Alcohol-related dysmorphic features as predictors of neurodevelopmental delay in infants and preschool-aged children: Results from a birth cohort in Ukraine.
Alcohol-related dysmorphic features as predictors of neurodevelopmental delay in infants and preschool-aged children: Results from a birth cohort in Ukraine.
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DOI：
10.1111/acer.14966
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发表时间：
2022-12
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--
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主要和非主要畸形特征与产前酒精暴露（PAE）有关;然而，它们与神经发育的关系尚不清楚。本研究的目的是确定酒精相关的畸形特征是否预示着婴儿和幼儿的神经发育迟缓。我们分析了2008 - 2014年间在乌克兰西部招募的前瞻性妊娠队列。在大约6 - 12个月大时进行体型、3个主要和14个非主要畸形特征的畸形学检查。PAE是自我报告的，并以受孕前后每天酒精的绝对盎司数进行操作。在6 - 12个月时使用Bayley婴儿发育量表-II（BSID-II）评估神经发育，并在3.5 - 4.5岁时使用差异能力量表-II，儿童行为检查表和用于创建执行功能因子评分的多项措施。我们进行了逻辑回归，以预测儿童的神经发育畸形的功能，生长措施，性别和PAE。从582个独特的儿童的分析样本，566 BSID-II分数在婴儿期，289完成了学前电池。与具有这些输入的子集的模型相比，具有所有基数和非基数畸形特征、生长指标、性别和PAE的模型具有最佳性能。一般来说，模型在婴儿期的延迟分类性能较差（AUC <0.7），而在学龄前结局方面的性能可接受（AUC~0.75）。当样本仅限于中度至高度PAE的儿童时，对学龄前结局的预测能力提高（AUC 0.76 - 0.89）。所有模型的敏感性相对较低（12 - 63%），尽管其他性能指标较高。在这个样本中，基于畸形特征和生长措施的预测分析表现温和。由于这些特征在比神经发育更早的年龄时就可以可靠地测量，因此应在不同的环境和人群中进一步探索和验证它们是否包含在预测模型中。
Cardinal and non-cardinal dysmorphic features are associated with prenatal alcohol exposure (PAE); however, their association with neurodevelopment is less clear. The objective of this study was to determine whether alcohol-related dysmorphic features predicted neurodevelopmental delay in infants and toddlers. We analyzed a prospective pregnancy cohort in western Ukraine enrolled between 2008-2014. A dysmorphology exam of body size, 3 cardinal and 14 non-cardinal dysmorphic features was performed at approximately 6-12 months of age. PAE was self-reported and operationalized as absolute ounces of alcohol per day around the time of conception. Neurodevelopment was assessed at 6-12 months with the Bayley Scales of Infant Development-II (BSID-II), and at 3.5-4.5 years of age with the Differential Ability Scales-II, the Child Behavior Checklist, and multiple measures that were used to create an executive functioning factor score. We performed logistic regression to predict children’s neurodevelopment from dysmorphic features, growth measures, sex and PAE. From an analytic sample of 582 unique children, 566 had BSID-II scores in infancy, and 289 completed the preschool battery. Models with all cardinal and non-cardinal dysmorphic features, growth measures, sex and PAE had the best performance compared to models with subsets of those inputs. In general, models had poor performance classifying delays in infancy (AUC <0.7) and acceptable performance on preschool-aged outcomes (AUC ~0.75). When the sample was limited to children with moderate to high PAE, predictive ability improved on preschool-aged outcomes (AUC 0.76-0.89). Sensitivity was relatively low on all models (12-63%), although other metrics of performance were higher. Predictive analysis based on dysmorphic features and measures of growth performed modestly in this sample. As these features are reliably measurable at an earlier age than neurodevelopment, their inclusion in predictive models should be further explored and validated in different settings and populations.
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DOI：
10.1111/acer.14325
发表时间：
2020-06
期刊：
ALCOHOL-CLINICAL AND EXPERIMENTAL RESEARCH
影响因子：
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作者：
Coles, Claire D.;Kalberg, Wendy;Kable, Julie A.;Tabachnick, Barbara;May, Philip A.;Chambers, Christina D.
通讯作者：
Chambers, Christina D.
DOI：
10.1111/acer.14525
发表时间：
2021-03
期刊：
Alcoholism, clinical and experimental research
影响因子：
--
作者：
Kable JA;Coles CD;Jones KL;Yevtushok L;Kulikovsky Y;Zymak-Zakutnya N;Dubchak I;Akhmedzhanova D;Wertelecki W;Chambers CD;CIFASD
通讯作者：
CIFASD
影响因子：
5.1
作者：
Astley, SJ;Clarren, SK
通讯作者：
Clarren, SK
影响因子：
3.2
作者：
Chambers, Christina D.;Yevtushok, Lyubov;Wertelecki, Wladimir
通讯作者：
Wertelecki, Wladimir
影响因子：
3.2
作者：
Coles, Claire D.;Gailey, Amanda R.;Jones, Kenneth Lyons
通讯作者：
Jones, Kenneth Lyons