Reassessing FASD: Novel Approaches for Evaluating Exposure, Diagnosis and Outcomes in Children Prenatally Exposed to Alcohol

重新评估 FASD：评估产前接触酒精儿童的暴露、诊断和结果的新方法

• 批准号: 10204862
• 负责人: Gretchen E. Bandoli
• 金额: $ 48.78万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10204862
• 关键词: 3-Dimensional; Address; Affect; Alcohol consumption; Alcohols; Behavior; Behavioral; Body Size; Caregivers; Categories; Characteristics; Child; Childhood; Classification; Clinical; Cluster Analysis; Code; Cognition; Cognitive; Collaborations; Communities; Cross-Sectional Studies; Data; Data Analyses; Data Set; Diagnosis; Diagnostic; Digit structure; Dysmorphology; Early Diagnosis; Early identification; Education; Etiology; Face; Fetal Alcohol Exposure; Fetal Alcohol Spectrum Disorder; Foundations; Functional disorder; Funding; Future; General Population; Growth; Health; Household; Image; Income; Individual; Intervention; Interview; Knowledge; Lead; Life; Manuscripts; Measurement; Measures; Mediating; Mediator of activation protein; Mental Health; Methodology; Methods; Minor; Mission; Modeling; Mothers; National Institute of Mental Health; National Institute on Alcohol Abuse and Alcoholism; Neurodevelopmental Deficit; Outcome; Pattern; Performance; Persons; Pharmaceutical Preparations; Population; Poverty; Predictive Value; Pregnancy; Pregnancy Complications; Pregnancy Histories; Preparation; Prevalence; Prevention; Protocols documentation; Publishing; Research; Research Design; Research Personnel; Research Priority; Research Proposals; Risk; Rural; Sampling; School-Age Population; Site; Testing; Time; United States National Institutes of Health; Work; alcohol consumption during pregnancy; alcohol exposure; archive data; archived data; base; cohesion; contextual factors; cost; demographics; developmental disease; disability; disease classification; experience; fetal; fetal diagnosis; first grade; impaired brain development; improved; innovation; insight; malformation; multidisciplinary; neurodevelopment; novel; novel strategies; offspring; population based; postnatal; prenatal exposure; resilience; screening; secondary analysis; sex; teacher; urban residence; urban setting

Project Summary Fetal alcohol spectrum disorders (FASD) are caused by prenatal alcohol exposure (PAE), and occur in 1-5% of the population at a cost that exceeds $4 billion dollars per year. FASD is a continuum of developmental disorders, and can result in life long disabilities. Although beneficial treatments exist, identification of affected individuals has proven difficult, and the majority of individuals with FASD are undiagnosed or misdiagnosed. There are a large number of gaps in knowledge that are critical to improvement in prevention, diagnosis and treatment for FASD. First, although PAE is the cause of FASD, it is not deterministic. A better understanding of the specific alcohol use patterns associated with specific FASD outcomes would inform prevention and intervention efforts, and support earlier diagnoses. Second, classification schema that most effectively utilizes the many physical signs associated with PAE and their contribution as markers of impaired brain development could lead to earlier and better diagnosis. Third, although several co-factors have been established as modifiers of risk for FASD, many more co-factors, mediators and modifiers remain unexplored that could substantially inform the pathophysiology and intervention efforts. Each of these knowledge gaps represent high research priorities for the prevention and treatment of FASD. The purpose of this study is to improve diagnosis of FASD through research that specifically addresses these aforementioned gaps. In a study previously funded by NIH-NIAAA, investigators formed The Collaboration on Fetal Alcohol Spectrum Disorders Prevalence consortium (CoFASP) to determine, for first time, a regionally- based prevalence estimate of FASD in four communities in the U.S. Together, these researchers developed a common protocol for the cross-sectional study design and established agreed upon classification criteria for FASD. Over 6,000 children were screened for FASD, and comprehensive data were collected on over 2,900 children for each of the relevant domains including dysmorphology; growth; cognitive, behavioral and adaptive functioning; maternal characteristics; PAE and for a subset 3D facial images. Using the CoFASP data set, we will 1) employ novel methods to elucidate exposure patterns associated with risk for PAE-related outcomes, 2) test new methodologies and diagnostic criteria as they pertain to FASD diagnosis and neurodevelopmental outcomes, and 3) investigate contextual and health-related covariates that function as mediators and/or modifiers of FASD. The advances proposed in this research allow for insights into the etiology and classification of FASD, and ultimately, factors that affect the prevalence of FASD. The investigators on this proposal are multidisciplinary, and together offer an innovative and cohesive approach to the research proposal. Through these novel approaches, we anticipate providing a foundation for future classification schema, exposure assessment and intervention strategies that are grounded in empirical evidence.

项目摘要 胎儿酒精谱系障碍(FASD)是由产前酒精暴露(PAE)引起的，发生在1-5% 人口每年的成本超过40亿美元。FASD是一系列发育障碍的连续体， 并可能导致终生残疾。尽管存在有益的治疗方法，但确定受影响的个人 事实证明很难，大多数FASD患者没有得到诊断或被误诊。有一种 对改善预防、诊断和治疗艾滋病至关重要的大量知识空白 FASD。首先，虽然PAE是FASD的原因，但它不是确定性的。更好地了解具体情况 与特定FASD结果相关的酒精使用模式将为预防和干预工作提供信息， 并支持早期诊断。第二，最有效地利用许多物理资源的分类方案 与PAE相关的体征及其作为大脑发育受损标记物的作用可能导致早期 以及更好的诊断。第三，尽管有几个共同因素被确定为FASD风险的修饰者， 还有更多的辅助因素、调解人和修饰者仍未被探索，这些因素可能会在很大程度上告知 病理生理学和干预努力。这些知识差距中的每一个都代表着高优先级的研究 FASD的防治。 本研究的目的是通过专门针对以下问题的研究来提高FASD的诊断水平 上述差距。在之前由NIH-NIAAA资助的一项研究中，调查人员在 胎儿酒精谱系障碍流行联盟(CoFASP)首次确定地区性- 基于对美国四个社区FASD患病率的估计，这些研究人员共同制定了一项 横断面研究设计的共同方案，并为以下项目确定了商定的分类标准 FASD。对6000多名儿童进行了FASD筛查，并收集了2900多名儿童的全面数据 每个相关领域的儿童，包括畸形；生长；认知、行为和适应 功能；母性特征；PAE和3D面部图像的子集。使用CoFASP数据集，我们 将1)使用新的方法来阐明与PAE相关结果风险相关的暴露模式，2) 测试与FASD诊断和神经发育相关的新方法和诊断标准 结果，以及3)调查作为中介和/或修饰者的上下文和健康相关的协变量 FASD的。 这项研究中提出的进展有助于深入了解FASD的病因和分类，以及 最终，影响FASD患病率的因素。这项提案的调查人员是多学科的， 并共同为研究提案提供了一种创新和连贯的方法。通过这些小说 方法，我们预计将为未来的分类方案、暴露评估和 以经验证据为基础的干预策略。