;Mortensen, Laust Hvas;Andersen, Anne-Marie Nybo
通讯作者：
Andersen, Anne-Marie Nybo
影响因子：
105.7
作者：
BROOKE, OG;ANDERSON, HR;STEWART, CM
通讯作者：
STEWART, CM