A 14-year retrospective maternal report of alcohol consumption in pregnancy predicts pregnancy and teen outcomes
A 14-year retrospective maternal report of alcohol consumption in pregnancy predicts pregnancy and teen outcomes
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DOI：
10.1016/j.alcohol.2009.03.003
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发表时间：
2010-11-01
期刊：
影响因子：
2.3
通讯作者：
Delaney-Black, Virginia
中科院分区：
文献类型：
--
作者：
Hannigan, John H.;Chiodo, Lisa M.;Delaney-Black, Virginia
检测孕妇饮酒的模式，使胎儿处于胎儿酒精谱系障碍（FASD）的风险是至关重要的诊断，治疗和预防，但具有挑战性，因为在怀孕期间收集的产前饮酒信息往往不足或缺乏。虽然回顾性评估已被认为是不太受欢迎的许多研究人员由于假定的可靠性差，这种看法可能是不准确的，因为减少产妇否认和/或扭曲。本研究假设，胎儿酒精暴露，回顾性评估在儿童青春期，将显着相关的母亲饮酒的先前措施，并预测酒精相关的行为问题，在青少年比产前措施的母亲饮酒。饮酒进行了评估，在怀孕期间，并回顾性地对同一怀孕，在14年的随访中，在288名非洲裔美国妇女使用有效的半结构化访谈。回归分析检验了饮酒评估对妊娠结局和教师报告的青少年行为结局的预测有效性。回顾性母亲自我报告的饮酒评估产后14年显着高于产前报告的消费。回顾性报告确定的危险饮酒者妇女人数是产前报告的10.8倍。回顾性和回顾性报告中度相关，两者均与密歇根酒精中毒筛查试验相关。基于回顾性报告的怀孕期间自我报告的酒精消费量发现，与产前和怀孕期间的报告相比，产前暴露于危险酒精水平的青少年明显更多。回顾性报告预测更多的青少年行为问题（例如，注意力问题和外化行为）比产前报告。产前报告预测出生时胎龄较小，回顾性报告预测出生时体型较小;两者均不能预测青少年智商。这些结果表明，如果只使用产前，怀孕期间的母亲报告，那么很大一部分儿童产前暴露于酒精的风险水平可能会被错误分类。通过预测青少年比产前报告更多的行为问题，建立了回顾性评估怀孕期间饮酒作为产前暴露的更有效指标的有效性。回顾性报告可以提供有关怀孕前饮酒的有效信息，并可能有助于教育工作者，社会服务人员和卫生保健提供者的诊断和后续干预，从而减少FASD的终身影响。(c)2010年爱思唯尔公司All rights reserved.
Detecting patterns of maternal drinking that place fetuses at risk for fetal alcohol spectrum disorders (FASDs) is critical to diagnosis, treatment, and prevention but is challenging because information on antenatal drinking collected during pregnancy is often insufficient or lacking. Although retrospective assessments have been considered less favored by many researchers due to presumed poor reliability, this perception may be inaccurate because of reduced maternal denial and/or distortion. The present study hypothesized that fetal alcohol exposure, as assessed retrospectively during child adolescence, would be related significantly to prior measures of maternal drinking and would predict alcohol-related behavioral problems in teens better than antenatal measures of maternal alcohol consumption. Drinking was assessed during pregnancy, and retrospectively about the same pregnancy, at a 14-year follow-up in 288 African-American women using well-validated semistructured interviews. Regression analysis examined the predictive validity of both drinking assessments on pregnancy outcomes and on teacher-reported teen behavior outcomes. Retrospective maternal self-reported drinking assessed 14 years postpartum was significantly higher than antenatal reports of consumption. Retrospective report identified 10.8 times more women as risk drinkers one drink per day) than the antenatal report. Antenatal and retrospective reports were moderately correlated and both were correlated with the Michigan Alcoholism Screening Test. Self-reported alcohol consumption during pregnancy based on retrospective report identified significantly more teens exposed prenatally to at-risk alcohol levels than antenatal, in-pregnancy reports. Retrospective report predicted more teen behavior problems (e.g., attention problems and externalizing behaviors) than the antenatal report. Antenatal report predicted younger gestational age at birth and retrospective report predicted smaller birth size; neither predicted teen IQ. These results suggest that if only antenatal, in-pregnancy maternal report is used, then a substantial proportion of children exposed prenatally to risk levels of alcohol might be misclassified. The validity of retrospective assessment of prior drinking during pregnancy as a more effective indicator of prenatal exposure was established by predicting more behavioral problems in teens than antenatal report. Retrospective report can provide valid information about drinking during a prior pregnancy and may facilitate diagnosis and subsequent interventions by educators, social service personnel, and health-care providers, thereby reducing the life-long impact of FASDs. (c) 2010 Elsevier Inc. All rights reserved.