Causal inferences regarding prenatal alcohol exposure and childhood externalizing problems
Causal inferences regarding prenatal alcohol exposure and childhood externalizing problems
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DOI：
10.1001/archpsyc.64.11.1296
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发表时间：
2007-11-01
影响因子：
--
通讯作者：
Lahey, Benjamin B.
中科院分区：
文献类型：
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作者：
D'Onofrio, Brian M.;Van Hulle, Carol A.;Lahey, Benjamin B.
背景：现有关于产前酒精暴露(PAE)神经行为后果的研究没有充分考虑遗传和环境冲突。目的：使用测量的协变量和准实验设计来研究美国具有代表性的大样本家庭中酒精暴露(PAE)与子女外化问题的相关性，以解释未测量的遗传和环境冲突。设计：本研究结合国家青年和儿童国家青年纵向调查的信息。这些分析对母亲和家庭的测量特征以及对其他产前精神活性物质的暴露进行了统计控制。在初步分析中，比较了不同孕期接触酒精的兄弟姐妹。背景和参与者：从社区招募妇女，采用分层和分组的概率样本，并进行纵向跟踪。研究样本包括4912名母亲的8621名子女。主要观察指标：母亲在儿童时期(4-11岁)的行为问题(CPS)和注意力/冲动问题(AIP)的报告，使用与精神诊断相关的标准化评估。结果：PAE与子女CPS之间存在关联，独立于混淆的遗传和固定环境效应以及测量的协变量。母亲孕期每天饮酒的儿童的CPS比孕期从不饮酒的儿童高0.35 SD。尽管在比较无血缘关系的子女时，AIP与PAE相关，但母亲在怀孕期间饮酒更频繁的孩子并不比在宫内接触酒精较少的兄弟姐妹有更多的AIP。结论：PAE对儿童CPS具有环境中介的因果关系，但PAE与AIPs之间的关系更可能是由孕期饮酒相关因素引起的。
Context: Existing research on the neurobehavioral consequences of prenatal alcohol exposure (PAE) has not adequately accounted for genetic and environmental confounds.Objective: To examine the association between PAE and offspring externalizing problems in a large representative sample of families in the United States using measured covariates and a quasi-experimental design to account for unmeasured genetic and environmental confounds.Design: This study combines information from the National Longitudinal Survey of Youth and the Children of the National Longitudinal Survey of Youth. The analyses statistically controlled for measured characteristics of the mothers and families and exposure to other prenatal psychoactive substances. In the primary analyses, siblings differentially exposed to prenatal alcohol were compared.Setting and Participants: Women were recruited from the community using a stratified and clustered probability sample and were followed longitudinally. The sample included 8621 offspring of 4912 mothers.Main Outcome Measures: Maternal report of conduct problems (CPs) and attention/impulsivity problems (AIPs) during childhood (ages 4-11 years) using standardized assessments related to psychiatric diagnoses.Results: There was an association between PAE and offspring CPs that was independent of confounded genetic and fixed environmental effects and the measured covariates. The CPs in children of mothers who drank daily during pregnancy were 0.35 SD greater than those in children whose mothers never drank during pregnancy. Although AIPs were associated with PAE when comparing unrelated offspring, children whose mothers drank more frequently during pregnancy did not have more AIPs than siblings who were less exposed to alcohol in utero. Additional subsample analyses suggested that maternal polysubstance use during pregnancy may account for the associations between PAE and AIPs.Conclusion: These results are consistent with PAE exerting an environmentally mediated causal effect on childhood CPs, but the relation between PAE and AIPs is more likely to be caused by other factors correlated with maternal drinking during pregnancy.