Prevalence of Fetal Alcohol Spectrum Disorders in 4 US Communities
Prevalence of Fetal Alcohol Spectrum Disorders in 4 US Communities
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DOI：
10.1001/jama.2017.21896
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发表时间：
2018-02-06
影响因子：
120.7
通讯作者：
Hoyme, H. Eugene
中科院分区：
文献类型：
--
作者：
May, Philip A.;Chambers, Christina D.;Hoyme, H. Eugene
胎儿酒精谱系障碍是昂贵的，终身残疾。较早的数据表明，在美国，这种疾病的患病率为每1000名儿童中有10人;目的评估美国4个地区胎儿酒精谱系障碍（包括胎儿酒精综合征、部分胎儿酒精综合征和酒精相关神经发育障碍）的患病率。使用横断面设计的主动病例确定方法评估2010年至2016年期间胎儿酒精谱系障碍的儿童。对儿童进行了系统的评估，在4个领域，有助于胎儿酒精谱系障碍的连续性：畸形特征，身体发育，神经行为发育，产前酒精暴露。这些设置是在落基山脉，中西部，东南部和太平洋西南地区的美国的4个社区。一年级儿童和他们的父母或监护人入组。暴露酒精消费在怀孕期间。主要结局和措施胎儿酒精谱系障碍的患病率在4个社区的主要结局。使用合格的一级人群作为分母计算疾病患病率的保守估计值和95% CI。加权患病率和95%CI也估计，占抽样计划和使用的数据仅限于儿童谁收到了全面evaluation.Results的儿童共6639人被选中参与人口13146一年级学生（男孩，51.9%，平均年龄，6.7岁[SD，0.41]和白色产妇种族，79.3%）。共有222例胎儿酒精谱系障碍被确定。胎儿酒精谱系障碍的保守患病率估计值范围为11.3（95% CI，7.8-15.8）至50.0（95% CI，39.9-61.7）/1000名儿童。胎儿酒精谱系障碍的加权患病率估计值范围为31.1（95%CI，16.1-54.0）至98.5（95%CI，57.5-139.5）每1000 children.CONCLUSIONS AND RELEVANCE使用保守的方法，在4个美国社区的一年级学生中，胎儿酒精谱系障碍的估计患病率范围为1.1%至5.0%。这些发现可能代表比以前的研究更准确的美国患病率估计，但可能无法推广到所有社区。
IMPORTANCE Fetal alcohol spectrum disorders are costly, life-long disabilities. Older data suggested the prevalence of the disorder in the United States was 10 per 1000 children; however, there are few current estimates based on larger, diverse US population samples.OBJECTIVE To estimate the prevalence of fetal alcohol spectrum disorders, including fetal alcohol syndrome, partial fetal alcohol syndrome, and alcohol-related neurodevelopmental disorder, in 4 regions of the United States.DESIGN, SETTING, AND PARTICIPANTS Active case ascertainment methods using a cross-sectional design were used to assess children for fetal alcohol spectrum disorders between 2010 and 2016. Children were systematically assessed in the 4 domains that contribute to the fetal alcohol spectrum disorder continuum: dysmorphic features, physical growth, neurobehavioral development, and prenatal alcohol exposure. The settings were 4 communities in the Rocky Mountain, Midwestern, Southeastern, and Pacific Southwestern regions of the United States. First-grade children and their parents or guardians were enrolled.EXPOSURES Alcohol consumption during pregnancy.MAIN OUTCOMES AND MEASURES Prevalence of fetal alcohol spectrum disorders in the 4 communities was the main outcome. Conservative estimates for the prevalence of the disorder and 95% CIs were calculated using the eligible first-grade population as the denominator. Weighted prevalences and 95% CIs were also estimated, accounting for the sampling schemes and using data restricted to children who received a full evaluation.RESULTS A total of 6639 children were selected for participation from a population of 13 146 first-graders (boys, 51.9%; mean age, 6.7 years [SD, 0.41] and white maternal race, 79.3%). A total of 222 cases of fetal alcohol spectrum disorders were identified. The conservative prevalence estimates for fetal alcohol spectrum disorders ranged from 11.3 (95% CI, 7.8-15.8) to 50.0 (95% CI, 39.9-61.7) per 1000 children. The weighted prevalence estimates for fetal alcohol spectrum disorders ranged from 31.1 (95% CI, 16.1-54.0) to 98.5 (95% CI, 57.5-139.5) per 1000 children.CONCLUSIONS AND RELEVANCE Estimated prevalence of fetal alcohol spectrum disorders among first-graders in 4 US communities ranged from 1.1% to 5.0% using a conservative approach. These findings may represent more accurate US prevalence estimates than previous studies but may not be generalizable to all communities.