TIME-DEPENDENT EFFECT OF ALCOHOL ON SPONTANEOUS ABORTION

这项建议的目的是评估温和的 孕期不同阶段饮酒对风险的影响 自然流产(SAB)，使用一个独特的数据库。重的 已知怀孕期间饮酒会导致不良反应 生殖结果，但关于适度消费的研究是 不太一致。这是一个重要的公共卫生问题，因为 “社交”饮酒在中国非常普遍。 美国，所以如果它代表着SAB的风险因素，许多人 怀孕可能会受到影响。约为10%-15% 孕妇经历临床上的自然流产和 另外20%的受孕可能会在怀孕前丢失 医学上公认的。接触酒精的临界期 是未知的。尽管许多女性听从了戒酒的建议 一旦怀孕被承认，他们之前的消费 或怀孕早期可能很重要，因此有必要进一步 公共卫生干预。这项研究将是最大的研究之一 SAB的前瞻性研究，以检查酒精暴露。数据是 最近在一项关于妊娠结局的多中心研究中收集 由加州卫生服务部和 凯撒永久医疗保健计划。孕妇(5300人) 来自凯撒的三家机构在他们的第一次 关于怀孕三个月的各种因素，包括通常的酒精 怀孕前的消费，是否以及何时在怀孕期间发生变化 头三个月，和最大消耗量。有关的信息 日常饮酒量的变化提供了暴露的数据 在怀孕前和怀孕期间，以及更准确的 每周暴露的评估比通过询问妇女如何获得的更多 她们在怀孕期间“通常”喝了很多酒。的另一个功能 这些数据是关于最大酒精含量的信息 食用过一次，发生在怀孕期间，这是 可以用来衡量酗酒的程度。分析将使用 计算SAB风险的比例风险模型 胎龄，在特定时间内饮酒 期间作为主要解释变量，根据其他变量进行调整 协变量。这些模型将扩展到将酒精作为一种 时间依赖变量也是如此。行动机制将是 通过比较SAB子集之间的结果进一步探索 可能有不同的病因。正在寻求资金以 提供研究分析师、生物统计咨询等 支持进行这些复杂的分析。

The purpose of this proposal is to assess the effect of moderate alcohol consumption at different stages of pregnancy on the risk of spontaneous abortion (SAB), using a unique data base. Heavy alcohol consumption during pregnancy is known to cause adverse reproductive outcomes, but studies on moderate consumption are less consistent. This is an important public health issue because "social" drinking of alcoholic beverages is very common in the United States, so if it represents a risk factor for SAB, many pregnancies are potentially affected. On the order of 10-15% of pregnant women experience a clinical spontaneous abortion and another 20% of conceptuses may be lost before pregnancy is medically recognized. The critical period of exposure to alcohol is unknown. Although many women follow advice to decrease alcohol consumption once pregnancy is recognized, their consumpiion before or very early in pregnancy may be important, warranting further public health intervention. This study will be one of the largest prospective studies of SAB to examine alcohol exposure. Data were collected in a multi-center study of pregnancy outcome recently conducted by the California Department of Health Services and the Kaiser Permanente Medical Care Program. Pregnant women (5300) from three Kaiser facilities were interviewed during their first trimester about a variety of factors, including usual alcohol consumption before pregnancy, whether and when it changed during the first trimester, and maximum consumption. The information on change in usual alcohol consumption provides data on exposure before and during early pregnancy, as well as a more accurate assessment of weekly exposure than is obtained by asking women how much they "usually" drank during pregnancy. Another feature of the data is the information on the greatest amount of alcohol consumed on one occasion and when in pregnancy it occurred, which can be used as a measure of binge drinking. The analysis will use proportional hazards models to calculate the risk of SAB by gestational age, with alcohol consumption during a specified time period as the primary explanatory variable, adjusted for other covariates. The models will be expanded to examine alcohol as a time-dependent variable as well. Mechanisms of action will be further explored by comparing results between sub-sets of SABs which may have different etiologies. Funds are being sought to provide a research analyst, biostatistical consultation and other support to conduct these complex analyses.