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Frennesson NF, Barnett J, Merouani Y, Attwood A, Zuccolo L, McQuire C. Analyzing Questions About Alcohol in Pregnancy Using Web-Based Forum Topics: Qualitative Content Analysis. JMIR INFODEMIOLOGY 2024; 4:e58056. [PMID: 38900536 DOI: 10.2196/58056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 04/15/2024] [Accepted: 05/13/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Prenatal alcohol exposure represents a substantial public health concern as it may lead to detrimental outcomes, including pregnancy complications and fetal alcohol spectrum disorder. Although UK national guidance recommends abstaining from alcohol if pregnant or planning a pregnancy, evidence suggests that confusion remains on this topic among members of the public, and little is known about what questions people have about consumption of alcohol in pregnancy outside of health care settings. OBJECTIVE This study aims to assess what questions and topics are raised on alcohol in pregnancy on a web-based UK-based parenting forum and how these correspond to official public health guidelines with respect to 2 critical events: the implementation of the revised UK Chief Medical Officers' (CMO) low-risk drinking guidelines (2016) and the first COVID-19 pandemic lockdown (2020). METHODS All thread starts mentioning alcohol in the "Pregnancy" forum were collected from Mumsnet for the period 2002 to 2022 and analyzed using qualitative content analysis. Descriptive statistics were used to characterize the number and proportion of thread starts for each topic over the whole study period and for the periods corresponding to the change in CMO guidance and the COVID-19 pandemic. RESULTS A total of 395 thread starts were analyzed, and key topics included "Asking for advice on whether it is safe to consume alcohol" or on "safe limits" and concerns about having consumed alcohol before being aware of a pregnancy. In addition, the Mumsnet thread starts included discussions and information seeking on "Research, guidelines, and official information about alcohol in pregnancy." Topics discussed on Mumsnet regarding alcohol in pregnancy remained broadly similar between 2002 and 2022, although thread starts disclosing prenatal alcohol use were more common before the introduction of the revised CMO guidance than in later periods. CONCLUSIONS Web-based discussions within a UK parenting forum indicated that users were often unclear on guidance and risks associated with prenatal alcohol use and that they used this platform to seek information and reassurance from peers.
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Affiliation(s)
- Nessie Felicia Frennesson
- Tobacco and Alcohol Research Group, School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Julie Barnett
- Department of Psychology, University of Bath, Bath, United Kingdom
| | - Youssouf Merouani
- Department of Economic History, School of Economics and Management, Lund University, Lund, Sweden
| | - Angela Attwood
- Tobacco and Alcohol Research Group, School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Luisa Zuccolo
- Health Data Science Centre, Human Technopole, Milan, Italy
| | - Cheryl McQuire
- Centre for Public Health, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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2
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Bourne LE, Jayash SN, Michels LV, Hopkinson M, Guppy FM, Clarkin CE, Gard P, Brissett N, Staines KA. Sexually dimorphic effects of prenatal alcohol exposure on the murine skeleton. Biol Sex Differ 2024; 15:51. [PMID: 38890762 PMCID: PMC11186175 DOI: 10.1186/s13293-024-00626-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 06/11/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Prenatal alcohol exposure (PAE) can result in lifelong disabilities known as foetal alcohol spectrum disorder (FASD) and is associated with childhood growth deficiencies and increased bone fracture risk. However, the effects of PAE on the adult skeleton remain unclear and any potential sexual dimorphism is undetermined. Therefore, we utilised a murine model to examine sex differences with PAE on in vitro bone formation, and in the juvenile and adult skeleton. METHODS Pregnant C57BL/6J female mice received 5% ethanol in their drinking water during gestation. Primary calvarial osteoblasts were isolated from neonatal offspring and mineralised bone nodule formation and gene expression assessed. Skeletal phenotyping of 4- and 12-week-old male and female offspring was conducted by micro-computed tomography (µCT), 3-point bending, growth plate analyses, and histology. RESULTS Osteoblasts from male and female PAE mice displayed reduced bone formation, compared to control (≤ 30%). Vegfa, Vegfb, Bmp6, Tgfbr1, Flt1 and Ahsg were downregulated in PAE male osteoblasts only, whilst Ahsg was upregulated in PAE females. In 12-week-old mice, µCT analysis revealed a sex and exposure interaction across several trabecular bone parameters. PAE was detrimental to the trabecular compartment in male mice compared to control, yet PAE females were unaffected. Both male and female mice had significant reductions in cortical parameters with PAE. Whilst male mice were negatively affected along the tibial length, females were only distally affected. Posterior cortical porosity was increased in PAE females only. Mechanical testing revealed PAE males had significantly reduced bone stiffness compared to controls; maximum load and yield were reduced in both sexes. PAE had no effect on total body weight or tibial bone length in either sex. However, total growth plate width in male PAE mice compared to control was reduced, whilst female PAE mice were unaffected. 4-week-old mice did not display the altered skeletal phenotype with PAE observed in 12-week-old animals. CONCLUSIONS Evidence herein suggests, for the first time, that PAE exerts divergent sex effects on the skeleton, possibly influenced by underlying sex-specific transcriptional mechanisms of osteoblasts. Establishing these sex differences will support future policies and clinical management of FASD.
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Affiliation(s)
- Lucie E Bourne
- School of Applied Sciences, Centre for Lifelong Health, University of Brighton, Lewes Road, Brighton, BN2 4GT, UK
| | - Soher N Jayash
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian, EH25 9RG, UK
| | - Lysanne V Michels
- School of Biological Sciences, University of Southampton, Southampton, SO17 1BJ, UK
| | - Mark Hopkinson
- Comparative Biomedical Sciences, Royal Veterinary College, London, NW1 0TU, UK
| | - Fergus M Guppy
- Institute of Life and Earth Sciences, School of Energy, Geosciences, Infrastructure and Society, Heriot Watt University, Edinburgh, EH14 4AS, UK
| | - Claire E Clarkin
- School of Biological Sciences, University of Southampton, Southampton, SO17 1BJ, UK
| | - Paul Gard
- School of Applied Sciences, Centre for Lifelong Health, University of Brighton, Lewes Road, Brighton, BN2 4GT, UK
| | - Nigel Brissett
- School of Applied Sciences, Centre for Lifelong Health, University of Brighton, Lewes Road, Brighton, BN2 4GT, UK
| | - Katherine A Staines
- School of Applied Sciences, Centre for Lifelong Health, University of Brighton, Lewes Road, Brighton, BN2 4GT, UK.
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3
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Benedetto C, Borella F, Divakar H, O'Riordan SL, Mazzoli M, Hanson M, O'Reilly S, Jacobsson B, Conry JA, McAuliffe FM. FIGO Preconception Checklist: Preconception care for mother and baby. Int J Gynaecol Obstet 2024; 165:1-8. [PMID: 38426290 DOI: 10.1002/ijgo.15446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
The preconception period is a unique and opportunistic time in a woman's life when she is motivated to adopt healthy behaviors that will benefit her and her child, making this time period a critical "window of opportunity" to improve short- and long-term health. Improving preconception health can ultimately improve both fetal and maternal outcomes. Promoting health before conception has several beneficial effects, including an increase in seeking antenatal care and a reduction in neonatal mortality. Preconception health is a broad concept that encompasses the management of chronic diseases, including optimal nutrition, adequate consumption of folic acid, control of body weight, adoption of healthy lifestyles, and receipt of appropriate vaccinations. Use of the FIGO Preconception Checklist, which includes the key elements of optimal preconception care, will empower women and their healthcare providers to better prepare women and their families for pregnancy.
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Affiliation(s)
- Chiara Benedetto
- Department of Obstetrics and Gynecology, Sant'Anna University Hospital, Torino, Italy
- FIGO Committee on Well Woman Health Care, London, UK
| | - Fulvio Borella
- Department of Obstetrics and Gynecology, Sant'Anna University Hospital, Torino, Italy
| | - Hema Divakar
- FIGO Committee on Well Woman Health Care, London, UK
| | - Sarah L O'Riordan
- UCD Perinatal Research Centre, National Maternity Hospital, University College Dublin, Dublin, Ireland
- FIGO Committee on the Impact of Pregnancy on Long-Term Health, London, UK
| | - Martina Mazzoli
- Department of Obstetrics and Gynecology, Sant'Anna University Hospital, Torino, Italy
| | - Mark Hanson
- Institute of Developmental Sciences, University of Southampton, Southampton, UK
| | - Sharleen O'Reilly
- UCD Perinatal Research Centre, National Maternity Hospital, University College Dublin, Dublin, Ireland
| | - Bo Jacobsson
- FIGO Division of Maternal and Newborn Health, London, UK
- Department of Genes and Environment, Norwegian Institute of Public Health, Oslo, Norway
- Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Jeanne A Conry
- The Environmental Health Leadership Foundation, California, USA
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, National Maternity Hospital, University College Dublin, Dublin, Ireland
- FIGO Committee on the Impact of Pregnancy on Long-Term Health, London, UK
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4
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Xie M, Kaiser M, Gershtein Y, Schnyder D, Deviatiiarov R, Gazizova G, Shagimardanova E, Zikmund T, Kerckhofs G, Ivashkin E, Batkovskyte D, Newton PT, Andersson O, Fried K, Gusev O, Zeberg H, Kaiser J, Adameyko I, Chagin AS. The level of protein in the maternal murine diet modulates the facial appearance of the offspring via mTORC1 signaling. Nat Commun 2024; 15:2367. [PMID: 38531868 DOI: 10.1038/s41467-024-46030-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 02/09/2024] [Indexed: 03/28/2024] Open
Abstract
The development of craniofacial skeletal structures is fascinatingly complex and elucidation of the underlying mechanisms will not only provide novel scientific insights, but also help develop more effective clinical approaches to the treatment and/or prevention of the numerous congenital craniofacial malformations. To this end, we performed a genome-wide analysis of RNA transcription from non-coding regulatory elements by CAGE-sequencing of the facial mesenchyme of human embryos and cross-checked the active enhancers thus identified against genes, identified by GWAS for the normal range human facial appearance. Among the identified active cis-enhancers, several belonged to the components of the PI3/AKT/mTORC1/autophagy pathway. To assess the functional role of this pathway, we manipulated it both genetically and pharmacologically in mice and zebrafish. These experiments revealed that mTORC1 signaling modulates craniofacial shaping at the stage of skeletal mesenchymal condensations, with subsequent fine-tuning during clonal intercalation. This ability of mTORC1 pathway to modulate facial shaping, along with its evolutionary conservation and ability to sense external stimuli, in particular dietary amino acids, indicate that the mTORC1 pathway may play a role in facial phenotypic plasticity. Indeed, the level of protein in the diet of pregnant female mice influenced the activity of mTORC1 in fetal craniofacial structures and altered the size of skeletogenic clones, thus exerting an impact on the local geometry and craniofacial shaping. Overall, our findings indicate that the mTORC1 signaling pathway is involved in the effect of environmental conditions on the shaping of craniofacial structures.
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Affiliation(s)
- Meng Xie
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
- Department of Biosciences and Nutrition, Karolinska Institute, Flemingsberg, Sweden
- School of Psychological and Cognitive Sciences, PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Markéta Kaiser
- Central European Institute of Technology, Brno University of Technology, Brno, Czech Republic
| | - Yaakov Gershtein
- Department of Neuroimmunology, Center for Brain Research, Medical University of Vienna, Vienna, Austria
| | - Daniela Schnyder
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
- Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Ruslan Deviatiiarov
- Regulatory Genomics Research Center, Kazan Federal University, Kazan, Russia
- Endocrinology Research Center, Moscow, Russia
- Life Improvement by Future Technologies (LIFT) Center, Moscow, Russia
- Intractable Disease Research Center, Juntendo University, Tokyo, Japan
| | - Guzel Gazizova
- Regulatory Genomics Research Center, Kazan Federal University, Kazan, Russia
| | - Elena Shagimardanova
- Regulatory Genomics Research Center, Kazan Federal University, Kazan, Russia
- Life Improvement by Future Technologies (LIFT) Center, Moscow, Russia
| | - Tomáš Zikmund
- Central European Institute of Technology, Brno University of Technology, Brno, Czech Republic
| | - Greet Kerckhofs
- Biomechanics Lab, Institute of Mechanics, Materials, and Civil Engineering (iMMC), UCLouvain, Louvain-la-Neuve, Belgium
- Pole of Morphology, Institute of Experimental and Clinical Research (IREC), UCLouvain, Woluwe, Belgium
- Department of Materials Engineering, KU Leuven, Leuven, Belgium
- Prometheus, Division for Skeletal Tissue Engineering, KU Leuven, Leuven, Belgium
| | - Evgeny Ivashkin
- A.N. Severtsov Institute of Ecology and Evolution, Russian Academy of Sciences, Moscow, Russia
- Department of Developmental and Comparative Physiology, N.K. Koltsov Institute of Developmental Biology, Russian Academy of Sciences, Moscow, Russia
| | - Dominyka Batkovskyte
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Phillip T Newton
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's hospital, Stockholm, Sweden
| | - Olov Andersson
- Department of Cell and Molecular Biology, Karolinska Institutet, Stockholm, Sweden
| | - Kaj Fried
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Oleg Gusev
- Regulatory Genomics Research Center, Kazan Federal University, Kazan, Russia
- Endocrinology Research Center, Moscow, Russia
- Life Improvement by Future Technologies (LIFT) Center, Moscow, Russia
- Intractable Disease Research Center, Juntendo University, Tokyo, Japan
| | - Hugo Zeberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Jozef Kaiser
- Central European Institute of Technology, Brno University of Technology, Brno, Czech Republic
| | - Igor Adameyko
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
- Department of Neuroimmunology, Center for Brain Research, Medical University of Vienna, Vienna, Austria.
| | - Andrei S Chagin
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
- Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
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Thompson DK, Kelly CE, Dhollander T, Muggli E, Hearps S, Lewis S, Nguyen TNN, Spittle A, Elliott EJ, Penington A, Halliday J, Anderson PJ. Associations between low-moderate prenatal alcohol exposure and brain development in childhood. Neuroimage Clin 2024; 42:103595. [PMID: 38555806 PMCID: PMC10998198 DOI: 10.1016/j.nicl.2024.103595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/19/2024] [Accepted: 03/19/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND The effects of low-moderate prenatal alcohol exposure (PAE) on brain development have been infrequently studied. AIM To compare cortical and white matter structure between children aged 6 to 8 years with low-moderate PAE in trimester 1 only, low-moderate PAE throughout gestation, or no PAE. METHODS Women reported quantity and frequency of alcohol consumption before and during pregnancy. Magnetic resonance imaging was undertaken for 143 children aged 6 to 8 years with PAE during trimester 1 only (n = 44), PAE throughout gestation (n = 58), and no PAE (n = 41). T1-weighted images were processed using FreeSurfer, obtaining brain volume, area, and thickness of 34 cortical regions per hemisphere. Fibre density (FD), fibre cross-section (FC) and fibre density and cross-section (FDC) metrics were computed for diffusion images. Brain measures were compared between PAE groups adjusted for age and sex, then additionally for intracranial volume. RESULTS After adjustments, the right caudal anterior cingulate cortex volume (pFDR = 0.045) and area (pFDR = 0.008), and right cingulum tract cross-sectional area (pFWE < 0.05) were smaller in children exposed to alcohol throughout gestation compared with no PAE. CONCLUSION This study reports a relationship between low-moderate PAE throughout gestation and cingulate cortex and cingulum tract alterations, suggesting a teratogenic vulnerability. Further investigation is warranted.
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Affiliation(s)
- Deanne K Thompson
- Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Victoria, Australia; Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Claire E Kelly
- Murdoch Children's Research Institute, Parkville, Victoria, Australia; Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Thijs Dhollander
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Evelyne Muggli
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Stephen Hearps
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Sharon Lewis
- Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Victoria, Australia
| | | | - Alicia Spittle
- Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Physiotherapy, The University of Melbourne, Victoria, Australia
| | - Elizabeth J Elliott
- The University of Sydney, Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Sydney, New South Wales, Australia; Kids Research, Children's Hospitals Network, Westmead, Sydney, New South Wales, Australia
| | - Anthony Penington
- Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Victoria, Australia; Royal Children's Hospital, Parkville, Victoria, Australia
| | - Jane Halliday
- Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Victoria, Australia
| | - Peter J Anderson
- Murdoch Children's Research Institute, Parkville, Victoria, Australia; Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia.
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6
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Klem JR, Schwantes-An TH, Abreu M, Suttie M, Gray R, Vo H, Conley G, Foroud TM, Wetherill L, Lovely CB. Mutation in the Bone Morphogenetic Protein signaling pathway sensitize zebrafish and humans to ethanol-induced jaw malformations. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.06.28.546932. [PMID: 37425959 PMCID: PMC10327032 DOI: 10.1101/2023.06.28.546932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Fetal Alcohol Spectrum Disorders (FASD) describe ethanol-induced developmental defects including craniofacial malformations. While ethanol-sensitive genetic mutations contribute to facial malformations, the impacted cellular mechanisms remain unknown. Bmp signaling is a key regulator of epithelial morphogenesis driving facial development, providing a possible ethanol-sensitive mechanism. We found that zebrafish mutants for Bmp signaling components are ethanol-sensitive and affect anterior pharyngeal endoderm shape and gene expression, indicating ethanol-induced malformations of the anterior pharyngeal endoderm cause facial malformations. Integrating FASD patient data, we provide the first evidence that variants in the human Bmp receptor gene BMPR1B associate with ethanol-related differences in jaw volume. Our results show that ethanol exposure disrupts proper morphogenesis of, and tissue interactions between, facial epithelia that mirror overall viscerocranial shape changes and are predictive for Bmp-ethanol associations in human jaw development. Our data provide a mechanistic paradigm linking ethanol to disrupted epithelial cell behaviors that underlie facial defects in FASD.
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7
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Chaudoin TR, Bonasera SJ, Dunaevsky A, Padmashri R. Exploring behavioral phenotypes in a mouse model of fetal alcohol spectrum disorders. Dev Neurobiol 2023; 83:184-204. [PMID: 37433012 PMCID: PMC10546278 DOI: 10.1002/dneu.22922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 04/18/2023] [Accepted: 06/24/2023] [Indexed: 07/13/2023]
Abstract
Fetal alcohol spectrum disorders are one of the leading causes of developmental abnormalities worldwide. Maternal consumption of alcohol during pregnancy leads to a diverse range of cognitive and neurobehavioral deficits. Although moderate-to-heavy levels of prenatal alcohol exposure (PAE) have been associated with adverse offspring outcomes, there is limited data on the consequences of chronic low-level PAE. Here, we use a model of maternal voluntary alcohol consumption throughout gestation in a mouse model to investigate the effects of PAE on behavioral phenotypes during late adolescence and early adulthood in male and female offspring. Body composition was measured by dual-energy X-ray absorptiometry. Baseline behaviors, including feeding, drinking, and movement, were examined by performing home cage monitoring studies. The impact of PAE on motor function, motor skill learning, hyperactivity, acoustic reactivity, and sensorimotor gating was investigated by performing a battery of behavioral tests. PAE was found to be associated with altered body composition. No differences in overall movement, food, or water consumption were observed between control and PAE mice. Although PAE offspring of both sexes exhibited deficits in motor skill learning, no differences were observed in basic motor skills such as grip strength and motor coordination. PAE females exhibited a hyperactive phenotype in a novel environment. PAE mice exhibited increased reactivity to acoustic stimuli, and PAE females showed disrupted short-term habituation. Sensorimotor gating was not altered in PAE mice. Collectively, our data show that chronic low-level exposure to alcohol in utero results in behavioral impairments.
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Affiliation(s)
- Tammy R Chaudoin
- Department of Internal Medicine, Division of Geriatrics, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Stephen J Bonasera
- Department of Internal Medicine, Division of Geriatrics, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Anna Dunaevsky
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Ragunathan Padmashri
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, Nebraska, USA
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8
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Breton-Larrivée M, Elder E, Legault LM, Langford-Avelar A, MacFarlane AJ, McGraw S. Mitigating the detrimental developmental impact of early fetal alcohol exposure using a maternal methyl donor-enriched diet. FASEB J 2023; 37:e22829. [PMID: 36856720 DOI: 10.1096/fj.202201564r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/23/2023] [Accepted: 02/03/2023] [Indexed: 03/02/2023]
Abstract
Fetal alcohol exposure at any stage of pregnancy can lead to fetal alcohol spectrum disorder (FASD), a group of life-long conditions characterized by congenital malformations, as well as cognitive, behavioral, and emotional impairments. The teratogenic effects of alcohol have long been publicized; yet fetal alcohol exposure is one of the most common preventable causes of birth defects. Currently, alcohol abstinence during pregnancy is the best and only way to prevent FASD. However, alcohol consumption remains astoundingly prevalent among pregnant women; therefore, additional measures need to be made available to help protect the developing embryo before irreparable damage is done. Maternal nutritional interventions using methyl donors have been investigated as potential preventative measures to mitigate the adverse effects of fetal alcohol exposure. Here, we show that a single acute preimplantation (E2.5; 8-cell stage) fetal alcohol exposure (2 × 2.5 g/kg ethanol with a 2h interval) in mice leads to long-term FASD-like morphological phenotypes (e.g. growth restriction, brain malformations, skeletal delays) in late-gestation embryos (E18.5) and demonstrate that supplementing the maternal diet with a combination of four methyl donor nutrients, folic acid, choline, betaine, and vitamin B12, prior to conception and throughout gestation effectively reduces the incidence and severity of alcohol-induced morphological defects without altering DNA methylation status of imprinting control regions and regulation of associated imprinted genes. This study clearly supports that preimplantation embryos are vulnerable to the teratogenic effects of alcohol, emphasizes the dangers of maternal alcohol consumption during early gestation, and provides a potential proactive maternal nutritional intervention to minimize FASD progression, reinforcing the importance of adequate preconception and prenatal nutrition.
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Affiliation(s)
- Mélanie Breton-Larrivée
- Centre Hospitalier Universitaire Sainte-Justine Research Center, Montreal, Canada.,Department of Biochemistry and Molecular Medicine, Université de Montréal, Montreal, Canada
| | - Elizabeth Elder
- Centre Hospitalier Universitaire Sainte-Justine Research Center, Montreal, Canada.,Department of Biochemistry and Molecular Medicine, Université de Montréal, Montreal, Canada
| | - Lisa-Marie Legault
- Centre Hospitalier Universitaire Sainte-Justine Research Center, Montreal, Canada.,Department of Biochemistry and Molecular Medicine, Université de Montréal, Montreal, Canada
| | - Alexandra Langford-Avelar
- Centre Hospitalier Universitaire Sainte-Justine Research Center, Montreal, Canada.,Department of Biochemistry and Molecular Medicine, Université de Montréal, Montreal, Canada
| | - Amanda J MacFarlane
- Agriculture, Food, and Nutrition Evidence Center, Texas A&M University, Texas, Fort Worth, USA.,Department of Nutrition, Texas A&M University, College Station, Texas, USA
| | - Serge McGraw
- Centre Hospitalier Universitaire Sainte-Justine Research Center, Montreal, Canada.,Department of Biochemistry and Molecular Medicine, Université de Montréal, Montreal, Canada.,Department of Obstetrics and Gynecology, Université de Montréal, Montreal, Canada
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9
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Popova S, Charness ME, Burd L, Crawford A, Hoyme HE, Mukherjee RAS, Riley EP, Elliott EJ. Fetal alcohol spectrum disorders. Nat Rev Dis Primers 2023; 9:11. [PMID: 36823161 DOI: 10.1038/s41572-023-00420-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/16/2023] [Indexed: 02/25/2023]
Abstract
Alcohol readily crosses the placenta and may disrupt fetal development. Harm from prenatal alcohol exposure (PAE) is determined by the dose, pattern, timing and duration of exposure, fetal and maternal genetics, maternal nutrition, concurrent substance use, and epigenetic responses. A safe dose of alcohol use during pregnancy has not been established. PAE can cause fetal alcohol spectrum disorders (FASD), which are characterized by neurodevelopmental impairment with or without facial dysmorphology, congenital anomalies and poor growth. FASD are a leading preventable cause of birth defects and developmental disability. The prevalence of FASD in 76 countries is >1% and is high in individuals living in out-of-home care or engaged in justice and mental health systems. The social and economic effects of FASD are profound, but the diagnosis is often missed or delayed and receives little public recognition. Future research should be informed by people living with FASD and be guided by cultural context, seek consensus on diagnostic criteria and evidence-based treatments, and describe the pathophysiology and lifelong effects of FASD. Imperatives include reducing stigma, equitable access to services, improved quality of life for people with FASD and FASD prevention in future generations.
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Affiliation(s)
- Svetlana Popova
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.
| | - Michael E Charness
- VA Boston Healthcare System, West Roxbury, MA, USA.,Department of Neurology, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA
| | - Larry Burd
- North Dakota Fetal Alcohol Syndrome Center, Department of Pediatrics, University of North Dakota School of Medicine and Health Sciences, Pediatric Therapy Services, Altru Health System, Grand Forks, ND, USA
| | - Andi Crawford
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - H Eugene Hoyme
- Sanford Children's Genomic Medicine Consortium, Sanford Health, and University of South Dakota Sanford School of Medicine, Sioux Falls, SD, USA
| | - Raja A S Mukherjee
- National UK FASD Clinic, Surrey and Borders Partnership NHS Foundation Trust, Redhill, Surrey, UK
| | - Edward P Riley
- Center for Behavioral Teratology, San Diego State University, San Diego, CA, USA
| | - Elizabeth J Elliott
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,New South Wales FASD Assessment Service, CICADA Centre for Care and Intervention for Children and Adolescents affected by Drugs and Alcohol, Sydney Children's Hospitals Network, Westmead, Sydney, New South Wales, Australia
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Ghosal R, Borrego-Soto G, Eberhart JK. Embryonic ethanol exposure disrupts craniofacial neuromuscular integration in zebrafish larvae. Front Physiol 2023; 14:1131075. [PMID: 36824468 PMCID: PMC9941677 DOI: 10.3389/fphys.2023.1131075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 01/24/2023] [Indexed: 02/10/2023] Open
Abstract
Forming a vertebrate head involves the meticulous integration of multiple tissue types during development. Prenatal alcohol exposure is known to cause a variety of birth defects, especially to tissues in the vertebrate head. However, a systematic analysis of coordinated defects across tissues in the head is lacking. Here, we delineate the effects of ethanol on individual tissue types and their integration during craniofacial development. We found that exposure to 1% ethanol induced ectopic cranial muscle and nerve defects with only slight effects on skeletal pattern. Ectopic muscles were, however, unaccompanied by ectopic tendons and could be partially rescued by anesthetizing the larvae before muscle fibers appeared. This finding suggests that the ectopic muscles result from fiber detachment and are not due to an underlying muscle patterning defect. Interestingly, immobilization did not rescue the nerve defects, thus ethanol has an independent effect on each tissue even though they are linked in developmental time and space. Time-course experiments demonstrated an increase in nerve defects with ethanol exposure between 48hpf-4dpf. Time-lapse imaging confirmed the absence of nerve pathfinding or misrouting defects until 48hpf. These results indicate that ethanol-induced nerve defects occur at the time of muscle innervation and after musculoskeletal patterning. Further, we investigated the effect of ethanol on the neuromuscular junctions of the craniofacial muscles and found a reduced number of postsynaptic receptors with no significant effect on the presynaptic terminals. Our study shows that craniofacial soft tissues are particularly susceptible to ethanol-induced damage and that these defects appear independent from one another. Thus, the effects of ethanol on the vertebrate head appear highly pleiotropic.
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Affiliation(s)
| | | | - Johann K. Eberhart
- Department of Molecular Biosciences, College of Natural Sciences and Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, Austin, TX, United States
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11
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Hitaka D, Fujiyama S, Nishihama Y, Ishii R, Hoshino Y, Hamada H, Miyazono Y, Nakayama SF, Takada H. Assessment of Alcohol Exposure From Alcohol-Based Disinfectants Among Premature Infants in Neonatal Incubators in Japan. JAMA Netw Open 2023; 6:e230691. [PMID: 36826814 PMCID: PMC9958524 DOI: 10.1001/jamanetworkopen.2023.0691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
IMPORTANCE The risk of premature infants in neonatal incubators exposed to evaporated alcohol from alcohol-based disinfectants (ABDs) is unknown. OBJECTIVE To assess alcohol concentrations in the peripheral blood of premature infants and neonatal incubators. DESIGN, SETTING, AND PARTICIPANTS A quality improvement study comparing 2 different populations before and after introduction of ABD practice (ABD-PRAC) was conducted in a neonatal intensive care unit of a single tertiary hospital in Japan. Participants included premature infants who were born before 34 weeks of gestational age and received medical care in neonatal incubators. The study consisted of 3 periods: (1) September 1, 2020, to August 1, 2021 (prospective observation of pre-ABD-PRAC, (2) August 2 to August 22, 2021 (introduction of ABD-PRAC to medical staff and parents in the neonatal intensive care unit), and (3) August 23, 2021, to March 31, 2022 (prospective observation of post-ABD-PRAC). No follow-up studies were initiated. INTERVENTIONS An ABD-PRAC that aimed to reduce alcohol evaporation from ABDs inside neonatal incubators was instituted: (1) place alcohol preps in the incubator just before use and remove them from the incubator as soon as possible and (2) withhold placing hands into the incubators until 60 seconds after using ABDs for disinfection (applied only to family members). MAIN OUTCOMES AND MEASURES Blood alcohol concentration and evaporated alcohol concentrations in neonatal incubators. RESULTS Disinfectant practice was assessed among 28 infants during the pre-ABD-PRAC (17 infants [10 girls]; median gestational age at birth, 29.4 [IQR, 26.3-30.3] weeks) and post-ABD-PRAC (11 infants [3 girls]; median gestational age at birth, 30.0 [IQR, 25.3-32.2] weeks) study periods. The median blood alcohol concentration was 7.0 (IQR, 5.4-9.3) mg/dL pre-ABD-PRAC and 4.2 (IQR, 2.5-7.2) mg/dL post-ABD-PRAC. The median evaporated alcohol concentration inside neonatal incubators during pre-ABD-PRAC during the day was 23.6 (IQR, 15.9-36.5) ppm and, at night, was 13.2 (IQR, 8.9-19.4) ppm; during post-ABD-PRAC, the concentration was 9.4 (IQR, 6.0-16.0) ppm during the day and 5.7 (IQR, 3.6-9.7) ppm at night. The introduction of ABD-PRAC at 22 weeks' corrected gestational age was associated with a lower blood alcohol concentration in premature infants: regression coefficient value, -8.3 (95% CI, -12.0 to -4.7). CONCLUSIONS AND RELEVANCE In this study, alcohol evaporated from ABDs was absorbed by premature infants in neonatal incubators. The findings suggest that introduction of ABD-PRAC was associated with lower alcohol concentrations in neonatal incubators and in the blood of premature infants.
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Affiliation(s)
- Daisuke Hitaka
- Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
- Health and Environmental Risk Division, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan
| | - Satoshi Fujiyama
- Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
- Health and Environmental Risk Division, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan
| | - Yukiko Nishihama
- Health and Environmental Risk Division, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan
| | - Ryota Ishii
- Department of Biostatistics, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Yusuke Hoshino
- Department of Neonatology, Ibaraki Children's Hospital, Mito, Ibaraki, Japan
| | - Hiromi Hamada
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Yayoi Miyazono
- Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
- Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Shoji F. Nakayama
- Health and Environmental Risk Division, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan
| | - Hidetoshi Takada
- Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
- Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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12
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Webster BM, Carlisle ACS, Livesey AC, Deeprose LR, Cook PA, Mukherjee RAS. Evaluating the Difference in Neuropsychological Profiles of Individuals with FASD Based on the Number of Sentinel Facial Features: A Service Evaluation of the FASD UK National Clinic Database. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020266. [PMID: 36832394 PMCID: PMC9955101 DOI: 10.3390/children10020266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/01/2023] [Accepted: 01/28/2023] [Indexed: 02/01/2023]
Abstract
(1) It might be implied that those with Fetal Alcohol Spectrum Disorder (FASD) with fewer sentinel facial features have a "milder" neuropsychological presentation, or present with fewer impairments than those with more sentinel facial features. The aim of this service evaluation was to compare the neuropsychological profile of people with FASD with varying numbers of sentinel facial features. (2) A clinical sample of 150 individuals with FASD, aged between 6 and 37 years, completed various standardised assessments as part of their diagnostic profiling. These included the documented level of risk of prenatal alcohol exposure (4-Digit Diagnostic Code), sensory needs (Short Sensory Profile), cognition (Wechsler Intelligence Scale for Children-4th Edition; WISC-IV), and communication and socialisation adaptive behaviours (Vineland Adaptive Behavior Scale-2nd Edition; VABS-II). As FASD has high comorbidity rates of Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD), these were also reviewed. The profiles of the 'FASD with 2 or 3 sentinel facial features' group (n = 41; 28 male, 13 female) were compared with the 'FASD with 0 or 1 sentinel facial features' group (n = 109; 50 male, 59 female) using Chi² tests, independent sample t-tests, and Mann-Whitney U analyses (where appropriate). (3) There were no significant differences between the two comparison groups across any measure included in this service evaluation. (4) Whilst sentinel facial features remain an important aspect in recognising FASD, our service evaluation indicates that there is no significant relationship between the number of sentinel facial features and the neuropsychological profile of people with FASD in terms of severity of presentation.
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Affiliation(s)
- Bethany M. Webster
- Fetal Alcohol Spectrum Disorders (FASD) Specialist Clinic, Gatton Place, St Matthews Rd, Redhill, Surrey RH1 1TA, UK
| | - Alexandra C. S. Carlisle
- Fetal Alcohol Spectrum Disorders (FASD) Specialist Clinic, Gatton Place, St Matthews Rd, Redhill, Surrey RH1 1TA, UK
| | - Alexandra C. Livesey
- Fetal Alcohol Spectrum Disorders (FASD) Specialist Clinic, Gatton Place, St Matthews Rd, Redhill, Surrey RH1 1TA, UK
| | - Lucy R. Deeprose
- Fetal Alcohol Spectrum Disorders (FASD) Specialist Clinic, Gatton Place, St Matthews Rd, Redhill, Surrey RH1 1TA, UK
| | - Penny A. Cook
- Fetal Alcohol Spectrum Disorders (FASD) Specialist Clinic, Gatton Place, St Matthews Rd, Redhill, Surrey RH1 1TA, UK
- School of Health and Society, University of Salford, Salford M6 6PU, UK
| | - Raja A. S. Mukherjee
- Fetal Alcohol Spectrum Disorders (FASD) Specialist Clinic, Gatton Place, St Matthews Rd, Redhill, Surrey RH1 1TA, UK
- School of Health and Society, University of Salford, Salford M6 6PU, UK
- Correspondence:
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Metruccio F, Battistoni M, Di Renzo F, Moretto A, Menegola E. Moderate alcohol consumption during pregnancy increases potency of two different drugs (the antifungal fluconazole and the antiepileptic valproate) in inducing craniofacial defects: prediction by the in vitro rat whole embryo culture. Arch Toxicol 2023; 97:619-629. [PMID: 36385218 PMCID: PMC9859839 DOI: 10.1007/s00204-022-03410-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/03/2022] [Indexed: 11/17/2022]
Abstract
The prenatal exposure to ethanol (Eth), fluconazole (FLUCO) and sodium valproate (VPA) is related to effects on development, producing characteristic syndromic pictures. Among embryotoxic effects described for the three molecules, the alteration on craniofacial morphogenesis is a common feature in humans and animal models, including rodent embryos developed in vitro. The aim of the present work is to evaluate the developmental effects of low Eth serum concentration (17 mM, corresponding to the legal limit to drive in UK, USA, Canada, and many other countries) in mixture with increasing realistic concentrations of the antifungal drug FLUCO (62.5-500 µM) or with increasing realistic concentrations of the antiepileptic drug VPA (31.25-250 µM). Groups exposed to Eth alone (17-127.5 mM), FLUCO alone (62.5-500 µM) or VPA alone (31.25-750 µM) were also included. The chosen alternative animal model was the post-implantation rat whole embryo culture (WEC). E9.5 embryos were exposed in vitro to the test molecules during the whole test period (48 h, corresponding to the developmental stages characteristics of any vertebrate, for human embryos post-fertilization days 23-31). Data were statistically analyzed and processed for modelling applying the benchmark dose (BMD) and relative potency factor (RPF) approaches. Concentration-related effects on facial outcomes were observed in all experimental groups, with a significant enhancement in the groups co-exposed with Eth in comparison to the single exposures. Data obtained by the present work suggest an additional alert for the assumption of even low levels of alcohol in pregnant women during FLUCO or VPA therapy.
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Affiliation(s)
| | - Maria Battistoni
- Department of Physics Aldo Pontremoli, Universita` degli Studi di Milano, via Celoria, 16, 20133 Milan, Italy
| | - Francesca Di Renzo
- Department of Environmental Science and Policy, Universita` degli Studi di Milano, via Celoria, 26, 20133 Milan, Italy
| | - Angelo Moretto
- Department of Cardiac Thoracic Vascular and Public Health Science, Università degli Studi di Padova, via Giustiniani 2, 35128 Padua, Italy
| | - Elena Menegola
- Department of Environmental Science and Policy, Universita` degli Studi di Milano, via Celoria, 26, 20133 Milan, Italy
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14
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Young SL, Steane SE, Kent NL, Reid N, Gallo LA, Moritz KM. Prevalence and Patterns of Prenatal Alcohol Exposure in Australian Cohort and Cross-Sectional Studies: A Systematic Review of Data Collection Approaches. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13144. [PMID: 36293721 PMCID: PMC9603223 DOI: 10.3390/ijerph192013144] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/02/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
This study sought to determine data collection approaches in Australian cohort studies and explore the potential impact on reported prenatal alcohol exposure (PAE) prevalence and patterns. Inclusion criteria were that studies related to a general Australian antenatal population where PAE was assessed and reported. Studies were excluded if they were not peer reviewed, examined the prevalence of PAE in pregnancies complicated by alcohol-use disorders, or were published in a language other than English. A systematic search of five electronic databases (PubMed, Embase, CINAHL, Web of Science, and Scopus) was conducted. Risk of bias was assessed using the Effective Public Health Practice Project quality assessment tool. Results were synthesised using MetaXL. Data from 16 separate birth cohorts (n = 78 articles) were included. Included cohorts were either general cohorts that included alcohol as a variable or alcohol-focused cohorts that were designed with a primary focus on PAE. PAE prevalence was estimated as 48% (95% CI: 38 to 57%). When subgroup analysis was performed, estimates of PAE prevalence when self-administered surveys and interviews were used for data collection were 53% (95% CI: 41% to 64%) and 43% (95% CI: 28% to 59%), respectively. Use of trained assessors was an influencing factor of the prevalence estimates when data were collected via interview. Alcohol-focused studies reported higher prevalence of PAE, regardless of method of survey administration. Where interviewer training is not possible, self-administered questionnaires will likely provide the most reliable PAE estimates. No funding sources are relevant to mention. Review was registered with PROSPERO (CRD42020204853).
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Affiliation(s)
- Sophia L. Young
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, St. Lucia, QLD 4072, Australia
- Child Health Research Centre, The University of Queensland, South Brisbane, QLD 4101, Australia
| | - Sarah E. Steane
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, St. Lucia, QLD 4072, Australia
- Child Health Research Centre, The University of Queensland, South Brisbane, QLD 4101, Australia
| | - Nykola L. Kent
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, St. Lucia, QLD 4072, Australia
- Child Health Research Centre, The University of Queensland, South Brisbane, QLD 4101, Australia
| | - Natasha Reid
- Child Health Research Centre, The University of Queensland, South Brisbane, QLD 4101, Australia
| | - Linda A. Gallo
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Petrie, QLD 4502, Australia
| | - Karen M. Moritz
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, St. Lucia, QLD 4072, Australia
- Child Health Research Centre, The University of Queensland, South Brisbane, QLD 4101, Australia
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15
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Abraham S, Lindo C, Peoples J, Cox A, Lytle E, Nguyen V, Mehta M, Alvarez JD, Yooseph S, Pacher P, Ebert SN. Maternal binge alcohol consumption leads to distinctive acute perturbations in embryonic cardiac gene expression profiles. Alcohol Clin Exp Res 2022; 46:1433-1448. [PMID: 35692084 DOI: 10.1111/acer.14880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 05/09/2022] [Accepted: 06/01/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Excessive alcohol consumption during pregnancy is associated with high risk of congenital heart defects, but it is unclear how alcohol specifically affects heart development during the acute aftermath of a maternal binge drinking episode. We hypothesize that administration of a single maternal binge dose of alcohol to pregnant mice at embryonic day 9.5 (E9.5) causes perturbations in the expression patterns of specific genes in the developing heart in the acute period (1-3 days) following the binge episode. To test this hypothesis and identify strong candidate ethanol-sensitive target genes of interest, we adapted a mouse binge alcohol model that is associated with a high incidence of congenital heart defects as described below. METHODS/RESULTS Pregnant mice were administered a single dose of alcohol (2.5 g/kg in saline) or control (saline alone) via oral gavage. To evaluate the impact of maternal binge alcohol on cardiac gene expression profiles, we isolated embryonic hearts from both groups (n = 5/group) at 24, 48, and 72 h post-gavage for transcriptomic analyses. RNA was extracted and evaluated using quantitative RNA-sequencing (RNA-Seq) methods. To identify a cohort of binge-altered cardiac genes, we set the threshold for change at >2.0-fold difference with adjusted p < 0.05 versus control. RNA-Seq analysis of cardiac gene expression revealed that of the 17 genes that were altered within the first 48 h post-binge, with the largest category consisting of transcription factors (Alx1, Alx4, HoxB7, HoxD8, and Runx2), followed by signaling molecules (Adamts18, Dkk2, Rtl1, and Wnt7a). Furthermore, multiple comparative and pathway analyses suggested that several of the candidate genes identified through differential RNA-Seq analysis may interact through certain common pathways. To investigate this further, we performed gene-specific qPCR analyses for three representative candidate targets: Runx2, Wnt7a, and Mlxipl. Notably, only Wnt7a showed significantly (p < 0.05) decreased expression in response to maternal binge alcohol in the qPCR assays. CONCLUSIONS These findings identify Wnt7a and a short list of potential other candidate genes and pathways for further study, which could provide mechanistic insights into how maternal binge alcohol consumption produces congenital cardiac malformations.
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Affiliation(s)
- Shani Abraham
- Division of Metabolic and Cardiovascular Science, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Chad Lindo
- Division of Metabolic and Cardiovascular Science, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Jessica Peoples
- Division of Metabolic and Cardiovascular Science, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Amanda Cox
- Division of Metabolic and Cardiovascular Science, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Erika Lytle
- Division of Metabolic and Cardiovascular Science, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Vu Nguyen
- Division of Metabolic and Cardiovascular Science, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Meeti Mehta
- Division of Metabolic and Cardiovascular Science, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Jose D Alvarez
- Division of Metabolic and Cardiovascular Science, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Shibu Yooseph
- Department of Computer Science, Genomics and Bioinformatics Cluster, College of Engineering and Computer Science, University of Central Florida, Orlando, Florida, USA
| | - Pal Pacher
- Laboratory of Cardiovascular Physiology and Tissue Injury, National Institute of Alcohol and Alcohol Abuse (NIAAA), The National Institutes of Health (NIH), Rockville, Maryland, USA
| | - Steven N Ebert
- Division of Metabolic and Cardiovascular Science, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida, USA
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16
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Planning is not equivalent to preparing, how Dutch women perceive their pregnancy planning in relation to preconceptional lifestyle behaviour change - a cross-sectional study. BMC Pregnancy Childbirth 2022; 22:577. [PMID: 35854217 PMCID: PMC9295368 DOI: 10.1186/s12884-022-04843-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/15/2022] [Indexed: 11/23/2022] Open
Abstract
Background Unhealthy prenatal lifestyle behaviours are associated with adverse pregnancy outcomes, but little is known about what motivates women to comply with preconceptional lifestyle recommendations or consciously plan their pregnancy. Therefore, the objective of this study is to explore the associations between preconceptional lifestyle behaviours, health beliefs and pregnancy planning among Dutch pregnant women. Methods In this cross-sectional study based on the data of the APROPOS-II study, 1,077 low-risk pregnant women were eligible for inclusion. Preconception lifestyle behaviours and actively preparing for pregnancy were assessed in relation to planned pregnancies (based on the London Measure of Unplanned Pregnancies) and health beliefs (14 statements). The following preconceptional lifestyle behaviours were assessed through a self-administered questionnaire in the first trimester of pregnancy: fruit intake, vegetable intake, caffeine intake, (second-hand)smoking, alcohol intake, folic acid supplement use and exercise. Data were analysed using multivariate logistic regression analyses. Results A total of 921 (85.5%) women in our cohort had a planned pregnancy. However, of these women, 640 (69.5%) adequately used folic acid supplements and 465 (50.5%) women consumed alcohol at any point during pregnancy. Of the women considering themselves ‘healthy enough and not needing preconception care’, 48 (9.1%) women had an adequate vegetable intake, 294 (55.6%) women consumed alcohol at any point during pregnancy and 161 (30.4%) women were either over-or underweight. Conclusion Despite consciously planning their pregnancy, most women did not adhere to preconceptional lifestyle behaviour recommendations. Women’s health beliefs and overestimation of their health status seem to interfere with actively planning and preparing for pregnancy. Findings from our study may encourage the development of prospective health-promoting interventions that focus on health beliefs and actively preparing for pregnancy, to improve preconceptional lifestyle behaviours, thereby optimizing the health of future generations. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04843-4.
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17
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Nam JY, Oh SS, Park EC. The Association Between Adequate Prenatal Care and Severe Maternal Morbidity Among Teenage Pregnancies: A Population-Based Cohort Study. Front Public Health 2022; 10:782143. [PMID: 35712308 PMCID: PMC9192951 DOI: 10.3389/fpubh.2022.782143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 05/12/2022] [Indexed: 11/13/2022] Open
Abstract
Background The aim of this study was to examine whether inadequate prenatal care affect the risk of severe maternal morbidity in teenage pregnancies. Methods We included 23,202 delivery cases among adolescent mothers aged between 13 and 19 years old with ≥ 37 weeks' gestational age. Data were derived from the National Health Insurance Service National Delivery Cohort in Korea between 2003 and 2018. We used a generalized estimating equation model while adjusting for numerous covariates to determine the adjusted relative risk (RR) associated with severe maternal morbidity. The main outcome measures were severe maternal morbidity and the Kessner Adequacy of Prenatal Care Index. Results Severe maternal morbidity occurred in 723 (3.1%) of the 23,202 investigated delivery cases. The risk of severe maternal morbidity was 1.8-fold higher among adolescent mothers who had received inadequate prenatal care (RR, 1.81, 95% confidence interval [CI], 1.39–2.37) and 1.6-fold higher among those who had received intermediate prenatal care (RR, 1.59, 95% CI, 1.33–1.87) compared to those with adequate prenatal care. Synergistic effects of inadequate prenatal care and maternal comorbidities affected severe maternal morbidity. Conclusion This study confirmed that inadequate prenatal care is associated with increased risk of severe maternal morbidity among pregnant teenagers. Notably, maternal comorbidity and inadequate prenatal care produced synergistic effects on severe maternal morbidity. Public health policy makers should focus on the development and implementation of programs to ensure that adequate prenatal care and financial/healthcare support is provided to teenage mothers during their pregnancies.
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Affiliation(s)
- Jin Young Nam
- Department of Healthcare Management, Eulji University, Seongnam, South Korea
| | - Sarah Soyeon Oh
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, United States
| | - Eun-Cheol Park
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea.,Institute of Health Services Research, Yonsei University College of Medicine, Seoul, South Korea
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18
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Davies KJM, Richmond S, Medeiros-Mirra RJ, Abbas HH, Wilson-Nagrani CE, Davis MG, Zhurov A. The effect of maternal smoking and alcohol consumption on lip morphology. J Orthod 2022; 49:403-411. [PMID: 35723071 DOI: 10.1177/14653125221094337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To determine whether maternal smoking and/or alcohol consumption has an influence on lip morphology. Maternal smoking is a known risk factor for orofacial clefts; however, its influence on normal lip variation is unknown. Recent research regarding normal lip morphology has been contradictory. DESIGN Retrospective cohort study. SETTING AND PARTICIPANTS A total of 4747 children from the Avon Longitudinal Study of Parents and Children (ALSPAC) who each had 3D facial scans carried out at 15 years of age were included in the study. METHODS Each of the participants was automatically categorised regarding predetermined lip morphological traits. Questionnaires completed by their mothers identified smoking and alcohol habits during pregnancy. Logistic regression analyses were applied to determine the effect of maternal smoking and alcohol consumption on lip morphology. RESULTS Maternal smoking has significant effects on upper and lower lip contours, Cupid's bow, lower lip-chin shape and lower lip tone (all P < 0.05). There was also an indication of a potential epigenetic effect of smoking pre-pregnancy on upper lip contour (P = 0.0573). Alcohol consumption is significantly associated with philtrum shape, particularly when >6 units of alcohol are consumed per week (P = 0.0149, 32 weeks). Overall results suggest a deeply grooved philtrum is more likely if alcohol is consumed. Investigating the combined effect of smoking and alcohol consumption, lower lip contour (P = 0.00923) and lower lip-chin shape (P = 0.0171) are statistically significant, with lower lip contour more likely to be narrow in the midline, and lower lip-chin shape more likely to be an angular concavity. CONCLUSION Maternal smoking influences a number of lip traits, including a possible epigenetic effect on upper lip contour. Maternal alcohol consumption, particularly at a high level, influences philtrum shape. Maternal smoking and alcohol consumption have a combined effect on lower lip contour and lower lip-chin shape.
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Affiliation(s)
| | - Stephen Richmond
- Department of Orthodontics, School of Dentistry, Cardiff University, Cardiff, UK
| | | | - Hawraa Hassan Abbas
- Department of Orthodontics, School of Dentistry, Cardiff University, Cardiff, UK
| | | | - Megan Gael Davis
- Department of Orthodontics, School of Dentistry, Cardiff University, Cardiff, UK
| | - Alexei Zhurov
- Department of Orthodontics, School of Dentistry, Cardiff University, Cardiff, UK
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19
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Roomaney I, Nyirenda C, Chetty M. Facial imaging to screen for fetal alcohol spectrum disorder: A scoping review. Alcohol Res 2022; 46:1166-1180. [PMID: 35616438 DOI: 10.1111/acer.14875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/15/2022] [Accepted: 05/20/2022] [Indexed: 12/01/2022] Open
Abstract
Facial imaging tools have rapidly advanced in recent years and show potential for use in fetal alcohol spectrum disorder (FASD) screening and diagnosis. This scoping review describes the current state of evidence regarding the use of facial imaging being as a screening tool for FASD at a community level. This review follows the guidelines for the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) extension for scoping reviews and is registered with the Open Science Framework (osf.io/e4xw6). An electronic search of five databases was conducted. The time frame was limited to the period 2006 to 2022. The search included any form of imaging of the head, neck, oral cavity, and dentition. Animal and antenatal studies were excluded, as were those using only brain imaging. The search retrieved 730 unique titles. After title, abstract, and full-text screening, 28 primary studies were included in this review. Most studies were conducted with South African participants. Imaging included 2D photographs, 3D stereophotogrammetry, 3D laser scanning, and radiographs. Various measurements and landmarks were used to discriminate FASD from non-FASD participants, which included anthropometry, face shape analysis, and facial curvatures. Methods of data processing, analysis, and modeling ranged from manual methods to fully automated systems utilizing artificial intelligence. The use of facial imaging to screen for and diagnose patients with FASD is a rapidly advancing field. Most studies in the field remain exploratory, attempting to find accurate, reliable, and consistent landmarks and measures across different populations. For community screening, none of the tools in this review in their current form completely fulfill all the identified properties of an ideal screening tool. More research and development are needed prior to advocating for the use of any tool listed and the ethical implications are yet to be fully explored.
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Affiliation(s)
- Imaan Roomaney
- Department of Craniofacial Biology, Faculty of Dentistry, University of Western Cape, Cape Town, South Africa
| | - Clement Nyirenda
- Department of Computer Science, Faculty of Natural Science, University of Western Cape, Cape Town, South Africa
| | - Manogari Chetty
- Department of Craniofacial Biology, Faculty of Dentistry, University of Western Cape, Cape Town, South Africa
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20
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Abstract
This article is part of a Festschrift commemorating the 50th anniversary of the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Established in 1970, first as part of the National Institute of Mental Health and later as an independent institute of the National Institutes of Health, NIAAA today is the world’s largest funding agency for alcohol research. In addition to its own intramural research program, NIAAA supports the entire spectrum of innovative basic, translational, and clinical research to advance the diagnosis, prevention, and treatment of alcohol use disorder and alcohol-related problems. To celebrate the anniversary, NIAAA hosted a 2-day symposium, “Alcohol Across the Lifespan: 50 Years of Evidence-Based Diagnosis, Prevention, and Treatment Research,” devoted to key topics within the field of alcohol research. This article is based on Dr. Charness’ presentation at the event. NIAAA Director George F. Koob, Ph.D., serves as editor of the Festschrift.
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Affiliation(s)
- Michael E Charness
- VA Boston Healthcare System, Boston, Massachusetts. Harvard Medical School, Boston, Massachusetts. Boston University School of Medicine, Boston, Massachusetts
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21
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Naqvi S, Hoskens H, Wilke F, Weinberg SM, Shaffer JR, Walsh S, Shriver MD, Wysocka J, Claes P. Decoding the Human Face: Challenges and Progress in Understanding the Genetics of Craniofacial Morphology. Annu Rev Genomics Hum Genet 2022; 23:383-412. [PMID: 35483406 PMCID: PMC9482780 DOI: 10.1146/annurev-genom-120121-102607] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Variations in the form of the human face, which plays a role in our individual identities and societal interactions, have fascinated scientists and artists alike. Here, we review our current understanding of the genetics underlying variation in craniofacial morphology and disease-associated dysmorphology, synthesizing decades of progress on Mendelian syndromes in addition to more recent results from genome-wide association studies of human facial shape and disease risk. We also discuss the various approaches used to phenotype and quantify facial shape, which are of particular importance due to the complex, multipartite nature of the craniofacial form. We close by discussing how experimental studies have contributed and will further contribute to our understanding of human genetic variation and then proposing future directions and applications for the field.
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Affiliation(s)
- Sahin Naqvi
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, California, USA; , .,Department of Genetics, Stanford University School of Medicine, Stanford, California, USA
| | - Hanne Hoskens
- Center for Processing Speech and Images, Department of Electrical Engineering, KU Leuven, Leuven, Belgium; , .,Medical Imaging Research Center, University Hospitals Leuven, Leuven, Belgium
| | - Franziska Wilke
- Department of Biology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA; ,
| | - Seth M Weinberg
- Department of Human Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; , .,Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Anthropology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - John R Shaffer
- Department of Human Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; , .,Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Susan Walsh
- Department of Biology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA; ,
| | - Mark D Shriver
- Department of Anthropology, The Pennsylvania State University, University Park, Pennsylvania, USA;
| | - Joanna Wysocka
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, California, USA; , .,Department of Developmental Biology, Stanford University School of Medicine, Stanford, California, USA.,Howard Hughes Medical Institute, Stanford University School of Medicine, Stanford, California, USA
| | - Peter Claes
- Center for Processing Speech and Images, Department of Electrical Engineering, KU Leuven, Leuven, Belgium; , .,Medical Imaging Research Center, University Hospitals Leuven, Leuven, Belgium.,Department of Human Genetics, KU Leuven, Leuven, Belgium.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia
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22
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Matthews H, de Jong G, Maal T, Claes P. Static and Motion Facial Analysis for Craniofacial Assessment and Diagnosing Diseases. Annu Rev Biomed Data Sci 2022; 5:19-42. [PMID: 35440145 DOI: 10.1146/annurev-biodatasci-122120-111413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Deviation from a normal facial shape and symmetry can arise from numerous sources, including physical injury and congenital birth defects. Such abnormalities can have important aesthetic and functional consequences. Furthermore, in clinical genetics distinctive facial appearances are often associated with clinical or genetic diagnoses; the recognition of a characteristic facial appearance can substantially narrow the search space of potential diagnoses for the clinician. Unusual patterns of facial movement and expression can indicate disturbances to normal mechanical functioning or emotional affect. Computational analyses of static and moving 2D and 3D images can serve clinicians and researchers by detecting and describing facial structural, mechanical, and affective abnormalities objectively. In this review we survey traditional and emerging methods of facial analysis, including statistical shape modeling, syndrome classification, modeling clinical face phenotype spaces, and analysis of facial motion and affect. Expected final online publication date for the Annual Review of Biomedical Data Science, Volume 5 is August 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Harold Matthews
- Department of Human Genetics, KU Leuven, Leuven, Belgium; .,Medical Imaging Research Center, UZ Leuven, Leuven, Belgium.,Facial Sciences Research Group, Murdoch Children's Research Institute, Parkville, Australia
| | - Guido de Jong
- 3D Lab, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Thomas Maal
- 3D Lab, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Peter Claes
- Department of Human Genetics, KU Leuven, Leuven, Belgium; .,Medical Imaging Research Center, UZ Leuven, Leuven, Belgium.,Facial Sciences Research Group, Murdoch Children's Research Institute, Parkville, Australia.,Processing Speech and Images (PSI), Department of Electrical Engineering (ESAT), KU Leuven, Leuven, Belgium
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23
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Finlay-Jones A, Elliott E, Chapman A, Halliday J, Jones H, Kippin N, Mullan N, Passmore H, Reibel T, Reynolds N, Symons M, Tsang TW, Watkins R, Bower C. It takes a village: Influencing policy and practice to prevent alcohol use in pregnancy and promote better outcomes for individuals living with Fetal Alcohol Spectrum Disorder. Int J Popul Data Sci 2022; 6:1703. [PMID: 35309099 PMCID: PMC8900649 DOI: 10.23889/ijpds.v6i1.1703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Fetal Alcohol Spectrum Disorder (FASD) is a neurodevelopmental disorder caused by exposure to alcohol in utero. It has pervasive, lifelong impacts and is recognised as a major public health concern in many countries where alcohol is used. The FASD Research Australia Centre of Research Excellence (CRE) was funded by the National Health and Medical Research Council to generate and translate evidence to address prevention, diagnosis, and management of FASD in Australia. The current paper describes the approach to policy and practice impact taken by our CRE, including our stakeholder engagement processes and the key principles that underlie our approach. We provide examples of policy and practice influence in FASD prevention, diagnosis and management that have been achieved over the past five years and discuss challenges that are routinely faced in the translation of our work.
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Affiliation(s)
- Amy Finlay-Jones
- FASD Research Australia Centre of Research Excellence, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia, 6009
| | - Elizabeth Elliott
- FASD Research Australia Centre of Research Excellence, Australia
- The University of Sydney, Discipline of Child and Adolescent Health, Faculty of Medicine and Health, Westmead, NSW, Australia, 2145
- Sydney Children’s Hospital Network, Kids Research, Westmead, NSW, Australia, 2145
| | - Astrid Chapman
- FASD Research Australia Centre of Research Excellence, Australia
| | - Jane Halliday
- FASD Research Australia Centre of Research Excellence, Australia
- Reproductive Epidemiology, Genetics, Murdoch Children’s Research Institute, The Royal Children’s Hospital, Victoria, 3052, Australia
- Department of Paediatrics, University of Melbourne, Victoria, 3010, Australia
| | - Heather Jones
- FASD Research Australia Centre of Research Excellence, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia, 6009
| | - Natalie Kippin
- FASD Research Australia Centre of Research Excellence, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia, 6009
| | - Narelle Mullan
- FASD Research Australia Centre of Research Excellence, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia, 6009
| | - Hayley Passmore
- FASD Research Australia Centre of Research Excellence, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia, 6009
| | - Tracy Reibel
- FASD Research Australia Centre of Research Excellence, Australia
- Ngangk Yira Research Centre for Aboriginal Health and Social Equity, Murdoch University, Western Australia, 6150, Australia
| | - Neil Reynolds
- FASD Research Australia Centre of Research Excellence, Australia
| | - Martyn Symons
- FASD Research Australia Centre of Research Excellence, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia, 6009
| | - Tracey W Tsang
- FASD Research Australia Centre of Research Excellence, Australia
- The University of Sydney, Discipline of Child and Adolescent Health, Faculty of Medicine and Health, Westmead, NSW, Australia, 2145
- Sydney Children’s Hospital Network, Kids Research, Westmead, NSW, Australia, 2145
| | - Rochelle Watkins
- FASD Research Australia Centre of Research Excellence, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia, 6009
| | - Carol Bower
- FASD Research Australia Centre of Research Excellence, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia, 6009
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24
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Muggli E, Halliday J, Elliott EJ, Penington A, Thompson D, Spittle AJ, Forster D, Lewis S, Hearps S, Anderson PJ. Cohort profile: early school years follow-up of the Asking Questions about Alcohol in Pregnancy Longitudinal Study in Melbourne, Australia (AQUA at 6). BMJ Open 2022; 12:e054706. [PMID: 35039298 PMCID: PMC8765013 DOI: 10.1136/bmjopen-2021-054706] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
PURPOSE The Asking Questions about Alcohol in Pregnancy (AQUA) study, established in 2011, is a prebirth cohort of 1570 mother and child pairs designed to assess the effects of low to moderate prenatal alcohol exposure and sporadic binge drinking on long-term child development. Women attending general antenatal clinics in public hospitals in Melbourne, Australia, were recruited in their first trimester, followed up three times during pregnancy and at 12 and 24 months postpartum. The current follow-up of the 6-8-year-old children aims to strengthen our understanding of the relationship between these levels of prenatal alcohol exposure and neuropsychological functioning, facial dysmorphology, brain structure and function. PARTICIPANTS Between June 2018 and April 2021, 802 of the 1342 eligible AQUA study families completed a parent-report questionnaire (60%). Restrictions associated with COVID-19 pandemic disrupted recruitment, but early school-age neuropsychological assessments were undertaken with 696 children (52%), and 482 (36%) craniofacial images were collected. A preplanned, exposure-representative subset of 146 children completed a brain MRI. An existing biobank was extended through collection of 427 (32%) child buccal swabs. FINDINGS TO DATE Over half (59%) of mothers consumed some alcohol during pregnancy, with one in five reporting at least one binge-drinking episode prior to pregnancy recognition. Children's craniofacial shape was examined at 12 months of age, and low to moderate prenatal alcohol exposure was associated with subtle midface changes. At 2 years of age, formal developmental assessments showed no evidence that cognitive, language or motor outcome was associated with any of exposure level. FUTURE PLANS We will investigate the relationship between prenatal alcohol exposure and specific aspects of neurodevelopment at 6-8 years, including craniofacial shape, brain structure and function. The contribution of genetics and epigenetics to individual variation in outcomes will be examined in conjunction with national and international collaborations.
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Affiliation(s)
- Evelyne Muggli
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jane Halliday
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Reproductive Epidemiology, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Elizabeth J Elliott
- Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
- Sydney Children's Hospital Network, Sydney, New South Wales, Australia
| | - Anthony Penington
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Plastic and Maxillofacial Unit, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Deanne Thompson
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Alicia Jane Spittle
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
| | - Della Forster
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
- The Royal Women's Hospital, Parkville, Victoria, Australia
| | - Sharon Lewis
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Reproductive Epidemiology, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Stephen Hearps
- Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Peter J Anderson
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
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25
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Etemadi-Aleagha A, Akhgari M. Psychotropic drug abuse in pregnancy and its impact on child neurodevelopment: A review. World J Clin Pediatr 2022; 11:1-13. [PMID: 35096542 PMCID: PMC8771314 DOI: 10.5409/wjcp.v11.i1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/21/2021] [Accepted: 11/29/2021] [Indexed: 02/06/2023] Open
Abstract
Substance abuse by women of child-bearing age and fetal in utero drug exposure has increased in the number of infants born with health issues. Prenatal exposure to psychoactive substances can lead to neurological and neurodevelopmental deficits later in life. Useful data concerning the effects of psychoactive drugs on fetal neurodevelopmental status are sparse. Understanding the neurodevelopmental consequences of prenatally drug-exposed children has become a pressing global concern. The aim of this review is to gather current evidence and information on neurodevelopmental outcomes of in utero drug exposure. A literature search was performed on the PubMed, Scopus, and Google Scholar databases using the terms “psychotropic drugs”, “neurodevelopmental consequences”, “prenatal drug exposure”, and “pregnancy”. Available studies on in utero drug exposure were reviewed and found to support the idea that some degree of health issues are present in fetuses and children. Different psychoactive substances have profound neurodevelopmental consequences, such as structural brain changes, poor attention span, Down syndrome, attention deficit hyperactivity disorder, autism spectrum disorder, imbalances in neurotransmitter levels, and many structural deficits. The pervasive use of psychoactive drugs in women of child-bearing age is an important health concern. Further scientific efforts are needed to investigate the effect of prenatal exposure to psychoactive drugs on children.
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Affiliation(s)
- Afshar Etemadi-Aleagha
- Department of Anesthesiology and Intensive Care, Tehran University of Medical Sciences, Tehran 1145765111, Iran
| | - Maryam Akhgari
- Legal Medicine Research Center, Legal Medicine Organization, Tehran 1114795113, Iran
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26
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Chandran S, Sreeraj VS, Venkatasubramanian G, Sathyaprabha TN, Murthy P. Corpus callosum morphometry in children with prenatal alcohol exposure. Psychiatry Res Neuroimaging 2021; 318:111405. [PMID: 34743066 DOI: 10.1016/j.pscychresns.2021.111405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 11/19/2022]
Abstract
Alcohol is known to have a neurotoxic effect on the brain of offspring of mothers consuming alcohol during pregnancy. Impact on the neurodevelopment in children who were exposed to alcohol specifically during the antenatal period without any clinically detectable features of fetal alcohol syndrome is less well studied. In this cross-sectional study, structural magnetic resonance imaging (MRI) of the brain was acquired in 28 children whose mothers had consumed alcohol during pregnancy and 30 children of mothers who did not consume alcohol during pregnancy. Areas of Corpus callosum (CC) and its parts in the mid-sagittal section were calculated using morphometric analysis of MRI through Witelson's method. Midbody of CC was found to be significantly smaller in children exposed to alcohol during the prenatal period. CC is a sensitive white matter structure to neurotoxic effects of alcohol during prenatal life. This impact could be visible in developmental age even in those without any clinically detectable features of alcohol exposure.
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Affiliation(s)
- Sajish Chandran
- Department of Neurophysiology, National Institute of Mental Health and Neuro Sciences (NIMHANS), 560061 Bengaluru India
| | - Vanteemar S Sreeraj
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru India
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru India
| | - Talakad N Sathyaprabha
- Department of Neurophysiology, National Institute of Mental Health and Neuro Sciences (NIMHANS), 560061 Bengaluru India
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru India.
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27
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Integration and Application of Multimodal Measurement Techniques: Relevance of Photogrammetry to Orthodontics. SENSORS 2021; 21:s21238026. [PMID: 34884030 PMCID: PMC8659967 DOI: 10.3390/s21238026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/27/2021] [Accepted: 11/27/2021] [Indexed: 11/18/2022]
Abstract
Multimodal imaging, including 3D modalities, is increasingly being applied in orthodontics, both as a diagnostic tool and especially for the design of intraoral appliances, where geometric accuracy is very important. Laser scanners and other precision 3D-imaging devices are expensive and cumbersome, which limits their use in medical practice. Photogrammetry, using ordinary 2D photographs or video recordings to create 3D imagery, offers a cheaper and more convenient alternative, replacing the specialised equipment with handy consumer cameras. The present study addresses the question of to what extent, and under what conditions, this technique can be an adequate replacement for the 3D scanner. The accuracy of simple surface reconstruction and of model embedding achieved with photogrammetry was verified against that obtained with a triangulating laser scanner. To roughly evaluate the impact of image imperfections on photogrammetric reconstruction, the photographs for photogrammetry were taken under various lighting conditions and were used either raw or with a blur-simulating defocus. Video footage was also tested as another 2D-imaging modality feeding data into photogrammetry. The results show the significant potential of photogrammetric techniques.
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28
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Loke YJ, Muggli E, Saffery R, Ryan J, Lewis S, Elliott EJ, Halliday J, Craig JM. Sex- and tissue-specific effects of binge-level prenatal alcohol consumption on DNA methylation at birth. Epigenomics 2021; 13:1921-1938. [PMID: 34841896 DOI: 10.2217/epi-2021-0285] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background: Binge-level prenatal alcohol exposure (PAE) causes developmental abnormalities, which may be mediated in part by epigenetic mechanisms. Despite this, few studies have characterised the association of binge PAE with DNA methylation in offspring. Methods: We investigated the association between binge PAE and genome-wide DNA methylation profiles in a sex-specific manner in neonatal buccal and placental samples. Results: We identified no differentially methylated CpGs or differentially methylated regions (DMRs) at false discovery rate <0.05. However, using a sum-of-ranks approach, we identified a DMR in each tissue of female offspring. The DMR identified in buccal samples is located near regions with previously-reported associations to fetal alcohol spectrum disorder (FASD) and binge PAE. Conclusion: Our findings warrant further replication and highlight a potential epigenetic link between binge PAE and FASD.
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Affiliation(s)
- Yuk Jing Loke
- Molecular Immunity, Murdoch Children's Research Institute, Victoria, 3052, Australia.,Department of Paediatrics, University of Melbourne, Victoria, 3010, Australia
| | - Evelyne Muggli
- Department of Paediatrics, University of Melbourne, Victoria, 3010, Australia.,Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, 3052, Australia.,Reproductive Epidemiology, Murdoch Children's Research Institute, Victoria, 3052, Australia
| | - Richard Saffery
- Molecular Immunity, Murdoch Children's Research Institute, Victoria, 3052, Australia.,Department of Paediatrics, University of Melbourne, Victoria, 3010, Australia
| | - Joanne Ryan
- Molecular Immunity, Murdoch Children's Research Institute, Victoria, 3052, Australia.,Biological Neuropsychiatry & Dementia Unit, School of Public Health, Monash University, Victoria, 3004, Australia
| | - Sharon Lewis
- Department of Paediatrics, University of Melbourne, Victoria, 3010, Australia.,Reproductive Epidemiology, Murdoch Children's Research Institute, Victoria, 3052, Australia
| | - Elizabeth J Elliott
- Specialty of Child & Adolescent Health, Faculty of Medicine & Health, University of Sydney, NSW, 2050, Australia.,The Australian Paediatric Surveillance Unit, Sydney Children's Hospital Network, NSW, 2045, Australia
| | - Jane Halliday
- Department of Paediatrics, University of Melbourne, Victoria, 3010, Australia.,Reproductive Epidemiology, Murdoch Children's Research Institute, Victoria, 3052, Australia
| | - Jeffrey M Craig
- Molecular Immunity, Murdoch Children's Research Institute, Victoria, 3052, Australia.,Department of Paediatrics, University of Melbourne, Victoria, 3010, Australia.,The Institute of Mental & Physical Health & Clinical Translation, Deakin University, Victoria, 3220, Australia
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29
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Fletcher TMD, Mullan B, Novoradovskaya E, Finlay-Jones A. Is 'a little' too much?: An exploration of women's beliefs about alcohol use during pregnancy. Psychol Health 2021:1-19. [PMID: 34658281 DOI: 10.1080/08870446.2021.1991342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Interventions to address alcohol use during pregnancy need to target underlying determinants of the behaviour. Using the theory of planned behaviour as a theoretical framework, the aim of this study was to identify behavioural, normative and control beliefs regarding alcohol use during pregnancy among a sample of women. Design: 435 women completed a 15-minute online questionnaire designed to identify beliefs about alcohol use during pregnancy. Data were categorised according to type of belief and then summarised and described. Results: The majority of respondents saw few advantages of consuming alcohol during pregnancy and believed that most people would disapprove of alcohol use during pregnancy. Although most women endorsed alcohol abstinence during pregnancy, views on the perceived risk of different levels of alcohol use and perceptions of the 'typical' person who drinks while pregnant varied between participants. Conclusion: This work contributes to the understanding of women's beliefs about alcohol use during pregnancy. Future research should explore how women's beliefs inform their decision making about different levels of alcohol use in pregnancy. Additionally, further research or messaging about alcohol use in pregnancy must also consider the potential for contributing to stigmatising beliefs.
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Affiliation(s)
- Tess M D Fletcher
- FASD Research Australia Centre for Research Excellence, Telethon Kids Institute, Perth, Australia.,Faculty of Health Sciences, Health Psychology & Behavioural Medicine Research Group, Curtin University, Perth, Australia
| | - Barbara Mullan
- Faculty of Health Sciences, Health Psychology & Behavioural Medicine Research Group, Curtin University, Perth, Australia
| | - Elizaveta Novoradovskaya
- Faculty of Health Sciences, Health Psychology & Behavioural Medicine Research Group, Curtin University, Perth, Australia
| | - Amy Finlay-Jones
- FASD Research Australia Centre for Research Excellence, Telethon Kids Institute, Perth, Australia
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30
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Cao J, Chen Y, Xia X, Qu H, Ao Y, Wang H. Intergenerational genetic programming mechanism and sex differences of the adrenal corticosterone synthesis dysfunction in offspring induced by prenatal ethanol exposure. Toxicol Lett 2021; 351:78-88. [PMID: 34454011 DOI: 10.1016/j.toxlet.2021.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/11/2021] [Accepted: 08/18/2021] [Indexed: 11/28/2022]
Abstract
We previously found that prenatal ethanol exposure (PEE) induced adrenal dysplasia in offspring, which was related to intrauterine maternal glucocorticoid overexposure. This study investigated the intergenerational genetic effect and sex differences of PEE-induced changes in the synthetic function of adrenal corticosterone in offspring, and to clarify the intrauterine origin programming mechanism. Wistar pregnant rats were gavaged with ethanol (4 g/kg bw/d) from gestation day (GD) 9-20, and F1 generation was born naturally. The F1 generation female rats in the PEE group were mated with normal male rats to produce F2 generation. Serum and adrenal glands of fetal rats and F1/F2 adult rats were collected at GD20 and postnatal week 28. PEE increased the serum corticosterone level, while diminishing the expression of adrenal steroid synthases of fetal rats. Moreover, PEE enhanced the mRNA expression of GR and HDAC1, but inhibited the mRNA expression of SF1 and reduced the H3K9ac level of P450scc in the fetal adrenal gland. In PEE adult offspring of F1 and F2 generation the serum corticosterone level, the H3K9ac level of P450scc and its expression were decreased in males but were increased in females. In NCI-H295R cells, cortisol reduced the production of endogenous cortisol, down-regulated SF1, and up-regulated HDAC1 expression by activating GR, and decreased H3K9ac level and expression of P450scc. In conclusion, PEE could induce adrenal dysplasia in offspring with sex differences and intergenerational genetic effects, and the adrenal insufficiency in male offspring was related to the induction of low functional genetic programming of P450scc by intrauterine high corticosterone through the GR/SF1/HDAC1 pathway.
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Affiliation(s)
- Jiangang Cao
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Yawen Chen
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Xuan Xia
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Hui Qu
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Ying Ao
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China.
| | - Hui Wang
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China.
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Wang JZ, Lillia J, Farhan M, Bi L, Kim J, Burns J, Cheng TL. Digital mapping of a manual fabrication method for paediatric ankle-foot orthoses. Sci Rep 2021; 11:19068. [PMID: 34561543 PMCID: PMC8463714 DOI: 10.1038/s41598-021-98786-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 09/13/2021] [Indexed: 11/09/2022] Open
Abstract
Ankle–foot orthoses (AFOs) are devices prescribed to improve mobility in people with neuromuscular disorders. Traditionally, AFOs are manually fabricated by an orthotist based on a plaster impression of the lower leg which is modified to correct for impairments. This study aimed to digitally analyse this manual modification process, an important first step in understanding the craftsmanship of AFO fabrication to inform the digital workflows (i.e. 3D scanning and 3D printing), as viable alternatives for AFO fabrication. Pre- and post-modified lower limb plaster casts of 50 children aged 1–18 years from a single orthotist were 3D scanned and registered. The Euclidean distance between the pre- and post-modified plaster casts was calculated, and relationships with participant characteristics (age, height, AFO type, and diagnosis) were analysed. Modification maps demonstrated that participant-specific modifications were combined with universally applied modifications on the cast's anterior and plantar surfaces. Positive differences (additions) ranged 2.12–3.81 mm, negative differences (subtractions) ranged 0.76–3.60 mm, with mean differences ranging from 1.37 to 3.12 mm. Height had a medium effect on plaster additions (rs = 0.35). We quantified the manual plaster modification process and demonstrated a reliable method to map and compare pre- and post-modified casts used to fabricate children's AFOs.
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Affiliation(s)
- Joyce Zhanzi Wang
- University of Sydney School of Health Sciences, Faculty of Medicine and Health & Children's Hospital at Westmead, University of Sydney, Sydney, NSW, Australia. .,EPIC Lab, Kids Research, The Children's Hospital at Westmead, Westmead, NSW, 2145, Australia.
| | - Jonathon Lillia
- EPIC Lab, Kids Research, The Children's Hospital at Westmead, Westmead, NSW, 2145, Australia
| | - Muhannad Farhan
- University of Sydney School of Health Sciences, Faculty of Medicine and Health & Children's Hospital at Westmead, University of Sydney, Sydney, NSW, Australia.,EPIC Lab, Kids Research, The Children's Hospital at Westmead, Westmead, NSW, 2145, Australia.,Faculty of Medical Rehabilitation Science, Taibah University, Al Madinah Al Munawarah, Saudi Arabia
| | - Lei Bi
- School of Computer Science, Faculty of Engineering, University of Sydney, Sydney, NSW, Australia
| | - Jinman Kim
- School of Computer Science, Faculty of Engineering, University of Sydney, Sydney, NSW, Australia
| | - Joshua Burns
- University of Sydney School of Health Sciences, Faculty of Medicine and Health & Children's Hospital at Westmead, University of Sydney, Sydney, NSW, Australia.,EPIC Lab, Kids Research, The Children's Hospital at Westmead, Westmead, NSW, 2145, Australia
| | - Tegan L Cheng
- University of Sydney School of Health Sciences, Faculty of Medicine and Health & Children's Hospital at Westmead, University of Sydney, Sydney, NSW, Australia.,EPIC Lab, Kids Research, The Children's Hospital at Westmead, Westmead, NSW, 2145, Australia
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Addila AE, Azale T, Gete YK, Yitayal M. Determinants of hazardous alcohol use among pregnant women attending antenatal care at public health facilities in Gondar town, Northwest Ethiopia: A nested case-control study. PLoS One 2021; 16:e0253162. [PMID: 34197507 PMCID: PMC8248645 DOI: 10.1371/journal.pone.0253162] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 05/31/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Alcohol use during pregnancy has a potential negative impact on the health of women and children. Binge or hazardous drinking may do greater alcohol-related damage to the developing fetus than drinking a comparable amount spread over several days or weeks. This study aimed to identify determinants of hazardous alcohol use among pregnant women attending antenatal care at Gondar town public health facilities, Northwest Ethiopia. METHODS An unmatched facility-based nested case-control study was carried out to identify the determinants of hazardous alcohol use among pregnant women within a prospective cohort study from 29 October 2019 to 7 May 2020. A two-stage random sampling technique was used to select 455 (113 cases and 342 controls) pregnant women. Data collection was performed using the AUDIT-C standardized and pretested questionnaire. Bivariable and multivariable logistic regression analyses were computed to identify the predictors of alcohol consumption using the odds ratio, 95% CI, and p-value < 0.05. RESULTS Multivariable logistic regression model revealed that no formal education of the husbands [AOR = 2.79; 95%CI: 1.24, 6.29], being housewife[AOR = 2.43; 95%CI: 1.12, 5.26], poor household wealth index[AOR = 2.65; 95%CI: 1.07, 6.54], unplanned pregnancy [AOR = 4.36;95%CI: 2.44, 7.79], poor social support [AOR = 4.9;95%CI: 2.4, 10.04], depression[AOR = 3.84;95%CI: 2.16, 6.82], and not ever heard the risk of alcohol drinking during pregnancy [AOR = 1.97; 95%CI: 1.08, 3.58] were significantly associated with hazardous alcohol use. CONCLUSIONS Routine alcohol screening during ANC visits creates an appropriate referral system for clinical management and provides an opportunity for healthcare workers to offer information on the potential risks associated with alcohol use in pregnancy. Antenatal care providers have a special role to play in assuring that women receive adequate advice about alcohol use and care to manage the problems especially for pregnant women with depression, poor social support, unplanned pregnancy, low socioeconomic status, and for housewives during the antenatal visits. The warning marks on alcoholic beverages including an ongoing message about the risks of alcohol use during pregnancy could be public health good strategies to minimize preventable harms attributed to alcohol consumption during pregnancy.
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Affiliation(s)
- Alemu Earsido Addila
- Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Telake Azale
- Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yigzaw Kebede Gete
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mezgebu Yitayal
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Yaesoubi R, Mahin M, Martin G, Paltiel AD, Sharifi M. Reducing the Prevalence of Alcohol-Exposed Pregnancies in the United States: A Simulation Modeling Study. Med Decis Making 2021; 42:217-227. [PMID: 34166146 DOI: 10.1177/0272989x211023203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Public health efforts to prevent alcohol-exposed pregnancies (AEPs) primarily focus on promoting abstinence from alcohol among women if pregnant or seeking pregnancy and using effective contraception to prevent unintended pregnancies if consuming alcohol. Little is known about how programs to improve adherence to these recommendations would affect the prevalence of AEPs. METHODS We developed an individual-based simulation model of US women of reproductive age to project the prevalence of AEPs under different public health strategies. The model varies each woman's risk of an AEP over time depending on fertility, contraceptive use, awareness of pregnancy, sexual activity, and drinking patterns. We used the 2013-2015 National Survey on Family Growth data set to parameterize the model. RESULTS We estimate that 54% (95% uncertainty interval: 48%-59%) of pregnancies that result in a live birth in the United States are exposed to alcohol, 12% (10%-15%) are ever exposed to ≥5 alcoholic drinks in a week, and 3.0% (1.3%-4.2%) to ≥9 drinks. Unintended pregnancies (either due to contraceptive failure or sex without contraceptives) account for 80% (75%-87%) of pregnancies unknowingly exposed to alcohol. We project that public health efforts that focus only on promoting alcohol abstinence among women who are aware of their pregnancy or seeking pregnancy could reduce the prevalence of AEPs by at most 42% (36%-48%). Augmenting this strategy with efforts to avert unintended pregnancies could yield an 80% (73%-86%) reduction in the prevalence of AEPs. CONCLUSIONS Promoting alcohol abstinence among women who are aware of their pregnancy or seeking pregnancy offers limited potential to reduce the prevalence of AEPs. Programs to avert unintended pregnancies are essential to achieve more substantial reductions in AEPs in the United States.
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Affiliation(s)
- Reza Yaesoubi
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
| | - Maya Mahin
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA.,Analysis Group, Inc., Boston, MA
| | | | - A David Paltiel
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
| | - Mona Sharifi
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA
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Friedrich RE, Zustin J, Luebke AM, Rosenbaum T, Gosau M, Hagel C, Kohlrusch FK, Wieland I, Zenker M. Neurofibromatosis Type 1 With Cherubism-like Phenotype, Multiple Osteolytic Bone Lesions of Lower Extremities, and Alagille-syndrome: Case Report With Literature Survey. In Vivo 2021; 35:1711-1736. [PMID: 33910856 DOI: 10.21873/invivo.12431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND/AIM Neurofibromatosis type 1 (NF) is an autosomal dominant hereditary disease. The cardinal clinical findings include characteristic skeletal alterations. Difficulties in diagnosis and therapy can arise if an individual has further illnesses. CASE REPORT This is a case report of a 16-year-old patient affected by NF1. She also suffered from Alagille syndrome and the consequences of fetal alcohol exposure. The patient's facial phenotype showed findings that could be assigned to one or more of the known diseases. The patient was referred for treating a cherubism-like recurrent central giant cell granuloma (CGCG) of the jaw. The patient developed bilateral, multilocular non-ossifying fibromas (NOF) of the long bones of the lower extremity. Treatment of the skeletal lesions consisted of local curettage. While NOF regressed after surgery, the CGCG of the jaw remained largely unchanged. Extensive genetic tests confirmed a previously unknown germline mutation in the JAG1 gene, the germline mutation of the NF1 gene, and the somatic mutation in the NF1 gene in the diffuse plexiform neurofibroma, but not in the CGCG. CONCLUSION Assigning facial findings to a defined syndrome is ambiguous in many cases and especially difficult in patients who have multiple diseases that can affect the facial phenotype. Surgical therapy should be adapted to the individual findings.
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Affiliation(s)
- Reinhard E Friedrich
- Oral and Craniomaxillofacial Surgery, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany;
| | - Jozef Zustin
- Institute of Osteology and Biomechanics, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany.,Institute of Pathology, Gemeinschaftspraxis Pathologie-Regensburg, Regensburg, Germany
| | - Andreas M Luebke
- Institute of Pathology, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany
| | | | - Martin Gosau
- Oral and Craniomaxillofacial Surgery, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany
| | - Christian Hagel
- Institute of Neuropathology, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany
| | - Felix K Kohlrusch
- Oral and Craniomaxillofacial Surgery, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany
| | - Ilse Wieland
- Institute of Human Genetics, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Martin Zenker
- Institute of Human Genetics, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
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Fischer M, Chander P, Kang H, Mellios N, Weick JP. Transcriptomic changes due to early, chronic intermittent alcohol exposure during forebrain development implicate WNT signaling, cell-type specification, and cortical regionalization as primary determinants of fetal alcohol syndrome. Alcohol Clin Exp Res 2021; 45:979-995. [PMID: 33682149 PMCID: PMC8643076 DOI: 10.1111/acer.14590] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 01/30/2021] [Accepted: 02/19/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Fetal alcohol syndrome (FAS) due to gestational alcohol exposure represents one of the most common causes of nonheritable lifelong disability worldwide. In vitro and in vivo models have successfully recapitulated multiple facets of the disorder, including morphological and behavioral deficits, but far less is understood regarding the molecular and genetic mechanisms underlying FAS. METHODS In this study, we utilized an in vitro human pluripotent stem cell-based (hPSC) model of corticogenesis to probe the effects of early, chronic intermittent alcohol exposure on the transcriptome of first trimester-equivalent cortical neurons. RESULTS We used RNA sequencing of developing hPSC-derived neurons treated for 50 days with 50 mM ethanol and identified a relatively small number of biological pathways significantly altered by alcohol exposure. These included cell-type specification, axon guidance, synaptic function, and regional patterning, with a notable upregulation of WNT signaling-associated transcripts observed in alcohol-exposed cultures relative to alcohol-naïve controls. Importantly, this effect paralleled a shift in gene expression of transcripts associated with regional patterning, such that caudal forebrain-related transcripts were upregulated at the expense of more anterior ones. Results from H9 embryonic stem cells were largely replicated in an induced pluripotent stem cell line (IMR90-4), indicating that these patterning alterations are not cell line-specific. CONCLUSIONS We found that a major effect of chronic intermittent alcohol on the developing cerebral cortex is an overall imbalance in regionalization, with enrichment of gene expression related to the production of posterodorsal progenitors and a diminution of anteroventral progenitors. This finding parallels behavioral and morphological phenotypes observed in animal models of high-dose prenatal alcohol exposure, as well as patients with FAS.
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Affiliation(s)
- Máté Fischer
- Department of Neurosciences, University of New Mexico HSC, Albuquerque, NM, USA
| | - Praveen Chander
- Department of Neurosciences, University of New Mexico HSC, Albuquerque, NM, USA
| | - Huining Kang
- Department of Internal Medicine, University of New Mexico HSC, Albuquerque, NM, USA
| | - Nikolaos Mellios
- Department of Neurosciences, University of New Mexico HSC, Albuquerque, NM, USA.,Autophagy Inflammation and Metabolism (AIM) Center, University of New Mexico HSC, Albuquerque, NM, USA
| | - Jason P Weick
- Department of Neurosciences, University of New Mexico HSC, Albuquerque, NM, USA.,Center for Brain Recovery and Repair, University of New Mexico HSC, Albuquerque, NM, USA.,New Mexico Alcohol Research Center, University of New Mexico HSC, Albuquerque, NM, USA
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36
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Farnell DJJ, Richmond S, Galloway J, Zhurov AI, Pirttiniemi P, Heikkinen T, Harila V, Matthews H, Claes P. An exploration of adolescent facial shape changes with age via multilevel partial least squares regression. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 200:105935. [PMID: 33485077 PMCID: PMC7920996 DOI: 10.1016/j.cmpb.2021.105935] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 01/05/2021] [Indexed: 05/24/2023]
Abstract
BACKGROUND AND OBJECTIVES Multilevel statistical models represent the existence of hierarchies or clustering within populations of subjects (or shapes in this work). This is a distinct advantage over single-level methods that do not. Multilevel partial-least squares regression (mPLSR) is used here to study facial shape changes with age during adolescence in Welsh and Finnish samples comprising males and females. METHODS 3D facial images were obtained for Welsh and Finnish male and female subjects at multiple ages from 12 to 17 years old. 1000 3D points were defined regularly for each shape by using "meshmonk" software. A three-level model was used here, including level 1 (sex/ethnicity); level 2, all "subject" variations excluding sex, ethnicity, and age; and level 3, age. The mathematical formalism of mPLSR is given in an Appendix. RESULTS Differences in facial shape between the ages of 12 and 17 predicted by mPLSR agree well with previous results of multilevel principal components analysis (mPCA); buccal fat is reduced with increasing age and features such as the nose, brow, and chin become larger and more distinct. Differences due to ethnicity and sex are also observed. Plausible simulated faces are predicted from the model for different ages, sexes and ethnicities. Our models provide good representations of the shape data by consideration of appropriate measures of model fit (RMSE and R2). CONCLUSIONS Repeat measures in our dataset for the same subject at different ages can only be modelled indirectly at the lowest level of the model at discrete ages via mPCA. By contrast, mPLSR models age explicitly as a continuous covariate, which is a strong advantage of mPLSR over mPCA. These investigations demonstrate that multivariate multilevel methods such as mPLSR can be used to describe such age-related changes for dense 3D point data. mPLSR might be of much use in future for the prediction of facial shapes for missing persons at specific ages or for simulating shapes for syndromes that affect facial shape in new subject populations.
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Affiliation(s)
- D J J Farnell
- School of Dentistry, Cardiff University, Heath Park, Cardiff CF14 4XY, United Kingdom.
| | - S Richmond
- School of Dentistry, Cardiff University, Heath Park, Cardiff CF14 4XY, United Kingdom
| | - J Galloway
- School of Dentistry, Cardiff University, Heath Park, Cardiff CF14 4XY, United Kingdom
| | - A I Zhurov
- School of Dentistry, Cardiff University, Heath Park, Cardiff CF14 4XY, United Kingdom
| | - P Pirttiniemi
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, Oulu, Finland
| | - T Heikkinen
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, Oulu, Finland
| | - V Harila
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, Oulu, Finland
| | - H Matthews
- Medical Imaging Research Center, UZ Leuven, 3000 Leuven, Belgium; Department of Human Genetics, KU Leuven, 3000 Leuven, Belgium; Facial Sciences Research Group, Murdoch Children's Research Institute, Melbourne; Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - P Claes
- Medical Imaging Research Center, UZ Leuven, 3000 Leuven, Belgium; Department of Human Genetics, KU Leuven, 3000 Leuven, Belgium; Department of Electrical Engineering, ESAT/PSI, KU Leuven, 3000 Leuven, Belgium
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Richmond S, Zhurov AI, Ali ABM, Pirttiniemi P, Heikkinen T, Harila V, Silinevica S, Jakobsone G, Urtane I. Exploring the midline soft tissue surface changes from 12 to 15 years of age in three distinct country population cohorts. Eur J Orthod 2021; 42:517-524. [PMID: 31748803 DOI: 10.1093/ejo/cjz080] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Several studies have highlighted differences in the facial features in a White European population. Genetics appear to have a major influence on normal facial variation, and environmental factors are likely to have minor influences on face shape directly or through epigenetic mechanisms. AIM The aim of this longitudinal cohort study is to determine the rate of change in midline facial landmarks in three distinct homogenous population groups (Finnish, Latvian, and Welsh) from 12.8 to 15.3 years of age. This age range covers the pubertal growth period for the majority of boys and girls. METHODS A cohort of children aged 12 were monitored for facial growth in three countries [Finland (n = 60), Latvia (n = 107), and Wales (n = 96)]. Three-dimensional facial surface images were acquired (using either laser or photogrammetric methods) at regular intervals (6-12 months) for 4 years. Ethical approval was granted in each country. Nine midline landmarks were identified and the relative spatial positions of these surface landmarks were measured relative to the mid-endocanthion (men) over a 4-year period. RESULTS This study reports the children who attended 95 per cent of all scanning sessions (Finland 48 out of 60; Latvia 104 out of 107; Wales 50 out of 96). Considerable facial variation is seen for all countries and sexes. There are clear patterns of growth that show different magnitudes at different age groups for the different country groups, sexes, and facial parameters. The greatest single yearly growth rate (5.4 mm) was seen for Welsh males for men-pogonion distance at 13.6 years of age. Males exhibit greater rates of growth compared to females. These variations in magnitude and timings are likely to be influenced by genetic ancestry as a result of population migration. CONCLUSION The midline points are a simple and valid method to assess the relative spatial positions of facial surface landmarks. This study confirms previous reports on the subtle differences in facial shapes and sizes of male and female children in different populations and also highlights the magnitudes and timings of growth for various midline landmark distances to the men point.
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Affiliation(s)
- Stephen Richmond
- Orthodontic Department, Applied Clinical Research and Public Health, School of Dentistry, College of Biomedical and Life Sciences, Heath Park, Cardiff, UK
| | - Alexei I Zhurov
- Orthodontic Department, Applied Clinical Research and Public Health, School of Dentistry, College of Biomedical and Life Sciences, Heath Park, Cardiff, UK
| | - Azrul Bin Mohd Ali
- Orthodontic Department, Applied Clinical Research and Public Health, School of Dentistry, College of Biomedical and Life Sciences, Heath Park, Cardiff, UK
| | - Pertti Pirttiniemi
- Oral Development and Orthodontics, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Tuomo Heikkinen
- Oral Development and Orthodontics, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Virpi Harila
- Oral Development and Orthodontics, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Signe Silinevica
- Orthodontic Department, RSU Institute of Stomatology, Rīga, Latvia
| | | | - Ilga Urtane
- Orthodontic Department, RSU Institute of Stomatology, Rīga, Latvia
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Prenatal Alcohol Exposure and the Facial Phenotype in Adolescents: A Study Based on Meconium Ethyl Glucuronide. Brain Sci 2021; 11:brainsci11020154. [PMID: 33503863 PMCID: PMC7911744 DOI: 10.3390/brainsci11020154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/12/2021] [Accepted: 01/19/2021] [Indexed: 02/07/2023] Open
Abstract
Here, we explore the effects of prenatal alcohol exposure (PAE) in adolescence. We investigated associations between meconium ethyl glucoronide (EtG) and facial malformation. For 129 children (66/63 male/female; M = 13.3, SD = 0.32, 12–14 years), PAE was implemented by newborn meconium EtG and maternal self-reports during the third trimester. Cognitive development was operationalized by standardized scores (WISC V). The EtG cut-off values were set at ≥10 ng/g (n = 32, 24.8% EtG10+) and ≥112 ng/g (n = 20, 15.5% EtG112+). The craniofacial shape was measured using FAS Facial Photographic Analysis Software. EtG10+− and EtG112+-affected children exhibited a shorter palpebral fissure length (p = 0.031/p = 0.055). Lip circularity was smaller in EtG112+-affected children (p = 0.026). Maternal self-reports were not associated (p > 0.164). Lip circularity correlated with fluid reasoning (EtG10+ p = 0.031; EtG112+ p = 0.298) and working memory (EtG10+ p = 0.084; EtG112+ p = 0.144). The present study demonstrates visible effects of the facial phenotype in exposed adolescents. Facial malformation was associated with a child’s cognitive performance in the alcohol-exposed group. The EtG biomarker was a better predictor than maternal self-reports.
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Week-by-week alcohol consumption in early pregnancy and spontaneous abortion risk: a prospective cohort study. Am J Obstet Gynecol 2021; 224:97.e1-97.e16. [PMID: 32673615 DOI: 10.1016/j.ajog.2020.07.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 05/28/2020] [Accepted: 07/07/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND Half of women use alcohol in the first weeks of gestation, but most stop once pregnancy is detected. The relationship between timing of alcohol use cessation in early pregnancy and spontaneous abortion risk has not been determined. OBJECTIVE This study aimed to evaluate the association between week-by-week alcohol consumption in early pregnancy and spontaneous abortion. STUDY DESIGN Participants in Right from the Start, a community-based prospective pregnancy cohort, were recruited from 8 metropolitan areas in the United States (2000-2012). In the first trimester, participants provided information about alcohol consumed in the prior 4 months, including whether they altered alcohol use; date of change in use; and frequency, amount, and type of alcohol consumed before and after change. We assessed the association between spontaneous abortion and week of alcohol use, cumulative weeks exposed, number of drinks per week, beverage type, and binge drinking. RESULTS Among 5353 participants, 49.7% reported using alcohol during early pregnancy and 12.0% miscarried. Median gestational age at change in alcohol use was 29 days (interquartile range, 15-35 days). Alcohol use during weeks 5 through 10 from last menstrual period was associated with increased spontaneous abortion risk, with risk peaking for use in week 9. Each successive week of alcohol use was associated with an 8% increase in spontaneous abortion relative to those who did not drink (adjusted hazard ratio, 1.08; 95% confidence interval, 1.04-1.12). This risk is cumulative. In addition, risk was not related to number of drinks per week, beverage type, or binge drinking. CONCLUSION Each additional week of alcohol exposure during the first trimester increases risk of spontaneous abortion, even at low levels of consumption and when excluding binge drinking.
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Römer P, Mathes B, Reinelt T, Stoyanova P, Petermann F, Zierul C. Systematic review showed that low and moderate prenatal alcohol and nicotine exposure affected early child development. Acta Paediatr 2020; 109:2491-2501. [PMID: 32603488 DOI: 10.1111/apa.15453] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/22/2020] [Accepted: 06/24/2020] [Indexed: 12/17/2022]
Abstract
AIM We systematically reviewed the literature on the influence of low and moderate amounts of prenatal alcohol and nicotine exposure on early child development. This paper also suggests possible directions for future research in order to tackle the controversial findings identified. METHODS The PubMed and Web of Science electronic databases were searched together with the reference lists of the selected papers. Empirical studies were included if they focused on the effects of low or moderate exposure, reported outcomes on child development within the first 2 years of life and were published in English between January 2009 and December 2019. The eligibility of the included studies was based on three authors reading the full text. RESULTS The final sample comprised 17 papers. Of these, 13 focused on the effects of prenatal alcohol exposure and they reported decreased sensory sensibility, smaller body sizes and increased cognitive capacities. The other four looked at prenatal nicotine exposure, and they primarily found impairments in children's orienting, communication and motor skills. CONCLUSION Any amount of prenatal alcohol and nicotine exposure appeared to risk healthy child development. There were many reasons for consumption and numerous effects on the child, but representative data from interdisciplinary research were missing.
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Affiliation(s)
- Pia Römer
- Centre for Clinical Psychology and Rehabilitation University of Bremen Bremen Germany
| | - Birgit Mathes
- Centre for Clinical Psychology and Rehabilitation University of Bremen Bremen Germany
| | - Tilman Reinelt
- Centre for Clinical Psychology and Rehabilitation University of Bremen Bremen Germany
| | - Polina Stoyanova
- Centre for Clinical Psychology and Rehabilitation University of Bremen Bremen Germany
| | - Franz Petermann
- Centre for Clinical Psychology and Rehabilitation University of Bremen Bremen Germany
| | - Claudia Zierul
- Centre for Clinical Psychology and Rehabilitation University of Bremen Bremen Germany
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Oh SS, Kim YJ, Jang SI, Park S, Nam CM, Park EC. Hospitalizations and mortality among patients with fetal alcohol spectrum disorders: a prospective study. Sci Rep 2020; 10:19512. [PMID: 33177533 PMCID: PMC7658994 DOI: 10.1038/s41598-020-76406-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 10/26/2020] [Indexed: 12/28/2022] Open
Abstract
With nearly 10% of women consuming alcohol during pregnancy, fetal alcohol spectrum disorders (FASDs) are becoming an increasing concern for clinicians and policymakers interested in the field of healthcare. Known as the range of mental and/or physical disabilities that occur among individuals with prenatal alcohol exposure, FASDs can result in dysmorphic features, problems with physical growth, neurobehavioral and cognitive problems that not only increase risk of various diseases, but also premature mortality. We investigated whether the diagnosis of FASDs result in increased risk of hospitalizations and mortality, with respect to FASD domains and relative diseases, when age effects are controlled for. The data for this study was taken from the National Health Insurance Service – National Sample Cohort (NHIS-NSC) between 2003 and 2013. The population attributable risk (PAR) statistic was used to estimate the percentage of hospitalizations and mortality attributable to FASDs and other factors. A time-dependent Cox proportional hazards model with age of diagnosis as the time-scale was employed to calculate adjusted hazard ratios and 95% CIs for hospitalizations and mortality among FASD populations compared to their general population peers. Among the 3,103 FASD cases, 27.5% experienced hospitalizations and 12.5% died. Overall, FASDs accounted for 853 FASD-attributable hospitalizations (51.0% of all hospitalizations in the study population) and 387 mortality events (34.5% of all deaths in the study population). 20.52% of hospitalizations and 21.35% of mortalities were attributable to FASDs in this population. Compared to the control group, FASD patients had a 1.25-fold (HR: 1.25, 95% CI: 1.05–1.49, p = 0.0114) increased risk of hospitalizations and a 1.33-fold (HR: 1.33, 95% CI: 1.07–1.67, p = 0.0118) increased risk of all-cause mortality. The most common cause for hospitalization was diseases of the nervous system, which accounted for 450 FASD-attributable hospitalizations (96.2% of all nervous system hospitalizations in the study population). In fact, FASD patients were 52 times more likely to be hospitalized for nervous system diseases than their peers (HR: 51.78, 95% CI: 29.09–92.17, p < .0001). The most common cause for mortality was neoplasms, which accounted for 94 FASD-attributable deaths (28.7% of all neoplasm deaths in the study population). However, FASD patients did not have increased risk of neoplasm mortality than the general population (HR: 0.88, 95% CI: 0.59–1.32, p < .0001). Overall, this study found that individuals diagnosed with FASDs have increased risk of both hospitalizations and mortality, compared to their general population peers. This is particularly so for diseases of the nervous system, which showed a 52-fold increase in hospitalizations and four-fold increase in mortality for FASD patients in our study. Likewise, while the association between FASDs and neoplasm mortality was not significant in our investigation, more attention by neurologists and related healthcare providers regarding the link between these two factors is necessary. Trial Registration: Institutional Review Board of Yonsei University’s Health System: Y-2019-0174.
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Affiliation(s)
- Sarah Soyeon Oh
- Fetal Alcohol Syndrome Prevention Center, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Public Health & Preventive Medicine, Graduate School, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Ju Kim
- Fetal Alcohol Syndrome Prevention Center, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea.,Department of Obstetrics & Gynecology, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Sung-In Jang
- Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Public Health & Preventive Medicine, Graduate School, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sohee Park
- Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Biostatistics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chung Mo Nam
- Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Biostatistics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea. .,Department of Public Health & Preventive Medicine, Graduate School, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Raghunathan R, Liu CH, Kouka A, Singh M, Miranda RC, Larin KV. Dose-response analysis of microvasculature changes in the murine fetal brain and the maternal extremities due to prenatal ethanol exposure. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:JBO-200176RR. [PMID: 33244919 PMCID: PMC7689263 DOI: 10.1117/1.jbo.25.12.126001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 11/06/2020] [Indexed: 05/29/2023]
Abstract
SIGNIFICANCE Prenatal exposure to ethanol causes several morphological and neurobehavioral deficits. While there are some studies on the effects of ethanol exposure on blood flow, research focusing on acute changes in the microvasculature is limited. AIM The first aim of this study was to assess the dose-dependent changes in murine fetal brain microvasculature of developing fetuses in response to maternal alcohol consumption. The second aim was to quantify changes in vasculature occurring concurrently in the mother's hindlimb and the fetus's brain after maternal exposure to alcohol. APPROACH Correlation mapping optical coherence angiography was used to evaluate the effects of prenatal exposure to different doses of ethanol (3, 1.5, and 0.75 g / kg) on murine fetal brain vasculature in utero. Additionally, simultaneous imaging of maternal peripheral vessels and the fetal brain vasculature was performed to assess changes of the vasculature occurring concurrently in response to ethanol consumption. RESULTS The fetal brain vessel diameters (VDs) decreased by ∼47 % , 30%, and 14% in response to ethanol doses of 3, 1.5, and 0.75 g / kg, respectively. However, the mother's hindlimb VD increased by 63% in response to ethanol at a dose of 3 g / kg. CONCLUSIONS Results showed a dose-dependent reduction in vascular blood flow in fetal brain vessels when the mother was exposed to ethanol, whereas vessels in the maternal hindlimb exhibited concurrent vasodilation.
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Affiliation(s)
- Raksha Raghunathan
- University of Houston, Department of Biomedical Engineering, Houston, Texas, United States
| | - Chih-Hao Liu
- University of Houston, Department of Biomedical Engineering, Houston, Texas, United States
| | - Amur Kouka
- University of Houston, Department of Biomedical Engineering, Houston, Texas, United States
| | - Manmohan Singh
- University of Houston, Department of Biomedical Engineering, Houston, Texas, United States
| | - Rajesh C. Miranda
- Texas A&M University Health Science Center College of Medicine, Department of Neuroscience and Experimental Therapeutics, Bryan, Texas, United States
| | - Kirill V. Larin
- University of Houston, Department of Biomedical Engineering, Houston, Texas, United States
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Atukorala ADS, Ratnayake RK. Cellular and molecular mechanisms in the development of a cleft lip and/or cleft palate; insights from zebrafish (Danio rerio). Anat Rec (Hoboken) 2020; 304:1650-1660. [PMID: 33099891 DOI: 10.1002/ar.24547] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 08/31/2020] [Accepted: 09/09/2020] [Indexed: 12/18/2022]
Abstract
Human cleft lip and/or palate (CLP) are immediately recognizable congenital abnormalities of the face. Lip and palate develop from facial primordia through the coordinated activities of ectodermal epithelium and neural crest cells (NCCs) derived from ectomesenchyme tissue. Subtle changes in the regulatory mechanisms of NCC or ectodermal epithelial cells can result in CLP. Genetic and environmental contributions or a combination of both play a significant role in the progression of CLP. Model organisms provide us with a wealth of information in understanding the pathophysiology and genetic etiology of this complex disease. Small teleost, zebrafish (Danio rerio) is one of the popular model in craniofacial developmental biology. The short generation time and large number of optically transparent, easily manipulated embryos increase the value of zebrafish to identify novel candidate genes and gene regulatory networks underlying craniofacial development. In addition, it is widely used to identify the mechanisms of environmental teratogens and in therapeutic drug screening. Here, we discuss the value of zebrafish as a model to understand epithelial and NCC induced ectomesenchymal cell activities during early palate morphogenesis and robustness of the zebrafish in modern research on identifying the genetic and environmental etiological factors of CLP.
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Affiliation(s)
- Atukorallaya Devi Sewvandini Atukorala
- Rady Faculty of Health Sciences, Department of Oral Biology, Dr. Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ravindra Kumar Ratnayake
- Rady Faculty of Health Sciences, Department of Oral Biology, Dr. Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, Manitoba, Canada
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Gomez DA, May PA, Tabachnick BG, Hasken JM, Lyden ER, Kalberg WO, Hoyme HE, Manning MA, Adam MP, Robinson LK, Jones KL, Buckley D, Abdul-Rahman OA. Ocular measurements in fetal alcohol spectrum disorders. Am J Med Genet A 2020; 182:2243-2252. [PMID: 32677343 DOI: 10.1002/ajmg.a.61759] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 05/30/2020] [Accepted: 06/13/2020] [Indexed: 01/03/2023]
Abstract
Fetal alcohol spectrum disorders (FASD) describe a range of physical, behavioral, and neurologic deficits in individuals exposed to alcohol prenatally. Reduced palpebral fissure length is one of the cardinal facial features of FASD. However, other ocular measurements have not been studied extensively in FASD. Using the Fetal Alcohol Syndrome Epidemiologic Research (FASER) database, we investigated how inner canthal distance (ICD), interpupillary distance (IPD), and outer canthal distance (OCD) centiles differed between FASD and non-FASD individuals. We compared ocular measurement centiles in children with FASD to non-FASD individuals and observed reductions in all three centiles for ICD, IPD, and OCD. However, when our non-FASD children who had various forms of growth deficiency (microcephaly, short-stature, or underweight) were compared to controls, we did not observe a similar reduction in ocular measurements. This suggests that reductions in ocular measurements are a direct effect of alcohol on ocular development independent of its effect on growth parameters, which is consistent with animal models showing a negative effect of alcohol on developing neural crest cells. Interpupillary distance centile appeared to be the most significantly reduced ocular measure we evaluated, suggesting it may be a useful measure to be considered in the diagnosis of FASD.
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Affiliation(s)
- Diego A Gomez
- College of Arts and Sciences, Creighton University, Omaha, Nebraska, USA
| | - Philip A May
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Center on Alcoholism, Substance Abuse, & Addictions, University of New Mexico, Albuquerque, New Mexico, USA
| | - Barbara G Tabachnick
- Department of Psychology, California State University, Northridge, California, USA
| | - Julie M Hasken
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Elizabeth R Lyden
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Wendy O Kalberg
- Center on Alcoholism, Substance Abuse, & Addictions, University of New Mexico, Albuquerque, New Mexico, USA
| | - H Eugene Hoyme
- Department of Pediatrics, University of Arizona College of Medicine, Tucson, Arizona, USA
- Sanford Children's Genomic Medicine Consortium, Sanford Health, Sioux Falls, South Dakota, USA
| | - Melanie A Manning
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Margaret P Adam
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
| | - Luther K Robinson
- Department of Pediatrics, State University of New York, Buffalo, New York, USA
| | - Kenneth Lyons Jones
- Department of Pediatrics, School of Medicine, University of California, San Diego, La Jolla, California, USA
| | - David Buckley
- Center on Alcoholism, Substance Abuse, & Addictions, University of New Mexico, Albuquerque, New Mexico, USA
| | - Omar A Abdul-Rahman
- Department of Genetic Medicine, Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Tan DW, Foo YZ, Downs J, Finlay-Jones A, Leonard H, Licari MK, Mullan N, Symons M, Varcin KJ, Whitehouse AJ, Alvares GA. A preliminary investigation of the effects of prenatal alcohol exposure on facial morphology in children with Autism Spectrum Disorder. Alcohol 2020; 86:75-80. [PMID: 32243902 DOI: 10.1016/j.alcohol.2020.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 02/12/2020] [Accepted: 03/23/2020] [Indexed: 01/13/2023]
Abstract
Alcohol exposure during pregnancy has been associated with altered brain development and facial dysmorphology. While Autism Spectrum Disorder (ASD) is not specifically related to distinct facial phenotypes, recent studies have suggested certain facial characteristics such as increased facial masculinity and asymmetry may be associated with ASD and its clinical presentations. In the present study, we conducted a preliminary investigation to examine facial morphology in autistic children with (n = 37; mean age = 8.21 years, SD = 2.72) and without (n = 100; mean age = 8.37 years, SD = 2.47) prenatal alcohol exposure. Using three-dimensional facial scans and principal component analysis, we identified a facial shape associated with prenatal alcohol exposure in autistic children. However, variations in the alcohol-related facial shape were generally not associated with behavioral and cognitive outcomes. These findings suggest that while early exposure to alcohol may influence the development of facial structures, it does not appear to be associated with ASD phenotypic variability. Importantly, although these findings do not implicate a role for prenatal alcohol exposure in the etiology of ASD, further research is warranted to investigate the link between prenatal alcohol exposure and facial morphology differences among neurodevelopmental conditions.
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Parviainen R, Auvinen J, Serlo W, Järvelin MR, Sinikumpu JJ. Maternal alcohol consumption during pregnancy associates with bone fractures in early childhood. A birth-cohort study of 6718 participants. Bone 2020; 137:115462. [PMID: 32485362 DOI: 10.1016/j.bone.2020.115462] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 05/23/2020] [Accepted: 05/29/2020] [Indexed: 12/22/2022]
Abstract
Fractures are common injuries in children, but their underlying biological and environmental risk factors are not well known. Maternal alcohol consumption during pregnancy is a known risk factor for bone malformations and impaired growth, in connection with Fetal Alcohol Spectrum Disorders (FASD). There is evidence that even lower doses of alcohol than what is needed for FASD can cause changes in the developing bone. Birth weight and length may also associate to childhood fractures. The aim of this study was to find out whether there exist associations between maternal alcohol use during pregnancy, birth weight or length and fractures of the long bones in childhood. A prospective birth cohort was performed, including all women in Northern Finland with an expected date of delivery between July 1985 and June 1986, and their offspring (N = 9432). The National Hospital Discharge Register (NHDR) provided the information on inpatient treated fractures. The subjects who declined participation or were treated as outpatient were excluded. The final study population consisted of 6718 children (71.2%). 98 (1.5%) of them suffered from inpatient treated fracture of a long bone (N = 105). Maternal alcohol consumption during pregnancy was inquired by questionnaires during late pregnancy or shortly after parturition. The birth length and weight were recorded immediately after birth. Binomial regression analysis was used to determine the association between the potential explanatory variables and bone fractures. Gender, socioeconomic status of the family, maternal age, premature birth, body mass index (BMI) of the children and maternal smoking during pregnancy were taken as possible confounders. In this study, the maternal alcohol consumption during pregnancy was associated to 2.22-fold (CI 1.09-4.12, p < 0.02) increased risk of a long bone fracture before the age of eight. Birth weight or length did not associate to childhood fractures. Bone fractures are an important cause of morbidity in childhood. Their prevention should start from the prenatal period by protecting the fetus from the alcohol exposure.
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Affiliation(s)
- Roope Parviainen
- Department of Pediatric Surgery and Orthopaedics, Oulu University Hospital, PEDEGO-research unit and Medical Research Center, University of Oulu, Oulu, Finland.
| | - Juha Auvinen
- The Center for Life Course Health Research and Medical Research Center, University of Oulu, Oulu, Finland; Oulunkaari Health Center, Ii, Finland
| | - Willy Serlo
- Department of Pediatric Surgery and Orthopaedics, Oulu University Hospital, PEDEGO-research unit and Medical Research Center, University of Oulu, Oulu, Finland
| | - Marjo-Riitta Järvelin
- Department of Epidemiology and Public Health, Imperial College, London, United Kingdom
| | - Juha-Jaakko Sinikumpu
- Department of Pediatric Surgery and Orthopaedics, Oulu University Hospital, PEDEGO-research unit and Medical Research Center, University of Oulu, Oulu, Finland
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Abstract
Alcohol, tobacco, and cannabis are the substances most frequently used during pregnancy, and opioid-exposed pregnancies have increased fourfold. The purpose of this review is to describe the prevalence and consequences of prenatal exposure to alcohol, tobacco, cannabis, and opioids. Currently available screening questionnaires for prenatal substance use are summarized and contrasted with the measures available for prenatal alcohol use. Because screening for prenatal alcohol and substance use is but the prelude to efforts to mitigate the potential adverse consequences, attempts for the modification of these consequences are briefly reviewed. In addition, areas of future research related to the criminalization of prenatal substance use, which may inhibit both inquiry and disclosure, are discussed. Indeed, the full potential of effective interventions has yet to be realized.
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Affiliation(s)
- Grace Chang
- U.S. Department of Veterans Affairs Boston Healthcare System, Boston, Massachusetts
- Harvard Medical School, Department of Psychiatry, Boston, Massachusetts
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48
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Galloway J, Farnell DJ, Richmond S, Zhurov AI. Multilevel Analysis of the Influence of Maternal Smoking and Alcohol Consumption on the Facial Shape of English Adolescents. J Imaging 2020; 6:34. [PMID: 34460736 PMCID: PMC8321032 DOI: 10.3390/jimaging6050034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/10/2020] [Accepted: 05/15/2020] [Indexed: 12/01/2022] Open
Abstract
This cross-sectional study aims to assess the influence of maternal smoking and alcohol consumption during pregnancy on the facial shape of non-syndromic English adolescents and demonstrate the potential benefits of using multilevel principal component analysis (mPCA). A cohort of 3755 non-syndromic 15-year-olds from the Avon Longitudinal Study of Parents and Children (ALSPAC), England, were included. Maternal smoking and alcohol consumption during the 1st and 2nd trimesters of pregnancy were determined via questionnaire at 18 weeks gestation. 21 facial landmarks, used as a proxy for the main facial features, were manually plotted onto 3D facial scans of the participants. The effect of maternal smoking and maternal alcohol consumption (average 1-2 glasses per week) was minimal, with 0.66% and 0.48% of the variation in the 21 landmarks of non-syndromic offspring explained, respectively. This study provides a further example of mPCA being used effectively as a descriptive analysis in facial shape research. This is the first example of mPCA being extended to four levels to assess the influence of environmental factors. Further work on the influence of high/low levels of smoking and alcohol and providing inferential evidence is required.
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Affiliation(s)
- Jennifer Galloway
- School of Dentistry, Cardiff University, Heath Park, Cardiff CF14 4XY, UK; (D.J.J.F.); (S.R.); (A.I.Z.)
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Farnell DJJ, Richmond S, Galloway J, Zhurov AI, Pirttiniemi P, Heikkinen T, Harila V, Matthews H, Claes P. Multilevel principal components analysis of three-dimensional facial growth in adolescents. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 188:105272. [PMID: 31865094 DOI: 10.1016/j.cmpb.2019.105272] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 11/19/2019] [Accepted: 12/10/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND OBJECTIVES The study of age-related facial shape changes across different populations and sexes requires new multivariate tools to disentangle different sources of variations present in 3D facial images. Here we wish to use a multivariate technique called multilevel principal components analysis (mPCA) to study three-dimensional facial growth in adolescents. METHODS These facial shapes were captured for Welsh and Finnish subjects (both male and female) at multiple ages from 12 to 17 years old (i.e., repeated-measures data). 1000 "dense" 3D points were defined regularly for each shape by using a deformable template via "meshmonk" software. A three-level model was used here, namely: level 1 (sex/ethnicity); level 2, all "subject" variations excluding sex, ethnicity, and age; and level 3, age. The technicalities underpinning the mPCA method are presented in Appendices. RESULTS Eigenvalues via mPCA predicted that: level 1 (ethnicity/sex) contained 7.9% of variation; level 2 contained 71.5%; and level 3 (age) contained 20.6%. The results for the eigenvalues via mPCA followed a similar pattern to those results of single-level PCA. Results for modes of variation made sense, where effects due to ethnicity, sex, and age were reflected in modes at appropriate levels of the model. Standardised scores at level 1 via mPCA showed much stronger differentiation between sex and ethnicity groups than results of single-level PCA. Results for standardised scores from both single-level PCA and mPCA at level 3 indicated that females had different average "trajectories" with respect to these scores than males, which suggests that facial shape matures in different ways for males and females. No strong evidence of differences in growth patterns between Finnish and Welsh subjects was observed. CONCLUSIONS mPCA results agree with existing research relating to the general process of facial changes in adolescents with respect to age quoted in the literature. They support previous evidence that suggests that males demonstrate larger changes and for a longer period of time compared to females, especially in the lower third of the face. These calculations are therefore an excellent initial test that multivariate multilevel methods such as mPCA can be used to describe such age-related changes for "dense" 3D point data.
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Affiliation(s)
- D J J Farnell
- School of Dentistry, Cardiff University, Heath Park, Cardiff CF14 4XY, United Kingdom.
| | - S Richmond
- School of Dentistry, Cardiff University, Heath Park, Cardiff CF14 4XY, United Kingdom
| | - J Galloway
- School of Dentistry, Cardiff University, Heath Park, Cardiff CF14 4XY, United Kingdom
| | - A I Zhurov
- School of Dentistry, Cardiff University, Heath Park, Cardiff CF14 4XY, United Kingdom
| | - P Pirttiniemi
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, Oulu, Finland
| | - T Heikkinen
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, Oulu, Finland
| | - V Harila
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, Oulu, Finland
| | - H Matthews
- Medical Imaging Research Center, UZ Leuven, 3000 Leuven, Belgium; Department of Human Genetics, KU Leuven, 3000 Leuven, Belgium; OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium; Facial Sciences Research Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - P Claes
- Medical Imaging Research Center, UZ Leuven, 3000 Leuven, Belgium; Department of Human Genetics, KU Leuven, 3000 Leuven, Belgium; Department of Electrical Engineering, ESAT/PSI, KU Leuven, 3000 Leuven, Belgium
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Influences on drinking choices among Indigenous and non-Indigenous pregnant women in Australia: A qualitative study. PLoS One 2020; 15:e0224719. [PMID: 32352991 PMCID: PMC7192424 DOI: 10.1371/journal.pone.0224719] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 04/13/2020] [Indexed: 12/24/2022] Open
Abstract
Despite women’s awareness that drinking alcohol in pregnancy can lead to lifelong disabilities in a child, it appears that an awareness alone does not discourage some pregnant women from drinking. To explore influences on pregnant women’s choices around alcohol use, we conducted interviews and group discussions with 14 Indigenous Australian and 14 non-Indigenous pregnant women attending antenatal care in a range of socioeconomic settings. Inductive content analysis identified five main influences on pregnant women’s alcohol use: the level and detail of women’s understanding of harm; women’s information sources on alcohol use in pregnancy; how this information influenced their choices; how women conceptualised their pregnancy; and whether the social and cultural environment supported abstinence. Results provide insight into how Indigenous Australian and non-Indigenous pregnant women understand and conceptualise the harms from drinking alcohol when making drinking choices, including how their social and cultural environments impact their ability to abstain. Strategies for behaviour change need to: correct misinformation about supposed ‘safe’ timing, quantity and types of alcohol; develop a more accurate perception of Fetal Alcohol Spectrum Disorder; reframe messages about harm to messages about optimising the child’s health and cognitive outcomes; and develop a holistic approach encompassing women’s social and cultural context.
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