Characterizing Alcohol-Related Neurodevelopmental Disorder: Prenatal Alcohol Exposure and the Spectrum of Outcomes.
Characterizing Alcohol-Related Neurodevelopmental Disorder: Prenatal Alcohol Exposure and the Spectrum of Outcomes.
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DOI：
10.1111/acer.14325
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发表时间：
2020-06
期刊：
影响因子：
--
通讯作者：
Chambers, Christina D.
中科院分区：
文献类型：
--
作者：
Coles, Claire D.;Kalberg, Wendy;Kable, Julie A.;Tabachnick, Barbara;May, Philip A.;Chambers, Christina D.
关键词：
产前酒精暴露（PAE）的影响被概念化为胎儿酒精谱系障碍（FASD），胎儿酒精综合征（FAS）是最严重的。许多人发现，在没有体征的情况下，更难描述暴露对中枢神经系统的行为和认知影响。本研究对酒精相关性神经发育障碍的操作性定义进行了研究，以确定其在区分基于行为（ARND/B）和认知（ARND/C）的ARND儿童与四个对照组儿童中的有用性，1）暴露于研究定义的“危险饮酒”的儿童; 2）任何报告的PAE儿童; 3）发育问题的“高风险”儿童;（4）被列为“低风险”的儿童。作为监测研究的一部分，对1842名儿童的酒精暴露、FAS的身体特征和完成的神经发育测试进行了评价。91例被确定为ARND/B或ARND/C，并与其他组进行对比，以进一步确定区分模式。多项逻辑回归（MLR）被用来检查分类的准确性，并确定有助于这种分类的因素。根据认知和行为以及人口统计学因素（例如，年龄、种族、社会经济地位）儿童特征（例如，孕龄;性别）和其他药物暴露，而ARND/B组仅在行为和其他药物暴露方面存在差异。MLR模型成功区分了ARND组和其他组的儿童，准确率从79%（高风险）到86.7%（低风险）。ARND一直是一个辩论的主题。这项分析表明，即使在没有特征性面部特征和可以识别的生长缺陷的情况下，酒精也会对行为和认知产生影响。结果还表明，有可能将这些儿童与其他高风险群体的儿童区分开来。
Effects of prenatal alcohol exposure (PAE) are conceptualized as fetal alcohol spectrum disorder (FASD), with fetal alcohol syndrome (FAS) as the most severe. Many find it more difficult to characterize behavioral and cognitive effects of exposure on the central nervous system when physical signs are not present. In the current study an operational definition of Alcohol Related Neurodevelopmental Disorder is examined to determine its usefulness in discrimination of children classified as ARND based on behavior (ARND/B) and cognition (ARND/C) from children in four contrast groups, 1) Children exposed to study-defined “risky drinking”; 2) Children with any reported PAE; 3) Children classified as “Higher Risk” for developmental problems; and 4) Children classified as “Lower Risk”. 1842 children seen as part of a surveillance study were evaluated for alcohol exposure, physical characteristics of FAS, and completed neurodevelopmental testing. Ninety one were identified as either ARND/B or ARND/C and contrasted with other groups to further identify distinguishing patterns. Multinomial Logistic Regression (MLR) was used to examine accuracy of classification and to identify factors contributing to such classification. Children described as ARND/C were distinct from other groups based on cognition and behavior as well as demographic factors (e.g., age, race, SES) child characteristics (e.g., gestational age; sex) and other drug exposures while those described as ARND/B differed only on behavior and other drug exposures. MLR models successfully discriminated ARND groups from children in other groups with accuracy ranging from 79% (Higher Risk) to 86.7% (Low Risk). ARND has been a subject of debate. This analysis suggests effects of alcohol on behavior and cognition even in the absence of the characteristic facial features and growth deficiency that can be identified. Results also indicate that it may be possible to distinguish such children from those in other high risk groups.
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