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Dyląg KA, Dumnicka P, Kowalska K, Migas-Majoch A, Przybyszewska K, Drożdż D. Increased incidence of renal and urinary tract anomalies among individuals with fetal alcohol spectrum disorders (FASD). Birth Defects Res 2024; 116:e2259. [PMID: 37828651 DOI: 10.1002/bdr2.2259] [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: 10/08/2022] [Revised: 07/24/2023] [Accepted: 09/13/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Fetal alcohol spectrum disorders (FASD) in a spectrum of neurodevelopmental conditions resulting from prenatal alcohol exposure (PAE). Animal models have confirmed the toxic effects of PAE on the kidneys and urinary tract, yet the evidence from human studies is contradictory. The purpose of this study was to establish the incidence of renal and urinary tract anomalies (RUTA), impaired kidney function, and hypertension among patients with FASD. METHODS Children from the FASD Diagnostic Center with FASD diagnosis (FAS, pFAS, or ARND) were offered participation in the study. The control group consisted of patients from the Gastroenterology Department of the same hospital. The patients underwent renal and urinary tract ultrasound examination. The serum creatinine level was also evaluated and the blood pressure was taken twice. Polish OLAF charts were used to determine the percentiles of blood pressure. RESULTS The incidence of kidney and urinary tract defects in the study group was significantly higher than in the control group (OR: 2.64 [1.60-4.34]). The kidney size among FASD patients was significantly lower (73 mm [60-83] vs. 83 mm [70-96]; p < .001) when compared to the control group. No differences were observed in the estimated glomerular filtration rate. In the study group, significantly lower systolic blood, diastolic blood pressure, percentile of systolic pressure, and diastolic pressure were observed. CONCLUSIONS RUTA occurred more frequently among patients with FASD compared to the control group, and decreased kidney size was also demonstrated among patients with FASD. However, impaired kidney function and the risk of hypertension were not observed.
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Affiliation(s)
- Katarzyna Anna Dyląg
- Department of Patophysiology, Jagiellonian University Medical College, Kraków, małopolskie, Poland
- St. Louis Children Hospital, Kraków, małopolskie, Poland
| | - Paulina Dumnicka
- Chair of Medical Biochemistry, Jagiellonian University Medical College, Kraków, małopolskie, Poland
| | | | | | | | - Dorota Drożdż
- Department of Paediatric Nephrology and Hypertension, Jagiellonian University Medical College, Krakow, małopolskie, Poland
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Liu L, Wen Y, Ni Q, Chen L, Wang H. Prenatal ethanol exposure and changes in fetal neuroendocrine metabolic programming. Biol Res 2023; 56:61. [PMID: 37978540 PMCID: PMC10656939 DOI: 10.1186/s40659-023-00473-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] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 11/08/2023] [Indexed: 11/19/2023] Open
Abstract
Prenatal ethanol exposure (PEE) (mainly through maternal alcohol consumption) has become widespread. However, studies suggest that it can cause intrauterine growth retardation (IUGR) and multi-organ developmental toxicity in offspring, and susceptibility to various chronic diseases (such as neuropsychiatric diseases, metabolic syndrome, and related diseases) in adults. Through ethanol's direct effects and its indirect effects mediated by maternal-derived glucocorticoids, PEE alters epigenetic modifications and organ developmental programming during fetal development, which damages the offspring health and increases susceptibility to various chronic diseases after birth. Ethanol directly leads to the developmental toxicity of multiple tissues and organs in many ways. Regarding maternal-derived glucocorticoid-mediated IUGR, developmental programming, and susceptibility to multiple conditions after birth, ethanol induces programmed changes in the neuroendocrine axes of offspring, such as the hypothalamus-pituitary-adrenal (HPA) and glucocorticoid-insulin-like growth factor 1 (GC-IGF1) axes. In addition, the differences in ethanol metabolic enzymes, placental glucocorticoid barrier function, and the sensitivity to glucocorticoids in various tissues and organs mediate the severity and sex differences in the developmental toxicity of ethanol exposure during pregnancy. Offspring exposed to ethanol during pregnancy have a "thrifty phenotype" in the fetal period, and show "catch-up growth" in the case of abundant nutrition after birth; when encountering adverse environments, these offspring are more likely to develop diseases. Here, we review the developmental toxicity, functional alterations in multiple organs, and neuroendocrine metabolic programming mechanisms induced by PEE based on our research and that of other investigators. This should provide new perspectives for the effective prevention and treatment of ethanol developmental toxicity and the early prevention of related fetal-originated diseases.
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Affiliation(s)
- Liang Liu
- Department of Orthopedic Surgery, Joint Disease Research Center of Wuhan University, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China
| | - Yinxian Wen
- Department of Orthopedic Surgery, Joint Disease Research Center of Wuhan University, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China
| | - Qubo Ni
- Department of Orthopedic Surgery, Joint Disease Research Center of Wuhan University, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China
| | - Liaobin Chen
- Department of Orthopedic Surgery, Joint Disease Research Center of Wuhan University, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China.
| | - Hui Wang
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China.
- Department of Pharmacology, Wuhan University School of Basic Medical Sciences, Wuhan, 430071, China.
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Tran EL, England LJ, Park Y, Denny CH, Kim SY. Systematic Review: Polysubstance Prevalence Estimates Reported during Pregnancy, US, 2009-2020. Matern Child Health J 2023; 27:426-458. [PMID: 36752906 PMCID: PMC10521102 DOI: 10.1007/s10995-023-03592-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2023] [Indexed: 02/09/2023]
Abstract
INTRODUCTION The objective of this systematic review is to describe polysubstance studies and their prevalence estimates among pregnant people in the US. METHODS This review was not subject to protocol preparation or registration with the International Prospective Register of Systematic Reviews (PROSPERO) because outcome data were not reported. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Checklist was followed. Four scientific literature databases were used to identify articles published from January 1, 2009 to June 3, 2020 reporting prenatal exposure to two or more substances in the US. A standardized process of title and abstract screening followed by a two-phase full-text review was used to assess study eligibility. RESULTS A total of 119 studies were included: 7 case-control studies, 7 clinical trials, 76 cohort studies, and 29 cross-sectional studies. Studies varied with respect to study design, time period, region, sampling and participant selection, substances assessed, and method of exposure ascertainment. Commonly reported polysubstance prevalence estimates among studies of pregnant people included combinations with alcohol, marijuana, and/or tobacco/nicotine. The range of prevalence estimates was wide (alcohol 1-99%; marijuana 3-95%; tobacco/nicotine 2-95%). DISCUSSION Polysubstance use during pregnancy is common, especially with alcohol, marijuana, and/or tobacco/nicotine. Future research to assess polysubstance use during pregnancy could help better describe patterns and ultimately help mitigate its effects on maternal and infant health outcomes.
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Affiliation(s)
- Emmy L Tran
- Division of Birth Defects and Infant Disorders, National Center On Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway, NE MS S106-3, Atlanta, GA, 30341, USA.
- Eagle Global Scientific, LLC, 2835 Brandywine Rd, Suite 200, Atlanta, GA, 30341, USA.
| | - Lucinda J England
- Division of Birth Defects and Infant Disorders, National Center On Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway, NE MS S106-3, Atlanta, GA, 30341, USA
| | - Youngjoo Park
- Division of Birth Defects and Infant Disorders, National Center On Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway, NE MS S106-3, Atlanta, GA, 30341, USA
- Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN, USA
| | - Clark H Denny
- Division of Birth Defects and Infant Disorders, National Center On Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway, NE MS S106-3, Atlanta, GA, 30341, USA
| | - Shin Y Kim
- Division of Birth Defects and Infant Disorders, National Center On Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway, NE MS S106-3, Atlanta, GA, 30341, USA
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Alcohol use during pregnancy: findings from a gender-based violence survey in Mongolia. Arch Womens Ment Health 2022; 25:789-795. [PMID: 35687163 DOI: 10.1007/s00737-022-01242-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 05/31/2022] [Indexed: 11/02/2022]
Abstract
This study aimed to explore the risk factors for alcohol use during pregnancy in Mongolia, wherein high-risk alcohol use is prevalent. We analyzed nationwide data from the Gender-Based Violence (GBV) Survey of Mongolia conducted in 2017. We conducted an analysis restricted to 2714 women who had given birth within 5 years of the survey and who had responded to questions about their health-related behaviors during pregnancy. We assessed the association between alcohol use during pregnancy and pregnancy-related factors, including maternal age, educational attainment, history of abortion, smoking during pregnancy, unintended pregnancy, prior experience of sexual and physical violence, physical violence during pregnancy, and current binge drinking while also considering their residential region. Alcohol use during pregnancy was reported in 5.4% of the participating women. Unintended pregnancy for women (OR = 1.95, 95% confidence interval [CI]: 1.60, 2.38), abortion history (1.89, 95% CI: 1.60, 2.24), smoking during pregnancy (8.30, 95% CI: 6.60, 10.43), physical violence during pregnancy (2.22, 95% CI: 1.75, 2.81), and being a binge drinker (6.05, 95% CI: 3.63, 10.10) were associated with higher odds of alcohol use during pregnancy. Associations with maternal age, marital status, higher education, or multiparity were not evident. Our finding provides knowledge of risk factors for alcohol drinking among pregnant women and evidence for another harm of gender-based violence. This would contribute to the development of effective strategies for preventing antenatal exposure to alcohol in Mongolia.
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Washio Y, Hayashi YP, Atreyapurapu S, Chang K, Ma T, Howard BN, van der Drift I, Browne FA, Wechsberg WM. A Scoping Review of Computer-Based and Telecommunication Technology Interventions to Address Drug and Alcohol Misuse and Smoking in Women. Subst Use Misuse 2022; 57:1257-1272. [PMID: 35582861 PMCID: PMC10083725 DOI: 10.1080/10826084.2022.2076878] [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] [Indexed: 10/18/2022]
Abstract
BACKGROUND Computer-based and telecommunication technology has become increasingly common to address addiction among women. This review assessed the effect of technology-based interventions on substance misuse, alcohol use, and smoking outcomes among women. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews (PRISMA-ScR) guideline was used to conduct the scoping review. Four databases (PubMed, Web of Science, PsycINFO, and Scopus) were used to search for peer-reviewed articles published in English on computer-based and telecommunication technology use to address substance misuse, alcohol use, and smoking among women. RESULTS A total of 30 articles were selected after the final full-text review from the U.S., England, Japan, and the Netherlands. The types of technology used in the interventions included computer software (standalone or web-based), mobile applications, video calling, phone, and text messaging. Intervention outcomes included alcohol and other substance misuse reduction as polysubstance misuse (n = 5), smoking cessation (n = 10), substance misuse reduction only (n = 6), and alcohol use reduction only (n = 9). The populations reached included women who were pregnant (n = 13), postpartum (n = 4), or non-pregnant (n = 14) ranging from adolescent to adulthood. Interventions that targeted polysubstance misuse showed statistically significant reductions (p < .05). CONCLUSION Although effective in reducing alcohol and other substance misuse, mixed findings were identified for other outcomes targeting a single substance. Technology-based interventions might maximize their effects by targeting polysubstance misuse and addressing associated contextual issues in the form of a computer-delivered module(s).
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Affiliation(s)
- Yukiko Washio
- Substance Use, Gender and Applied Research, RTI International, Research Triangle Park, NC, 27709 U.S.A
- Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University Lewis Katz School of Medicine, Philadelphia, PA, 19140 U.S.A
| | | | | | - Katie Chang
- Benten Technologies, Inc., Manassas, VA, U.S.A
| | - Tony Ma
- Benten Technologies, Inc., Manassas, VA, U.S.A
| | - Brittni N. Howard
- Substance Use, Gender and Applied Research, RTI International, Research Triangle Park, NC, 27709 U.S.A
| | - Isa van der Drift
- Substance Use, Gender and Applied Research, RTI International, Research Triangle Park, NC, 27709 U.S.A
| | - Felicia A. Browne
- Substance Use, Gender and Applied Research, RTI International, Research Triangle Park, NC, 27709 U.S.A
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, U.S.A
| | - Wendee M. Wechsberg
- Substance Use, Gender and Applied Research, RTI International, Research Triangle Park, NC, 27709 U.S.A
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, U.S.A
- Department of Psychology, North Carolina State University, Raleigh, NC, U.S.A
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, U.S.A
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Isaacs KR, Atreyapurapu S, Alyusuf AH, Ledgerwood DM, Finnegan LP, Chang KHK, Ma TX, Washio Y. Neonatal Outcomes after Combined Opioid and Nicotine Exposure in Utero: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10215. [PMID: 34639512 PMCID: PMC8508043 DOI: 10.3390/ijerph181910215] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/03/2021] [Accepted: 09/21/2021] [Indexed: 12/02/2022]
Abstract
BACKGROUND The majority of women who are pregnant with opioid use disorder (OUD) also smoke tobacco but are rarely offered tobacco cessation counseling. While the effects of exposure to opioids and nicotine in utero are well-understood separately, understanding the impact of the combined exposure to these substances on neonatal outcomes is lacking. METHODS A scoping review was conducted using PubMed and Scopus databases for studies addressing the combined exposure to opioids and nicotine during pregnancy published between 1 January 1980 and 9 July 2019. A total of 29 papers met the eligibility criteria for inclusion, with nine being identified as clinical trials (three from the MOTHER study) and two as secondary data analysis of clinical trial data. RESULTS Neonatal outcomes for infants who had a combined exposure to opioids and nicotine in utero indicated a reduction in birth weight and birth length. Findings in infants exposed to both nicotine and opioids were mixed with regard to the duration of neonatal abstinence syndrome (NAS), the likelihood of treatment for NAS, doses of medicine used to treat NAS, and NAS scores when compared with infants who had opioid exposure without nicotine. CONCLUSIONS The combined exposure to nicotine and opioids during pregnancy may lead to a reduction in neonatal birth weight and birth length and more severe NAS signs, compared with opioid use alone, but more research is necessary to identify the minimum dosage and length of nicotine exposure to accurately predict these outcomes.
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Affiliation(s)
- Krystyna R. Isaacs
- Benten Technologies, 9408 Grant Ave Suite 206, Manassas, VA 20110, USA; (K.R.I.); (S.A.); (A.H.A.); (K.H.K.C.); (T.X.M.)
| | - Sravanthi Atreyapurapu
- Benten Technologies, 9408 Grant Ave Suite 206, Manassas, VA 20110, USA; (K.R.I.); (S.A.); (A.H.A.); (K.H.K.C.); (T.X.M.)
| | - Amal H. Alyusuf
- Benten Technologies, 9408 Grant Ave Suite 206, Manassas, VA 20110, USA; (K.R.I.); (S.A.); (A.H.A.); (K.H.K.C.); (T.X.M.)
| | - David M. Ledgerwood
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Drive, Detroit, MI 48201, USA;
| | - Loretta P. Finnegan
- Executive Officer of the College on Problems of Drug Dependence and Finnegan Consulting, Philadelphia, PA 19140, USA;
| | - Katie H. K. Chang
- Benten Technologies, 9408 Grant Ave Suite 206, Manassas, VA 20110, USA; (K.R.I.); (S.A.); (A.H.A.); (K.H.K.C.); (T.X.M.)
| | - Tony X. Ma
- Benten Technologies, 9408 Grant Ave Suite 206, Manassas, VA 20110, USA; (K.R.I.); (S.A.); (A.H.A.); (K.H.K.C.); (T.X.M.)
| | - Yukiko Washio
- Substance Use, Gender and Applied Research, RTI International, 3040 E Cornwallis Rd, Durham, NC 27709, USA
- Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University Lewis Katz School of Medicine, 3500 N Broad St, Philadelphia, PA 19140, USA
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Hayes N, Reid N, Akison LK, Moritz KM. The effect of heavy prenatal alcohol exposure on adolescent body mass index and waist-to-height ratio at 12-13 years. Int J Obes (Lond) 2021; 45:2118-2125. [PMID: 34226636 DOI: 10.1038/s41366-021-00884-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 05/24/2021] [Accepted: 06/22/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Growing evidence suggests that prenatal alcohol exposure (PAE) has the potential to impact on a wide range of physical outcomes in offspring, including metabolism and body composition, although the evidence to-date is primarily from preclinical studies. The current clinical study examined the association between heavy PAE and indirect measures of adiposity in adolescence. METHODS Analyses drew on data from the Longitudinal Study of Australian Children, a national prospective cohort of children and their families from birth to adolescence. Participants included children with heavy PAE (≥70 g/week; n = 46), measured via maternal self-report of alcohol use during pregnancy and a comparison group of children without any PAE (n = 782), frequency matched on sex, ethnicity and socio-economic position. Body mass index (BMI) z-scores, waist-to-height ratios and proportion overweight/obese were calculated from height, weight and waist circumference measured at age 12-13 years. Two (PAE) × two (sex) ANCOVA and logistic regression models were performed, controlling for matching variables, adolescent age, pubertal status and birthweight; maternal age at birth and smoking during pregnancy. RESULTS Female adolescents with heavy PAE during late pregnancy had significantly higher BMI z-scores (M = 0.75, SD = 0.69) and proportion overweight/obese (38.5%) than females not exposed to any prenatal alcohol (M = 0.29, SD = 1.07, P = 0.04; 23.8%, P = 0.03, respectively). There was no significant effect of heavy PAE on male adolescent BMI z-scores and proportion overweight/obese or adolescent waist-to-height ratios (all P > 0.05). CONCLUSIONS Heavy PAE had a sex-specific effect on measures of adiposity in early adolescence, with girls more likely to have increased BMI and overweight/obesity status. Further longitudinal follow-up of children exposed to PAE is required to confirm if maternal alcohol consumption is a risk factor for later life obesity.
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Affiliation(s)
- N Hayes
- Child Health Research Centre, The University of Queensland, South Brisbane, QLD, Australia
| | - N Reid
- Child Health Research Centre, The University of Queensland, South Brisbane, QLD, Australia
| | - L K Akison
- Child Health Research Centre, The University of Queensland, South Brisbane, QLD, Australia.,School of Biomedical Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - K M Moritz
- Child Health Research Centre, The University of Queensland, South Brisbane, QLD, Australia. .,School of Biomedical Sciences, The University of Queensland, St Lucia, QLD, Australia.
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Odendaal H, Dukes KA, Elliott AJ, Willinger M, Sullivan LM, Tripp T, Groenewald C, Myers MM, Fifer WP, Angal J, Boyd TK, Burd L, Cotton JB, Folkerth RD, Hankins G, Haynes RL, Hoffman HJ, Jacobs PK, Petersen J, Pini N, Randall BB, Roberts DJ, Robinson F, Sens MA, Van Eerden P, Wright C, Holm IA, Kinney HC. Association of Prenatal Exposure to Maternal Drinking and Smoking With the Risk of Stillbirth. JAMA Netw Open 2021; 4:e2121726. [PMID: 34424306 PMCID: PMC8383134 DOI: 10.1001/jamanetworkopen.2021.21726] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Prenatal smoking is a known modifiable risk factor for stillbirth; however, the contribution of prenatal drinking or the combination of smoking and drinking is uncertain. OBJECTIVE To examine whether prenatal exposure to alcohol and tobacco cigarettes is associated with the risk of stillbirth. DESIGN, SETTING, AND PARTICIPANTS The Safe Passage Study was a longitudinal, prospective cohort study with data collection conducted between August 1, 2007, and January 31, 2015. Pregnant women from Cape Town, South Africa, and the Northern Plains region of the US were recruited and followed up throughout pregnancy. Data analysis was performed from November 1, 2018, to November 20, 2020. EXPOSURE Maternal consumption of alcohol and tobacco cigarettes in the prenatal period. MAIN OUTCOMES AND MEASURES The main outcomes were stillbirth, defined as fetal death at 20 or more weeks' gestation, and late stillbirth, defined as fetal death at 28 or more weeks' gestation. Self-reported alcohol and tobacco cigarette consumption was captured at the recruitment interview and up to 3 scheduled visits during pregnancy. Participants were followed up during pregnancy to obtain delivery outcome. RESULTS Of 11663 pregnancies (mean [SD] gestational age at enrollment, 18.6 [6.6] weeks) in 8506 women for whom the pregnancy outcome was known by 20 weeks' gestation or later and who did not terminate their pregnancies, there were 145 stillbirths (12.4 per 1000 pregnancies) and 82 late stillbirths (7.1 per 1000 pregnancies). A total of 59% of pregnancies were in women from South Africa, 59% were in multiracial women, 23% were in White women, 17% were in American Indian women, and 0.9% were in women of other races. A total of 8% were older than 35 years. In 51% of pregnancies, women reported no alcohol or tobacco cigarette exposure (risk of stillbirth, 4 per 1000 pregnancies). After the first trimester, 18% drank and smoked (risk of stillbirth, 15 per 1000 births), 9% drank only (risk of stillbirth, 10 per 1000 pregnancies), and 22% smoked only (risk of stillbirth, 8 per 1000 pregnancies). Compared with the reference group (pregnancies not prenatally exposed or without any exposure after the first trimester), the adjusted relative risk of late stillbirth was 2.78 (98.3% CI, 1.12-6.67) for pregnancies prenatally exposed to drinking and smoking, 2.22 (98.3% CI, 0.78-6.18) for pregnancies prenatally exposed to drinking only after the first trimester, and 1.60 (98.3% CI, 0.64-3.98) for pregnancies prenatally exposed to smoking only after the first trimester. The adjusted relative risk for all stillbirths was 1.75 (98.3% CI, 0.96-3.18) for dual exposure, 1.26 (98.3% CI, 0.58-2.74) for drinking only, and 1.27 (98.3% CI, 0.69-2.35) for smoking only compared with the reference group. CONCLUSIONS AND RELEVANCE These results suggest that combined drinking and smoking after the first trimester of pregnancy, compared with no exposure or quitting before the end of the first trimester, may be associated with a significantly increased risk of late stillbirth.
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Affiliation(s)
- Hein Odendaal
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Kimberly A. Dukes
- DM-STAT Inc, Malden, Massachusetts
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
- Biostatistics and Epidemiology Data Analys Center, Boston University School of Public Health, Boston, Massachusetts
| | - Amy J. Elliott
- Center for Pediatric & Community Research, Avera Research Institute, Sioux Falls, South Dakota
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls
| | - Marian Willinger
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Lisa M. Sullivan
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Tara Tripp
- DM-STAT Inc, Malden, Massachusetts
- Biostatistics and Epidemiology Data Analys Center, Boston University School of Public Health, Boston, Massachusetts
| | - Coen Groenewald
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Michael M. Myers
- Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York
- Department of Pediatrics, Columbia University Medical Center, New York State Psychiatric Institute, New York
| | - William P. Fifer
- Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York
- Department of Pediatrics, Columbia University Medical Center, New York State Psychiatric Institute, New York
| | - Jyoti Angal
- Center for Pediatric & Community Research, Avera Research Institute, Sioux Falls, South Dakota
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls
| | - Theonia K. Boyd
- Department of Pathology, Boston Children’s Hospital, Harvard School of Medicine, Boston, Massachusetts
| | - Larry Burd
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls
| | - Jacob B. Cotton
- Department of Pathology, Boston Children’s Hospital, Harvard School of Medicine, Boston, Massachusetts
| | - Rebecca D. Folkerth
- Department of Pathology, Boston Children’s Hospital, Harvard School of Medicine, Boston, Massachusetts
| | - Gary Hankins
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston
| | - Robin L. Haynes
- Department of Pathology, Boston Children’s Hospital, Harvard School of Medicine, Boston, Massachusetts
| | - Howard J. Hoffman
- Epidemiology and Statistics Program, National Institute on Deafness and Other Communication Disorders, Bethesda, Maryland
| | - Perri K. Jacobs
- Department of Pathology, Boston Children’s Hospital, Harvard School of Medicine, Boston, Massachusetts
| | - Julie Petersen
- DM-STAT Inc, Malden, Massachusetts
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Nicolò Pini
- Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York
| | - Bradley B. Randall
- Department of Pathology, University of South Dakota School of Medicine, Sioux Falls
| | | | - Fay Robinson
- DM-STAT Inc, Malden, Massachusetts
- PPD, Wilmington, North Carolina
| | - Mary A. Sens
- Department of Pathology, University of North Dakota, School of Medicine and Health Sciences, Grand Forks
| | - Peter Van Eerden
- Department of Obstetrics and Gynecology, School of Medicine, University of North Dakota, Fargo
| | - Colleen Wright
- Department of Pathology, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
| | - Ingrid A. Holm
- Department of Pediatrics, Division of Genetics & Genomics, Manton Center for Orphan Diseases Research, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Hannah C. Kinney
- Department of Pathology, Boston Children’s Hospital, Harvard School of Medicine, Boston, Massachusetts
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Abdallah AY, Joho AA, Yahaya JJ. Influence of maternal lifestyle behaviors on birth weight and Apgar score. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2021. [DOI: 10.1016/j.ijans.2021.100334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Wallin HP, Gissler M, Korhonen PE, Ekblad MO. Maternal Smoking and Hospital Treatment During Pregnancy. Nicotine Tob Res 2020; 22:1162-1169. [PMID: 31418024 DOI: 10.1093/ntr/ntz137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 08/02/2019] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Previous research suggests that young maternal age, smoking, hospitalization during a previous pregnancy, and poor self-rated health could be risk factors for prenatal hospitalization. METHODS The objective of this retrospective observational register study was to investigate if maternal smoking during pregnancy is associated with mother's need for hospital treatment during pregnancy. The study population consists of all singleton pregnancies (n = 961 127) in 1999-2015 in Finland. Information on maternal smoking was received from the Medical Birth Register in three classes: nonsmoker, quit smoking in the first trimester, and continued smoking throughout the pregnancy. These data were linked with the Hospital Discharge Register data and analyzed according to ICD-10 chapters. RESULTS 10.7% of women continued to smoke after the first trimester. After adjusting for confounding factors women in both smoking groups had more hospital treatment compared with nonsmokers. Especially outpatient treatment was more common among mothers who continued to smoke compared to those who quit smoking in the first trimester in several ICD-10 chapters. Compared to non-smokers, aOR for mental and behavioral disorders (F00-F99) was 2.14 (95% confidence interval 2.00-2.30) in the quit smoking group and 3.88 (3.71-4.06) in the continued smoking group. Similarly, aOR for respiratory diseases (J00-J99) was 1.26 (1.15-1.39) and 1.61 (1.52-1.71), respectively and aOR for genitourinary diseases (N00-N99) was 1.10 (1.03-1.17) and 1.29 (1.23-1.35), respectively. Some similar findings were made also in inpatient care. Some similar findings were made also in inpatient care. CONCLUSIONS Women who smoke during pregnancy seem to require more hospital care for various reasons. These findings emphasize the importance of actions for smoking cessation during pregnancy and women should be encouraged to quit as early as possible. IMPLICATIONS Maternal smoking during pregnancy is associated with greater rates of both outpatient and inpatient hospital care during pregnancy. Women who quit smoking had a similar risk for hospital care during pregnancy with nonsmokers in certain diagnosis chapters, which is very motivational and could be used as an informational tool in prenatal clinics to encourage smoking cessation as it is never too late to quit smoking during pregnancy.
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Affiliation(s)
- Hanna P Wallin
- Department of Clinical Medicine; General Practice, University of Turku and Turku University Hospital, Turku, Finland.,Central Satakunta Health Federation of Municipalities, Harjavalta, Finland
| | - Mika Gissler
- National Institute for Health and Welfare (THL), Helsinki, Finland.,Research Centre for Child Psychiatry, University of Turku, Turku, Finland.,Department of Neurobiology, Care Sciences and Society, Division of Family Medicine, Karolinska Institute, Stockholm, Sweden
| | - Päivi E Korhonen
- Department of Clinical Medicine; General Practice, University of Turku and Turku University Hospital, Turku, Finland.,Central Satakunta Health Federation of Municipalities, Harjavalta, Finland
| | - Mikael O Ekblad
- Department of Clinical Medicine; General Practice, University of Turku and Turku University Hospital, Turku, Finland.,Central Satakunta Health Federation of Municipalities, Harjavalta, Finland.,Department of Human Development and Family Studies, Purdue University, West Lafayette, IN, USA
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11
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Popova S, Lange S, Temple V, Poznyak V, Chudley AE, Burd L, Murray M, Rehm J. Profile of Mothers of Children with Fetal Alcohol Spectrum Disorder: A Population-Based Study in Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217986. [PMID: 33143108 PMCID: PMC7663482 DOI: 10.3390/ijerph17217986] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 12/14/2022]
Abstract
Objective: To compare the characteristics of mothers of children with Fetal Alcohol Spectrum Disorder (FASD) with mothers of typically developing control children. Methods: The study utilized a cross-sectional, observational design, using active case ascertainment. Biological mothers were interviewed using a standardized retrospective questionnaire to collect data on demographics, living environment, pregnancy history, nutrition, alcohol and other drug use prior to and following pregnancy recognition. Results: A total of 173 mothers were interviewed. Of these, 19 had a child who was diagnosed with FASD, five had a child who had received a deferred FASD diagnosis, and 37 had children who were selected into the control group as typically developing children. The remaining 112 mothers had children who did not meet diagnostic criteria for FASD. The mothers of children with FASD did not differ significantly from mothers of the control group children with respect to age, ethnicity, marital status, and employment status at the time of pregnancy. However, mothers of children with FASD had lower levels of education (p < 0.01) and were more likely to have received financial support (p < 0.05) at the time of pregnancy, to have smoked tobacco (p < 0.001), and to have used marijuana or hashish (p < 0.01) prior to pregnancy recognition, compared with mothers of control children. All mothers of children with FASD reported alcohol consumption prior to pregnancy recognition; however, only 10.5% reported alcohol consumption following pregnancy recognition. None of the mothers interviewed reported any drug use following pregnancy recognition. Conclusions: Population-based preventive interventions, including repeated screening, monitoring, and education regarding the effects of alcohol use, as well as other substances, before and during pregnancy, are needed to eliminate risk for FASD and other negative consequences on child and maternal health.
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Affiliation(s)
- Svetlana Popova
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada; (S.L.); (J.R.)
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, ON M5S 1V4, Canada
- Institute of Medical Science, University of Toronto, Faculty of Medicine, Medical Sciences, Building, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
- Correspondence:
| | - Shannon Lange
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada; (S.L.); (J.R.)
| | - Valerie Temple
- Surrey Place, 2 Surrey Place, Toronto, ON M5S 2C2, Canada;
| | - Vladimir Poznyak
- Department of Mental Health and Substance Abuse, World Health Organization, 20 Avenue Appia, CH-1211 Geneva, Switzerland;
| | - Albert E. Chudley
- Department of Paediatrics and Child Health, University of Manitoba, 840 Sherbrook Street, Winnipeg, MB R3A 1S1, Canada;
| | - Larry Burd
- North Dakota Fetal Alcohol Syndrome Center, Pediatrics Department, 1301 N Columbia Rd, Stop 9037 Grand Forks, ND 58202-9037, Canada;
| | - Margaret Murray
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Jürgen Rehm
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada; (S.L.); (J.R.)
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada
- Institute of Medical Science, University of Toronto, Faculty of Medicine, Medical Sciences, Building, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
- Institute of Clinical Psychology and Psychotherapy & Center of Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON M5T 1R8, Canada
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12
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Odendaal H, Wright C, Schubert P, Boyd TK, Roberts DJ, Brink L, Nel D, Groenewald C. Associations of maternal smoking and drinking with fetal growth and placental abruption. Eur J Obstet Gynecol Reprod Biol 2020; 253:95-102. [PMID: 32862031 DOI: 10.1016/j.ejogrb.2020.07.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/30/2020] [Accepted: 07/10/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate pregnant women from the Safe Passage Study for the individual and combined effects of smoking and drinking during pregnancy on the prevalence of clinical placental abruption. STUDY DESIGN The aim of the original Safe Passage Study was to investigate the association of alcohol use during pregnancy with stillbirths and sudden infant deaths. Recruitment for this longitudinal study occurred between August 2007 and October 2016. Information on smoking and drinking was collected prospectively at up to 4 occasions during pregnancy where a modified timeline follow-back method was used to assess the exposure to alcohol. Placentas were examined histologically in a subset of pregnant women. For this study we examined the effects of smoking and drinking on fetal growth and the prevalence rate of placental abruption. High smoking constituted of 10 or more cigarettes per day and high drinking of four or more binge drinking episodes or 32 and more standard drinks during pregnancy. Placental abruption was diagnosed in two ways, by the clinical picture or the macroscopic and microscopic examination of the placenta. RESULTS When compared to the non-drinking/non-smoking group, the high drinking/high smoking group were significantly older, had a higher gravidity, had a lower household income and booked later for prenatal care; fewer of them were employed and had toilet and running water facilities in their houses. Clinical placental abruption was diagnosed in 49 (0.87 %) of 5806 pregnancies. Histological examination was done in 1319 placentas; macroscopic and microscopic diagnosis of placental abruption was made in 8.2 % and 11.9 % of placentas respectively. These 49 cases were then correlated with seven smoking/drinking patterns during pregnancy. When compared to rates for no smoking/no drinking (0.11 %) and low smoking/no drinking (0.55 %), the prevalence rate of placental abruption was significantly higher (p < .005) in the low smoking/low drinking group (1.25 %). There was also a significant relationship between low maternal employment and methamphetamine use with placental abruption. CONCLUSION As many conditions and habits are associated with placental abruption, it is impossible to single out one specific cause but concomitant drinking and smoking seem to increase the risk of placental abruption.
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Affiliation(s)
- Hein Odendaal
- Department of Obstetrics and Gynecology, Stellenbosch University, Cape Town, South Africa.
| | - Colleen Wright
- Lancet Laboratories, Johannesburg, South Africa; Division of Anatomical Pathology, Stellenbosch University, Cape Town, South Africa
| | - Pawel Schubert
- Division of Anatomical Pathology, Stellenbosch University, Cape Town, South Africa
| | - Theonia K Boyd
- Department of Pathology, Boston Children's Hospital, Boston, MA, United States
| | - Drucilla J Roberts
- Department of Pathology, Massachusetts General Hospital, Boston, MA, United States
| | - Lucy Brink
- Department of Obstetrics and Gynecology, Stellenbosch University, Cape Town, South Africa
| | - Daan Nel
- Department of Statistics and Actuarial Science, Stellenbosch University, Stellenbosch, South Africa
| | - Coen Groenewald
- Department of Obstetrics and Gynecology, Stellenbosch University, Cape Town, South Africa
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13
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Screening, Brief Intervention, and Referral to Treatment for Prenatal Alcohol Use and Cigarette Smoking: A Survey of Academic and Community Health Care Providers. J Addict Med 2019; 14:e76-e82. [PMID: 31703018 PMCID: PMC7413672 DOI: 10.1097/adm.0000000000000588] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Prenatal alcohol and cigarette smoking are associated with numerous adverse pregnancy outcomes. Screening, Brief Intervention, and Referral to Treatment (SBIRT) represents a standardized approach; however, implementation in routine pregnancy care remains a challenge. The purpose of the study was to determine current practices, barriers to implementation, and education needs of healthcare providers utilizing SBIRT to address prenatal alcohol and cigarette smoking.
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14
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Arnold C, Ullrich C, Wensing M, Pfinder M. Prenatal Alcohol Exposure and the Associated Risk of Elevated Blood Pressure: A Cross-sectional Analysis of 3- to 17-Year-Olds in Germany. Am J Hypertens 2019; 32:1118-1125. [PMID: 31269195 DOI: 10.1093/ajh/hpz107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 06/16/2019] [Accepted: 07/02/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND As the prevalence of obesity and high blood pressure increases among the population, early action is needed to reduce blood pressure. Certain lifestyles during pregnancy have negative effects resulting in high blood pressure for children and adolescents. Using data from the "German Health Interview and Examination Survey for Children and Adolescents" (KiGGS), this study analyzed: (i) the association between low-to-moderate prenatal alcohol exposure (PAE) and the risk of increased systolic and diastolic blood pressure and (ii) whether associations were modified by socioeconomic status (SES), prenatal smoke exposure (PSE), and body mass index (BMI) of the children and adolescents. METHODS We applied multivariate logistic regression analyses and stratified analyses by SES, PSE, and BMI with cross-sectional data from the KiGGS study (N = 14,253) to examine the association between PAE and prehypertension or hypertension in 3- to 17-year-olds. RESULTS Of the surveyed children and adolescents, 13.7% had a systolic prehypertension and 11.5% had a diastolic prehypertension. A further 7.5% were identified as having systolic hypertension and 6.0% diastolic hypertension. In the regression analyses, PAE resulted in a decreased risk of systolic prehypertension (odds ratio [OR]: 0.83, 95% confidence interval [CI]: 0.70, 0.99) and diastolic prehypertension (OR: 0.82, 95% CI: 0.68, 0.98). Risk reductions were not significant in surveyed children and adolescents with hypertension. Interactions between PAE and SES, PSE, and offspring BMI were not significant. CONCLUSIONS Contrary to our initial hypothesis, PAE reduces the risk of prehypertension. Animal studies suggest that vasodilation is induced by nitric oxide in small quantities of PAE.
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Affiliation(s)
- Christine Arnold
- Department of General Practice and Health Service Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Charlotte Ullrich
- Department of General Practice and Health Service Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Michel Wensing
- Department of General Practice and Health Service Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Manuela Pfinder
- Department of General Practice and Health Service Research, University Hospital Heidelberg, Heidelberg, Germany
- Department of Health Promotion, AOK Baden-Württemberg, Stuttgart, Germany
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15
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Alcohol Interaction with Cocaine, Methamphetamine, Opioids, Nicotine, Cannabis, and γ-Hydroxybutyric Acid. Biomedicines 2019; 7:biomedicines7010016. [PMID: 30866524 PMCID: PMC6466217 DOI: 10.3390/biomedicines7010016] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 02/21/2019] [Accepted: 02/27/2019] [Indexed: 12/18/2022] Open
Abstract
Millions of people around the world drink alcoholic beverages to cope with the stress of modern lifestyle. Although moderate alcohol drinking may have some relaxing and euphoric effects, uncontrolled drinking exacerbates the problems associated with alcohol abuse that are exploding in quantity and intensity in the United States and around the world. Recently, mixing of alcohol with other drugs of abuse (such as opioids, cocaine, methamphetamine, nicotine, cannabis, and γ-hydroxybutyric acid) and medications has become an emerging trend, exacerbating the public health concerns. Mixing of alcohol with other drugs may additively or synergistically augment the seriousness of the adverse effects such as the withdrawal symptoms, cardiovascular disorders, liver damage, reproductive abnormalities, and behavioral abnormalities. Despite the seriousness of the situation, possible mechanisms underlying the interactions is not yet understood. This has been one of the key hindrances in developing effective treatments. Therefore, the aim of this article is to review the consequences of alcohol's interaction with other drugs and decipher the underlying mechanisms.
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16
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Dessì A, Corona L, Pintus R, Fanos V. Exposure to tobacco smoke and low birth weight: from epidemiology to metabolomics. Expert Rev Proteomics 2018; 15:647-656. [PMID: 30052087 DOI: 10.1080/14789450.2018.1505508] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION The exposure to tobacco smoke during pregnancy is one of the leading causes of perinatal adverse outcomes such as stillbirth, intrauterine growth restriction (IUGR), and low birth weight, but the underlying biological mechanisms are still unclear. The incidence of this phenomenon maybe largely underestimated since the evaluation is made mainly by self-assessment questionnaires rather than measuring nicotine metabolites (such as cotinine) in biological fluids. In this context metabolomics may be useful to assess the actual number of pregnant women and to highlight the pathophysiological mechanisms that lead to the abovementioned adverse outcomes. Areas covered: The aims of this review are to analyze the literature and the application of the omics sciences, such as genomics and metabolomics concerning the negative effects of smoking during pregnancy in order to give a comprehensive picture of all the study made so far and to point out the potential of metabolomics as an investigative, predictive, and diagnostic tool. Expert commentary: Metabolomics in recent years has proved an excellent tool to try to understand the problems in perinatal medicine. With the increase in the number of studies we are convinced that it can be a useful instrument of investigation in this field.
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Affiliation(s)
- Angelica Dessì
- a Neonatal Intensive Care Unit , Neonatal Pathology and Neonatal Section - Azienda Ospedaliero Universitaria , Cagliari , Italy
| | - Laura Corona
- a Neonatal Intensive Care Unit , Neonatal Pathology and Neonatal Section - Azienda Ospedaliero Universitaria , Cagliari , Italy
| | - Roberta Pintus
- a Neonatal Intensive Care Unit , Neonatal Pathology and Neonatal Section - Azienda Ospedaliero Universitaria , Cagliari , Italy
| | - Vassilios Fanos
- a Neonatal Intensive Care Unit , Neonatal Pathology and Neonatal Section - Azienda Ospedaliero Universitaria , Cagliari , Italy
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17
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Sabra S, Malmqvist E, Almeida L, Gratacos E, Gomez Roig MD. Differential correlations between maternal hair levels of tobacco and alcohol with fetal growth restriction clinical subtypes. Alcohol 2018; 70:43-49. [PMID: 29778069 DOI: 10.1016/j.alcohol.2018.01.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 11/22/2017] [Accepted: 01/02/2018] [Indexed: 12/22/2022]
Abstract
Maternal exposure to tobacco and alcohol is a known cause, among others, for fetal growth restriction (FGR). Clinically, FGR can be subclassified into two forms: intrauterine growth restriction (IUGR) and small for gestational age (SGA), based on the severity of the growth retardation, and abnormal uterine artery Doppler or cerebro-placental ratio. This study aimed at investigating any differential correlation between maternal exposures to these toxins with the two clinical forms of FGR. Therefore, a case-control study was conducted in Barcelona, Spain. Sixty-four FGR subjects, who were further subclassified into IUGR (n = 36) and SGA (n = 28), and 89 subjects matched appropriate-for-gestational age (AGA), were included. The levels of nicotine (NIC) and ethyl glucuronide (EtG), biomarkers of tobacco and alcohol exposure, respectively, were assessed in the maternal hair in the third trimester. Our analysis showed 65% of the pregnant women consumed alcohol, 25% smoked, and 19% did both. The odds ratios (ORs) of IUGR were 21 times versus 14 times for being SGA with maternal heavy smoking, while with alcohol consumption the ORs for IUGR were 22 times versus 37 times for the SGA group. The differential correlations between these toxins with the two subtypes of FGR suggest different mechanisms influencing fetal weight. Our alarming data of alcohol consumption during pregnancy should be considered for further confirmation among Spanish women.
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Affiliation(s)
- Sally Sabra
- BC Natal Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu and Hospital Clínic, Passeig Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain.
| | - Ebba Malmqvist
- Occupational and Environmental Medicine, Lund University, Scheelevägen 2, 223 63 Lund, Sweden.
| | - Laura Almeida
- BC Natal Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu and Hospital Clínic, Passeig Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain.
| | - Eduard Gratacos
- BC Natal Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu and Hospital Clínic, Passeig Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain; IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases CIBER-ER, Carrer del Rosselló, 149, 08036 Barcelona, Spain.
| | - Maria Dolores Gomez Roig
- BC Natal Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu and Hospital Clínic, Passeig Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain; Maternal and Child Health and Development Network II (SAMID II), Instituto de Salud Carlos III (ISCIII), e Sub-Directorate General for Research Assessment and Promotion and the European Regional Development Fund (FEDER), Av. de Monforte de Lemos, 5, 28029 Madrid, Spain; Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Passeig Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain.
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18
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Washio Y, Goldstein ND, Butler R, Rogers S, Paul DA, Terplan M, Hoffman MK. Self-report measure as a useful tool to identify prenatal substance use and predict adverse birth outcomes. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/1477750918765224] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives The purpose of the current study was to examine whether a self-report measure identifies prenatal substance use and predicts resulting adverse birth outcomes in a large cohort using electronic medical records. Methods Pregnant patients who were admitted between 2014 and 2015 at Christiana Care Health System and delivered singleton birth were included in the analyses ( N = 11,020). Participant demographic information, pregnancy comorbidities, self-reported substance use, and birth outcomes were retrieved from electronic medical records. Detailed descriptive analyses of prenatal substance use were conducted, and logistic models were evaluated for the associations between substance use and each birth outcome (preterm birth, low birth weight, neonatal intensive care unit admission). Results The average maternal age was 30 years (standard deviation: 6), 37% receiving Medicaid. Over 58% were White, 26% were Black, and 13% were Hispanic. Cigarette smoking only showed the highest prevalence among substance users (53%). Self-reported cigarette smoking and illicit drug use other than marijuana significantly predicted all three adverse birth outcomes (Adjusted Odds Ratio [AOR] range: 1.33 (95% Confidence Interval [CI]: 1.08–1.64)–3.09 (95% CI: 2.03–4.67)). Nonresponders to the cigarette smoking question also significantly predicted two adverse birth outcomes of preterm birth delivery (AOR: 4.16; 95% CI: 1.27–14.71) and having low birth weight babies (AOR: 3.50; 95% CI: 1.04–12.61). Conclusions/Importance: Prenatal cigarette smoking only had the highest prevalence, and co-use with illicit drugs was also high, leading to significant associations with adverse birth outcomes. The study findings indicate that the self-report measurement is a useful tool to identify prenatal substance use and predict resulting adverse birth outcomes.
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Affiliation(s)
- Yukiko Washio
- Christiana Care Health System, University of Delaware, Newark, DE,, USA
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19
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Slavensky JA, Kesmodel US. Alcohol binge drinking in early pregnancy and the effect on fetal growth: a cohort study. Acta Obstet Gynecol Scand 2018; 97:477-482. [PMID: 29432645 DOI: 10.1111/aogs.13329] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 02/06/2018] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Alcohol binge drinking is common in early pregnancy and is a well-established risk factor for subsequent child health. Yet, very few studies have investigated the effect on fetal growth. Furthermore, it has been speculated that the timing of binge drinking may be a determining factor for neonatal growth. The objective of this study was to assess the potential effect of binge drinking and different drinking patterns (timing and number of binge drinking episodes) in early pregnancy on fetal growth estimated by birthweight and birth length. MATERIAL AND METHODS From 1 March to 31 August 2000, 1836 pregnant Danish women from Aarhus University Hospital and Fredericia Hospital were included in the study and interviewed around the early second trimester about their drinking habits during their pregnancy. Information on anthropometric measures at birth was obtained from the Danish Medical Birth Registry. The potential effect of binge drinking and different drinking patterns was estimated using a multivariate general linear regression model adjusted for potential confounders that were selected a priori based on the currently available scientific literature. RESULTS The women who reported any binge drinking gave birth to children with a reduction in birth length of -0.02 cm (95% CI -0.23 to 0.18) and an increase in birthweight of 0.2 g (95% CI -42.8 to 43.2). The number of binge episodes and the timing of these episodes were also not associated with fetal growth. CONCLUSIONS The study suggests that binge drinking and different drinking patterns in early pregnancy do not affect fetal growth.
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Affiliation(s)
- Julie A Slavensky
- Department of Obstetrics and Gynecology, Herlev Hospital, Herlev, Denmark
| | - Ulrik S Kesmodel
- Department of Obstetrics and Gynecology, Herlev Hospital, Herlev, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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20
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Myers B, Koen N, Donald KA, Nhapi RT, Workman L, Barnett W, Hoffman N, Koopowitz S, Zar HJ, Stein DJ. Effect of Hazardous Alcohol Use During Pregnancy on Growth Outcomes at Birth: Findings from a South African Cohort Study. Alcohol Clin Exp Res 2017; 42:369-377. [PMID: 29197115 PMCID: PMC5887896 DOI: 10.1111/acer.13566] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 11/20/2017] [Indexed: 11/30/2022]
Abstract
Background Cohort studies have noted associations between hazardous alcohol use during pregnancy and infant growth outcomes, but many have not controlled for potential psychosocial confounders. To assess the unique contribution of hazardous alcohol use, we examined its effect on infant growth outcomes while controlling for maternal psychosocial stressors and hazardous tobacco and drug use in a cohort of 986 pregnant South African women enrolled into the Drakenstein Child Health Study between 2012 and 2015. Methods Data on psychosocial stressors and maternal risk behaviors were collected between 28 and 32 weeks of gestation. Participants were categorized as hazardous alcohol users if they obtained moderate or high scores (>10) on the Alcohol, Smoking and Substance Involvement Screening Test at this assessment or retrospectively reported drinking at least 2 drinks weekly during any trimester of pregnancy. Infant growth outcomes were recorded at delivery. Multivariable regression models examined correlates of hazardous alcohol use and associations between hazardous alcohol use and birth outcomes. Results Overall, 13% of mothers reported hazardous alcohol use. Recent exposure to intimate partner violence (adjusted odds ratio (aOR) = 2.08; 95% confidence interval (CI): 1.37, 3.18) and hazardous tobacco use (aOR = 5.03; 95% CI: 2.97, 8.52) were significant correlates of hazardous alcohol use. After controlling for potential psychosocial confounders, hazardous alcohol use remained associated with lower infant weight‐for‐age (B = −0.35, 95% CI: −0.56, −0.14), height‐for‐age (B = −0.46, 95% CI: −0.76, −0.17), and head‐circumference‐for‐age z‐scores (B = −0.43, 95% CI: −0.69, −0.17). Conclusions Interventions to reduce hazardous alcohol use among pregnant women in South Africa are needed to prevent alcohol‐related infant growth restrictions. As these growth deficits may lead to neurodevelopmental consequences, it is critical to identify alcohol‐related growth restrictions at birth and link exposed infants to early interventions for neurodevelopment.
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Affiliation(s)
- Bronwyn Myers
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa.,Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Nastassja Koen
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Kirsten A Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Raymond T Nhapi
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.,Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Lesley Workman
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Whitney Barnett
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.,South African Medical Research Council Unit on Child and Adolescent Health, Cape Town, South Africa
| | - Nadia Hoffman
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Sheri Koopowitz
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.,South African Medical Research Council Unit on Child and Adolescent Health, Cape Town, South Africa
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.,South African Medical Research Council Unit on Anxiety and Stress Disorders, Cape Town, South Africa
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Washio Y, Mericle AA, Cassey H, Daubert AM, Kirby KC. Characteristics of Low-income Racial/Ethnic Minority Pregnant Women Screening Positive for Alcohol Risk. J Immigr Minor Health 2017; 18:850-855. [PMID: 26187172 DOI: 10.1007/s10903-015-0238-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The current study examined the prevalence and characteristics associated with alcohol risk among low-income, predominantly racial/ethnic minority pregnant women in an urban area. We surveyed 225 pregnant women receiving nutritional care. Twenty-six percent screened positive for alcohol risk. Current smoking status (AOR 2.9, p = 0.018, 95 % CI [1.2, 7.0]) and a history of marijuana use (AOR 3.1, p = 0.001, 95 % CI [1.6, 6.2]) were the strongest predictors of alcohol risk status. This study underscores the need for screening for alcohol risk, smoking, and illicit drug use among low-income, racial/ethnic minority pregnant women and highlights the usefulness of the TWEAK in identifying alcohol risk in WIC settings.
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Affiliation(s)
- Yukiko Washio
- Treatment Research Institute, 600 Public Ledger Building, 150 S. Independence Mall West, Philadelphia, PA, 19106, USA.
| | - Amy A Mericle
- Alcohol Research Group, 6475 Christie Avenue, Suite 400, Emeryville, CA, 94608, USA
| | - Heather Cassey
- Applied Behavior Analysis Program, College of Education, Temple University, 1801 N. Broad St., Philadelphia, PA, 19122, USA
| | - Angela M Daubert
- Applied Behavior Analysis Program, College of Education, Temple University, 1801 N. Broad St., Philadelphia, PA, 19122, USA
| | - Kimberly C Kirby
- Treatment Research Institute, 600 Public Ledger Building, 150 S. Independence Mall West, Philadelphia, PA, 19106, USA
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22
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Washio Y, E. Martin C, Goldstein ND, Terplan M. Characteristics of pregnant women who reported alcohol use at admission to substance use treatment. J Subst Abuse Treat 2017; 82:82-86. [DOI: 10.1016/j.jsat.2017.09.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 09/13/2017] [Accepted: 09/14/2017] [Indexed: 11/29/2022]
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23
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Loxton D, Chojenta C, Anderson AE, Powers JR, Shakeshaft A, Burns L. Acquisition and Utilization of Information About Alcohol Use in Pregnancy Among Australian Pregnant Women and Service Providers. J Midwifery Womens Health 2016; 58:523-30. [PMID: 26055614 DOI: 10.1111/jmwh.12014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Because of an unknown safe level of alcohol consumption during pregnancy and inconsistent alcohol guidelines for pregnant women, it is unclear what information is being circulated with regard to alcohol use and pregnancy. This study aimed to explore how pregnant women and service providers acquire and utilize information about alcohol use during pregnancy. METHODS This qualitative study involved 10-minute semistructured interviews with 74 mothers of young children and focus groups with 14 service providers in urban and rural areas of New South Wales in 2008 and 2009. Mothers were asked about their use of pregnancy-related services, social support, and their perceptions about advice they received about alcohol use during pregnancy. Service providers were asked about what they knew about recommended alcohol use during pregnancy, how they knew it, and how they communicated this information to pregnant clients. RESULTS Women and service providers expressed uncertainty about what the alcohol recommendations were for pregnant women. Health care providers were inclined to discuss alcohol use with women they perceived to be high risk but not otherwise. Women felt pressure to both drink and not drink during their pregnancies. Those who drank discounted abstinence messages and reported a process of internal bargaining on issues such as the stage of their pregnancy and the type of beverages they consumed. Those who abstained did so mainly because they were afraid of being held responsible for any problems with their pregnancies or infants that might have occurred from drinking. DISCUSSION Confusion surrounding the recommendations regarding alcohol use during pregnancy, inconsistency in addressing alcohol use with pregnant women, information overload, and a perceived culture of drinking appear to contribute to the high proportion of Australian women drinking during pregnancy.
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24
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Erickson AC, Ostry A, Chan HM, Arbour L. Air pollution, neighbourhood and maternal-level factors modify the effect of smoking on birth weight: a multilevel analysis in British Columbia, Canada. BMC Public Health 2016; 16:585. [PMID: 27784277 PMCID: PMC5080752 DOI: 10.1186/s12889-016-3273-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 04/11/2016] [Accepted: 07/07/2016] [Indexed: 11/10/2022] Open
Abstract
Background Maternal smoking during pregnancy negatively impacts fetal growth, but the effect is not homogenous across the population. We sought to determine how the relationship between cigarette use and fetal growth is modified by the social and physical environment. Methods Birth records with covariates were obtained from the BC Perinatal Database Registry (N = 232,291). Maternal smoking status was self-reported as the number of cigarettes smoked per day usually at the first prenatal care visit. Census dissemination areas (DAs) were used as neighbourhood-level units and linked to individual births using residential postal codes to assign exposure to particulate air pollution (PM2.5) and neighbourhood-level attributes such as socioeconomic status (SES), proportion of post-secondary education, immigrant density and living in a rural place. Random coefficient models were used with cigarettes/day modeled with a random slope to estimate its between-DA variability and test cross-level interactions with the neighbourhood-level variables on continuous birth weight. Results A significant negative and non-linear association was found between maternal smoking and birth weight. There was significant between-DA intercept variability in birth weight as well as between-DA slope variability of maternal smoking on birth weight of which 68 and 30 % respectively was explained with the inclusion of DA-level variables and their cross-level interactions. High DA-level SES had a strong positive association with birth weight but the effect was moderated with increased cigarettes/day. Conversely, heavy smokers showed the largest increases in birth weight with rising neighbourhood education levels. Increased levels of PM2.5 and immigrant density were negatively associated with birth weight, but showed positive interactions with increased levels of smoking. Older maternal age and suspected drug or alcohol use both had negative interactions with increased levels of maternal smoking. Conclusion Maternal smoking had a negative and non-linear dose-response association with birth weight which was highly variable between neighbourhoods and evidence of effect modification with neighbourhood-level factors. These results suggest that focusing exclusively on individual behaviours may have limited success in improving outcomes without addressing the contextual influences at the neighbourhood-level. Further studies are needed to corroborate our findings and to understand how neighbourhood-level attributes interact with smoking to affect birth outcomes.
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Affiliation(s)
- Anders C Erickson
- Division of Medical Sciences, University of Victoria, Medical Science Bld. Rm-104, University of Victoria, PO Box 1700 STN CSC, Victoria, V8W 2Y2, BC, Canada.,Department of Geography, University of Victoria, David Turpin Bldg. Rm-B203, University of Victoria, PO Box 1700 STN CSC, Victoria, V8W 2Y2, BC, Canada
| | - Aleck Ostry
- Department of Geography, University of Victoria, David Turpin Bldg. Rm-B203, University of Victoria, PO Box 1700 STN CSC, Victoria, V8W 2Y2, BC, Canada
| | - Hing Man Chan
- Center for Advanced Research in Environmental Genomics, University of Ottawa, 20 Marie-Curie, Ottawa, K1N 6 N5, ON, Canada
| | - Laura Arbour
- Division of Medical Sciences, University of Victoria, Medical Science Bld. Rm-104, University of Victoria, PO Box 1700 STN CSC, Victoria, V8W 2Y2, BC, Canada. .,Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada.
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25
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Abstract
Alcohol consumption with psychostimulants is very common among drug addicts. There is little known about the possible pharmacological interactions between alcohol and psychostimulants. Among most commonly co-abused psychostimulants with alcohol are methamphetamine, cocaine, 3,4-methylenedioxymethamphetaminen, and nicotine. Co-abuse of alcohol with psychostimulants can lead to several neurophysiological dysfunctions such as decrease in brain antioxidant enzymes, disruption of learning and memory processes, cerebral hypo-perfusion, neurotransmitters depletion as well as potentiation of drug seeking behaviour. Moreover, co-abuse of alcohol and psychostimulants can lead to increase in heart rate, blood pressure, myocardial oxygen consumption and cellular stress, and the risk of developing different types of cancer. Co-abuse of alcohol with psychostimulants during pregnancy can lead to fetal brain abnormalities. Further studies are needed to investigate the pharmacokinetics, pharmacodynamics, and neurochemical changes on co-abuse of alcohol and psychostimulants.
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Affiliation(s)
- Yusuf S Althobaiti
- University of Toledo, College of Pharmacy and Pharmaceutical Sciences, Department of Pharmacology and Experimental Therapeutics, Toledo, OH, USA
| | - Youssef Sari
- University of Toledo, College of Pharmacy and Pharmaceutical Sciences, Department of Pharmacology and Experimental Therapeutics, Toledo, OH, USA
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26
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Sbrana M, Grandi C, Brazan M, Junquera N, Nascimento MS, Barbieri MA, Bettiol H, Cardoso VC. Alcohol consumption during pregnancy and perinatal results: a cohort study. SAO PAULO MED J 2016; 134:146-52. [PMID: 27007799 PMCID: PMC10496540 DOI: 10.1590/1516-3180.2015.02040211] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 10/07/2015] [Accepted: 11/02/2015] [Indexed: 11/21/2022] Open
Abstract
CONTEXT AND OBJECTIVE Alcohol consumption during pregnancy is a significant social problem that may be associated with adverse perinatal outcomes. The aim of this study was to describe alcohol consumption during pregnancy and to study its association with low birth weight, newborns small for gestational age and preterm birth. DESIGN AND SETTING Nested cohort study, in the city of Ribeirão Preto, São Paulo, Brazil. METHODS 1,370 women and their newborns were evaluated. A standardized questionnaire on health and lifestyle habits was applied to the mothers. Anthropometry was performed on the newborns. Alcohol consumption was defined as low, moderate or high, as defined by the World Health Organization. Adjusted logistic regression analysis was used. RESULTS 23% of the women consumed alcohol during pregnancy. Consumption mainly occurred in the first trimester (14.8%) and decreased as the pregnancy progressed. The median alcohol intake was 3.89 g (interquartile range, IQR = 8 g) per day. In the unadjusted analysis, alcohol consumption increased the risk of low birth weight almost twofold (odds ratio, OR 1.91; 95% confidence interval, CI: 1.25-2.92). The risk was lower in the adjusted analysis (OR 1.62; 95% CI: 1.03-2.54). Alcohol consumption did not show associations with small for gestational age or preterm birth. There was greater risk of low birth weight and newborns small for gestational age and preterm birth among mothers who were both smokers and drinkers. CONCLUSIONS The alcohol consumption rate during pregnancy was 23% and was independently associated with low birth weight, but there was no risk of newborns small for gestational age or preterm birth.
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Affiliation(s)
- Mariana Sbrana
- MD. Medical Resident, Department of Pediatrics, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
| | - Carlos Grandi
- MD, PhD. Postdoctoral Student, Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
| | - Murilo Brazan
- MD. Medical Resident, Department of Pediatrics, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
| | - Natacha Junquera
- MD. Medical Resident, Department of Pediatrics, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
| | - Marina Stevaux Nascimento
- MD. Medical Resident, Department of Pediatrics, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
| | - Marco Antonio Barbieri
- MD, PhD. Senior Professor, Department of Pediatrics, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
| | - Heloisa Bettiol
- MD, PhD. Associate Professor, Department of Pediatrics, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
| | - Viviane Cunha Cardoso
- MD, PhD. Adjunct Professor, Department of Pediatrics, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
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27
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van Stuijvenberg ME, Schoeman SE, Nel J, Lombard CJ, Dhansay MA. Serum retinol in post-partum mothers and newborns from an impoverished South African community where liver is frequently eaten and vitamin A deficiency is absent. MATERNAL AND CHILD NUTRITION 2015; 13. [PMID: 26564246 DOI: 10.1111/mcn.12223] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 07/23/2015] [Accepted: 08/20/2015] [Indexed: 11/30/2022]
Abstract
Serum retinol was assessed in mothers and newborns from an impoverished South African community where liver is frequently eaten and vitamin A deficiency known to be absent. Paired cord and maternal blood (n = 201) were collected after delivery and analysed for serum retinol and C-reactive protein (CRP). Liver intake during pregnancy and intention to breastfeed were also assessed. Mean serum retinol was 1.03 µmol/L ± 0.40 in mothers and 0.73 ± 0.24 µmol/L in newborns, with 21.4% and 49.3% having serum retinol <0.70 µmol/L (<20 µg/dL), respectively. Raised CRP was found in 59.9% of mothers, with a significant negative correlation between serum retinol and CRP (r = -0.273; p < 0.0001). Liver was eaten by 87.6% of mothers, and 99% indicated their intention to breastfeed. Despite consumption of liver, serum retinol was low in both the mother and the newborn. The conventional cut-off for serum retinol, i.e. <0.70 µmol/L may therefore not apply for the mother and newborn in the period immediately after delivery. Serum retinol may be influenced by factors other than vitamin A status, e.g. the haemodilution of pregnancy, as well as the acute phase response induced by the birth process, as suggested by raised CRP in 60% of mothers. In the newborns, the low serum retinol is likely to increase rapidly, as liver is frequently eaten by mothers and practically all of them intended to breastfeed. Our results confirm the need for better indicators of vitamin A status or alternative cut-off values during this period.
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Affiliation(s)
- Martha E van Stuijvenberg
- Nutritional Intervention Research Unit, South African Medical Research Council, Cape Town, South Africa.,Non-communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Serina E Schoeman
- Nutritional Intervention Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Jana Nel
- Integrated Nutrition Programme, Department of Health, Northern Cape, South Africa
| | - Carl J Lombard
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
| | - Muhammad A Dhansay
- Nutritional Intervention Research Unit, South African Medical Research Council, Cape Town, South Africa.,Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa.,Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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28
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Abstract
Type 2 diabetes (T2D) is a chronic non-communicable disease that is driven by insulin resistance as a result of increasing obesity and decreasing activity levels that occur with increasing age. This disease generally develops after the age of 40, but it is now increasingly diagnosed in children and young adults. Increasing evidence, however, suggests that T2D can originate during early development. It has been repeatedly found that malnutrition during the gestational period can result in intrauterine growth restriction and low birth weight, which in combination with postnatal catch-up growth may subsequently lead to the development of T2D. There is ample evidence that T2D may also be programmed by maternal substance abuse (the harmful use of psychoactive substances such as illicit drugs or alcohol) during pregnancy and/or lactation. The research activity in this field is currently mainly focused on the childhood health problems following prenatal exposures to substance abuse. The delayed programming effects on adult-onset disorders, including metabolic syndrome and T2D, however, have been reported only rarely. This review provides animal and human evidence that early-life exposure to substance abuse, including alcohol, nicotine, and cocaine, may program not only childhood health outcomes but also life-long metabolic health status, including risk of T2D and related conditions.
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Affiliation(s)
- A M Vaiserman
- Laboratory of Epigenetics, D.F. Chebotarev State Institute of Gerontology NAMS of Ukraine, Vyshgorodskaya st. 67, Kiev, 04114, Ukraine,
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29
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Low intake of calcium and vitamin D, but not zinc, iron or vitamin A, is associated with stunting in 2- to 5-year-old children. Nutrition 2015; 31:841-6. [DOI: 10.1016/j.nut.2014.12.011] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 11/22/2014] [Accepted: 12/09/2014] [Indexed: 01/30/2023]
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Janisse JJ, Bailey BA, Ager J, Sokol RJ. Alcohol, tobacco, cocaine, and marijuana use: relative contributions to preterm delivery and fetal growth restriction. Subst Abus 2015; 35:60-7. [PMID: 24588295 DOI: 10.1080/08897077.2013.804483] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Pregnancy substance use is linked to low birth weight. However, less is known about relative contributions of various substances and whether effects are due to decreased gestational duration, restriction of fetal growth, or both. The study goal was to use causal modeling to evaluate the individual impact of alcohol, tobacco, cocaine, and marijuana on gestational duration and fetal growth. METHODS Participants were 3164 urban black women recruited at entry to prenatal care and followed to delivery, with all gestational dating ultrasound supported. Pregnancy substance use was assessed via self-report (alcohol, tobacco, cocaine, and marijuana). RESULTS Alcohol, cigarette, and cocaine use were all individually and negatively related to gestational age at delivery. However, only alcohol, cigarette, and marijuana use predicted fetal growth, with effects for alcohol and cigarette greater and more discrepant for older women. Overall, heavy cigarette smoking had the greatest individual impact on birth weight (up to 431 g). Heavy levels of use of all 4 substances by older women decreased birth weight by 26% (806 g). CONCLUSIONS For perhaps the first time, reduced birth weight is apportioned both by type of substance and mechanism of effect. The use of alcohol and/or cigarettes was clearly more harmful to fetal growth than cocaine use. Findings demonstrate the need for continued emphasis on intervention efforts to address legal and illicit pregnancy substance use.
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Affiliation(s)
- James J Janisse
- a Department of Family Medicine and Public Health Sciences, School of Medicine , Wayne State University , Detroit , Michigan , USA
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31
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Pfinder M, Liebig S, Feldmann R. Impact of Moderate Prenatal Alcohol Exposure on Problem Behaviors in Preschool and School Children. ZEITSCHRIFT FUR ENTWICKLUNGSPSYCHOLOGIE UND PADAGOGISCHE PSYCHOLOGIE 2014. [DOI: 10.1026/0049-8637/a000106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Data on the relation between moderate prenatal alcohol exposure (PAE) and behavioral disorders are inconsistent, and this raises new questions. We examined (1) the association between moderate PAE and problem behaviors and (2) whether these associations differed by levels of socioeconomic status (SES), fetal smoke exposure, or exposure to environmental tobacco smoke (ETS). Data were taken from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) study. Parents evaluated children’s behaviors using the Strengths and Difficulties Questionnaire (SDQ). Results showed a slight, but insignificant, increase of problem behaviors in children with moderate PAE. In 3- to 6-year-olds, PAE had a stronger effect on hyperactivity/inattention in combination with fetal smoke exposure (odds ratio = 2.82), than did PAE alone. Effects were not stronger in low-SES children, but they were stronger in children with ETS. We conclude that moderate PAE might have adverse effects on neurodevelopment, with stronger effects in disadvantaged populations. To confirm our preliminary findings, further research should be conducted.
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Affiliation(s)
- Manuela Pfinder
- Bielefeld Graduate School of History and Sociology, University of Bielefeld, Bielefeld, Germany
| | - Stefan Liebig
- Bielefeld Graduate School of History and Sociology, University of Bielefeld, Bielefeld, Germany
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32
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Miyake Y, Tanaka K, Okubo H, Sasaki S, Arakawa M. Alcohol consumption during pregnancy and birth outcomes: the Kyushu Okinawa Maternal and Child Health Study. BMC Pregnancy Childbirth 2014; 14:79. [PMID: 24555868 PMCID: PMC3933512 DOI: 10.1186/1471-2393-14-79] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2013] [Accepted: 02/12/2014] [Indexed: 11/24/2022] Open
Abstract
Background A recent meta-analysis showed no relationships between light to moderate alcohol consumption during pregnancy and the risk of low birth weight (LBW), preterm birth (PTB), or small-for-gestational-age (SGA). Here, we present the first epidemiological study on this topic in Japan. Methods Study subjects were 1565 Japanese mothers with singleton pregnancies and the babies born from these pregnancies. Alcohol consumption during pregnancy was assessed using a self-administered diet history questionnaire. Alcohol consumption during pregnancy was classified into three categories (none, < 1 g/day, and ≥ 1 g/day). Results The mean birth weight of the babies was 3006.3 g. 7.7% were classified as LBW, 4.0% as PTB, and 7.8% as SGA. The range of maternal alcohol consumption during pregnancy was 0.0 to 11.7 g per day: 1356 (86.7%) mothers were abstainers and the 95th percentile value was 0.84 g per day. Compared with abstinence, alcohol consumption of 1.0 g or more per day during pregnancy was significantly associated with an increased risk of PTB with a significant positive linear trend: the adjusted OR for PTB associated with maternal alcohol consumption of 1.0 g or more per day was 2.58 (95% CI: 1.004 - 5.80, P for trend = 0.03). No significant relationships were observed between maternal alcohol consumption during pregnancy and the risk of LBW or SGA, and there was no material association between maternal alcohol consumption during pregnancy and birth weight. Conclusions This is the first study in Japan to show that maternal alcohol consumption during pregnancy of 1.0 g or more per day was significantly positively associated with the risk of PTB, but not LBW or SGA.
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Affiliation(s)
- Yoshihiro Miyake
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
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33
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Pfinder M. Anthropometric and health-related behavioral factors in the explanation of social inequalities in low birth weight in children with prenatal alcohol exposure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:849-65. [PMID: 24406666 PMCID: PMC3924478 DOI: 10.3390/ijerph110100849] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 12/18/2013] [Accepted: 12/25/2013] [Indexed: 12/01/2022]
Abstract
There is evidence for social inequalities in the health status of children with prenatal alcohol exposure (PAE). This study aimed to describe social inequalities in low birth weight (LBW) in children/adolescents with PAE and to examine the contribution of anthropometric and health-related behavioral factors to the explanation of social inequalities. A total of 2,159 participants with parental self-reported moderate to regular PAE (enrolled in the cross-sectional German Health Interview and Examination Survey for Children and Adolescents) were examined. At similar levels of PAE, the risk of LBW was significantly increased in subjects with a low socioeconomic status (SES) (adjusted odds ratio (OR) 2.78, 95% confidence interval (CI) 1.59, 4.86) and middle SES (adjusted OR 2.04, 95% CI 1.28, 3.24). Maternal height, maternal body mass index (BMI) and smoking during pregnancy mediated the association. The mediating effect of maternal height was 12.5% to 33.7%. Maternal BMI explained 7.9% of the socioeconomic difference in LBW between the high and low SES groups in children with PAE. The mediating effect of smoking during pregnancy was 17.3% to 31.5%. Maternal height, maternal BMI and smoking during pregnancy together explained 24.4% to 60.1% of the socioeconomic differences in LBW in children with PAE. A large proportion of the socioeconomic differences in LBW in children with PAE can be attributed to anthropometric and health-related behavioral factors.
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Affiliation(s)
- Manuela Pfinder
- Bielefeld Graduate School in History and Sociology, Faculty of Sociology, University of Bielefeld, P.O. Box 10-01-31, Bielefeld 33501, Germany.
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Iñiguez C, Ballester F, Costa O, Murcia M, Souto A, Santa-Marina L, Aurrekoetxea JJ, Espada M, Vrijheid M, Alvarez-Avellón SM, Alvarez-Pedrerol M, Rebagliato M. Maternal smoking during pregnancy and fetal biometry: the INMA Mother and Child Cohort Study. Am J Epidemiol 2013; 178:1067-75. [PMID: 24008909 DOI: 10.1093/aje/kwt085] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In utero tobacco exposure has been associated with fetal growth restriction, but uncertainty remains about critical windows of exposure and specific effects on body segments. In the present study, we aimed to examine the association of maternal smoking with fetal biometry in different stages of pregnancy. The study population comprised 2,478 fetuses from a Spanish birth cohort study that was established between 2003 and 2008. Biparietal diameter, femur length, abdominal circumference, and estimated fetal weight were evaluated at 12, 20, and 34 weeks of gestation. Fetal size and growth were assessed by standard deviation scores adjusted by maternal and fetal characteristics. Maternal smoking was assessed using questionnaire and a sample of urinary cotinine at week 32 of gestation. Associations were estimated using multiple regression analysis. Smokers at week 12 of gestation showed decreased fetal growth as reflected by all growth parameters at 20-34 weeks, leading to a reduced fetal size at week 34. The reduction was greatest in femur length, at -9.4% (95% confidence interval -13.4, -5.4) and least in abdominal circumference, at -4.4% (95% CI: -8.7, -0.1). Fetuses of smokers who quit smoking before week 12 showed reduced growth only in femur length (-5.5; 95% CI: -10.1, -0.9). Dose-response curves for smoking versus fetal growth parameters (abscissa: log2 cotinine) were linear for biparietal diameter and femur length.
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35
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Kumar S, Forand S, Babcock G, Hwang SA. Total Trihalomethanes in Public Drinking Water Supply and Birth Outcomes: A Cross-Sectional Study. Matern Child Health J 2013; 18:996-1006. [DOI: 10.1007/s10995-013-1328-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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36
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A prospective study of prevalence and predictors of concurrent alcohol and tobacco use during pregnancy. Matern Child Health J 2013; 17:76-84. [PMID: 22350683 DOI: 10.1007/s10995-012-0949-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Concurrent drinking and smoking during pregnancy is a major public health concern. Changes in these behaviours are under-researched, although essential if effective interventions are to be implemented. Hence this paper investigated characteristics of women who decreased concurrent drinking and smoking during pregnancy. 1,591 women were identified as pregnant at one of three surveys from 2000 to 2006 of the Australian Longitudinal Study on Women's Health and not pregnant at the previous survey. Relative risks (RRs) were calculated for concurrent drinkers and smokers before pregnancy of (1) decreasing drinking, (2) decreasing smoking and (3) decreasing drinking and smoking during pregnancy. Three hundred and fifty-four women (22%) were concurrent drinkers and smokers before pregnancy; of these women, 73% decreased drinking, 72% decreased smoking and 53% decreased drinking and smoking during pregnancy. Decreased concurrent drinking and smoking was significantly higher among women who had at least 12 years education (RRs: 1.5-1.6), who drank at least 1-2 days/week (RRs: 1.5-1.6) and who had 3 or more drinks per occasion (RRs: 1.6-1.8), and significantly lower among heavy smokers, mothers of other children (RRs: 0.8) and disadvantaged women: those stressed about money, with poor mental health, low social support and experience of partner violence (RRs: 0.6-0.7). Clearly programs are needed to tackle concurrent drinking and smoking during pregnancy. Given many pregnancies are unplanned, these programs should target drinking and smoking before and during pregnancy, as well as disadvantaged women, to reduce the deleterious effects of concurrent substance use on their babies and themselves.
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Cooper DL, Petherick ES, Wright J. The association between binge drinking and birth outcomes: results from the Born in Bradford cohort study. J Epidemiol Community Health 2013; 67:821-8. [PMID: 23729326 DOI: 10.1136/jech-2012-202303] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Various human and animal studies suggest that peak alcohol exposure during a binge episode, rather than total alcohol exposure, may determine fetal development. Research about the impact of binge drinking on birth outcomes is sparse and inconclusive. Data from the Born in Bradford cohort study were used to explore the impact of binge drinking on birth outcomes. METHODS Interview-administered questionnaire data about the lifestyle and social characteristics of 10 851 pregnancies were linked to maternity and birth data. The impact of self-reported binge drinking (5 units: 40 g of pure alcohol) on two birth outcomes (small for gestational age (SGA) and preterm birth (<37 weeks)) was assessed using multivariate logistic regression models, while adjusting for confounders. RESULTS The percentage of women classified as binge drinkers fell from 24.5% before pregnancy to 9% during the first trimester and 3.1% during the second trimester. There was a significant association between SGA birth and binge drinking (all categories combined; OR 1.68, 95% CI 1.15 to 2.47, p=0.01). No association was observed between moderate drinking and either birth outcome, or between binge drinking and preterm birth. CONCLUSIONS Binge drinking during the second trimester of pregnancy was associated with an increased risk of SGA birth. No association was found between any level of alcohol consumption and premature birth. This work supports previous research showing no association between SGA and low-alcohol exposure but adds to evidence of a dose-response relationship with significant risks observed at binge drinking levels.
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Affiliation(s)
- Duncan L Cooper
- Born in Bradford Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, , Bradford, West Yorkshire, UK
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Truong KD, Reifsnider OS, Mayorga ME, Spitler H. Estimated number of preterm births and low birth weight children born in the United States due to maternal binge drinking. Matern Child Health J 2013; 17:677-88. [PMID: 22711260 PMCID: PMC3664940 DOI: 10.1007/s10995-012-1048-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The objective of this study was to estimate the aggregate burden of maternal binge drinking on preterm birth (PTB) and low birth weight (LBW) across American sociodemographic groups in 2008. To estimate the aggregate burden of maternal binge drinking on preterm birth (PTB) and low birth weight (LBW) across American sociodemographic groups in 2008. A simulation model was developed to estimate the number of PTB and LBW cases due to maternal binge drinking. Data inputs for the model included number of births and rates of preterm and LBW from the National Center for Health Statistics; female population by childbearing age groups from the U.S. Census; increased relative risks of preterm and LBW deliveries due to maternal binge drinking extracted from the literature; and adjusted prevalence of binge drinking among pregnant women estimated in a multivariate logistic regression model using Behavioral Risk Factor Surveillance System survey. The most conservative estimates attributed maternal binge drinking to 8,701 (95% CI: 7,804-9,598) PTBs (1.75% of all PTBs) and 5,627 (95% CI 5,121-6,133) LBW deliveries in 2008, with 3,708 (95% CI: 3,375-4,041) cases of both PTB and LBW. The estimated rate of PTB due to maternal binge drinking was 1.57% among all PTBs to White women, 0.69% among Black women, 3.31% among Hispanic women, and 2.35% among other races. Compared to other age groups, women ages 40-44 had the highest adjusted binge drinking rate and highest PTB rate due to maternal binge drinking (4.33%). Maternal binge drinking contributed significantly to PTB and LBW differentially across sociodemographic groups.
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Affiliation(s)
- Khoa D Truong
- Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA.
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Pfinder M, Kunst AE, Feldmann R, van Eijsden M, Vrijkotte TGM. Preterm birth and small for gestational age in relation to alcohol consumption during pregnancy: stronger associations among vulnerable women? Results from two large Western-European studies. BMC Pregnancy Childbirth 2013; 13:49. [PMID: 23433310 PMCID: PMC3607897 DOI: 10.1186/1471-2393-13-49] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 02/14/2013] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Inconsistent data on the association between prenatal alcohol exposure and a range of pregnancy outcomes, such as preterm birth (PTB) and small for gestational age (SGA) raise new questions. This study aimed to assess whether the association between low-moderate prenatal alcohol exposure and PTB and SGA differs according to maternal education, maternal mental distress or maternal smoking. METHODS The Amsterdam Born Children and their Development (ABCD) Study (N = 5,238) and the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) (N = 16,301) are both large studies. Women provide information on alcohol intake in early pregnancy, 3 months postpartum and up to 17 years retrospectively. Multivariate logistic regression analyses and stratified regression analyses were performed to examine the association between prenatal alcohol exposure and PTB and SGA, respectively. RESULTS No association was found between any level of prenatal alcohol exposure (non-daily, daily, non-abstaining) and SGA. The offspring of daily drinkers and non-abstainers had a lower risk of PTB [ABCD: odds ratio (OR) 0.31, 95% confidence interval (CI) 0.13, 0.77; KiGGS: OR 0.75, 95% CI 0.57, 0.99]. Interactions with maternal education, maternal distress or maternal smoking were not significant. CONCLUSIONS Although these results should be interpreted with caution, both studies showed no adverse effects of low-moderate prenatal alcohol exposure on PTB and SGA, not even in the offspring of women who were disadvantaged in terms of low education, high levels of distress, or smoking during pregnancy.
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Affiliation(s)
- Manuela Pfinder
- Bielefeld Graduate School in History and Sociology, Faculty of Sociology, Bielefeld University, PO Box 100131, 33501 Bielefeld, Germany
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- FAS Ambulance, Polyclinic for Children’s and Youth Medicine, University Hospital Munster, Albert-Schweitzer-Straße 33, 48129 Munster, Germany
| | - Anton E Kunst
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Reinhold Feldmann
- FAS Ambulance, Polyclinic for Children’s and Youth Medicine, University Hospital Munster, Albert-Schweitzer-Straße 33, 48129 Munster, Germany
| | - Manon van Eijsden
- Department of Epidemiology, Documentation and Health Promotion, Public Health Service of Amsterdam (GGD), Nieuwe Achtergracht 100, 1018 WT Amsterdam, PO Box 22001000 CE, Amsterdam, The Netherlands
- Department of Health Sciences, VU University, De Boelelaan 1085, 1081 HV, Amsterdam,The Netherlands
| | - Tanja G M Vrijkotte
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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Bosco C, Diaz E. Placental Hypoxia and Foetal Development Versus Alcohol Exposure in Pregnancy. Alcohol Alcohol 2012; 47:109-17. [DOI: 10.1093/alcalc/agr166] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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Silva ID, Quevedo LDA, Silva RAD, Oliveira SSD, Pinheiro RT. Associação entre abuso de álcool durante a gestação e o peso ao nascer. Rev Saude Publica 2011; 45:864-9. [DOI: 10.1590/s0034-89102011005000062] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2010] [Accepted: 04/06/2011] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO: Analisar a associação entre abuso de álcool durante a gestação e baixo peso ao nascer. MÉTODOS: Estudo transversal de base populacional aninhado a uma coorte de 957 gestantes que realizaram acompanhamento pré-natal no Sistema Único de Saúde da cidade de Pelotas, RS, e deram à luz entre setembro de 2007 e setembro de 2008. As mães foram entrevistadas em dois momentos distintos: no período de pré-parto e após o parto. Para verificar o abuso do álcool foi utilizada a escala Cut down, Annoyed by criticism, Guilty and Eye-opener. Foram realizadas análises bivariadas e regressão logística múltipla, ajustada pelas variáveis prematuridade e abuso de álcool. O nível de significância adotado foi de 95%. RESULTADOS: Das mulheres que participaram do estudo, 2,1% abusaram de álcool na gestação e, entre essas, 26,3% tiveram filhos com baixo peso. Houve associação entre o abuso de álcool e baixo peso ao nascer (p < 0,038). CONCLUSÕES: Os achados indicam que o abuso de álcool durante a gestação está associado ao baixo peso ao nascer.
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O'LEARY COLLEENM, BOWER CAROL. Guidelines for pregnancy: What's an acceptable risk, and how is the evidence (finally) shaping up? Drug Alcohol Rev 2011; 31:170-83. [DOI: 10.1111/j.1465-3362.2011.00331.x] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Aliyu MH, Lynch O, Nana PN, Alio AP, Wilson RE, Marty PJ, Zoorob R, Salihu HM. Alcohol consumption during pregnancy and risk of placental abruption and placenta previa. Matern Child Health J 2011; 15:670-6. [PMID: 20437196 DOI: 10.1007/s10995-010-0615-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The purpose of this study was to examine the association between prenatal alcohol consumption and the occurrence of placental abruption and placenta previa in a population-based sample. We used linked birth data files to conduct a retrospective cohort study of singleton deliveries in the state of Missouri during the period 1989 through 2005 (n = 1,221,310). The main outcomes of interest were placenta previa, placental abruption and a composite outcome defined as the occurrence of either or both lesions. Multivariate logistic regression was used to generate adjusted odd ratios, with non-drinking mothers as the referent category. Women who consumed alcohol during pregnancy had a 33% greater likelihood for placental abruption during pregnancy (adjusted odds ratio (OR), 95% confidence interval (CI) = 1.33 [1.16-1.54]). No association was observed between prenatal alcohol use and the risk of placenta previa. Alcohol consumption in pregnancy was positively related to the occurrence of either or both placental conditions (adjusted OR [95% CI] = 1.29 [1.14-1.45]). Mothers who consumed alcohol during pregnancy were at elevated risk of experiencing placental abruption, but not placenta previa. Our findings underscore the need for screening and behavioral counseling interventions to combat alcohol use by pregnant women and women of childbearing age.
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Affiliation(s)
- Muktar H Aliyu
- Department of Preventive Medicine, Institute for Global Health, Vanderbilt University, Nashville, TN, USA
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Profile of nucleotide catabolism and ectonucleotidase expression from the hippocampi of neonatal rats after caffeine exposure. Neurochem Res 2011; 37:23-30. [PMID: 21842269 DOI: 10.1007/s11064-011-0577-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Revised: 07/18/2011] [Accepted: 08/04/2011] [Indexed: 10/17/2022]
Abstract
Nucleotides and nucleosides play an important role in neurodevelopment acting through specific receptors. Ectonucleotidases are the major enzymes involved in controlling the availability of purinergic receptors ligands. ATP is co-released with several neurotransmitters and is the most important source of extracellular adenosine by catabolism exerted by ectonucleotidases. The main ectonucleotidases are named NTPDases (1-8) and 5'-nucleotidase. Adenosine is a powerful modulator of neurotransmitter release. Caffeine blocks adenosine receptor activity as well as adenosine-mediated neuromodulation. Considering the susceptibility of the immature brain to caffeine and the need for correct purinergic signaling during fetal development, we have analyzed the effects of caffeine exposure during gestational and lactational periods on nucleotide degradation and ectonucleotidase expression from the hippocampi of 7-, 14- and 21-days-old rats. Nucleotides hydrolysis was assessed by colorimetric determination of inorganic phosphate released. Ectonucleotidases expression was performed by RT-PCR. ATP and ADP hydrolysis displayed parallel age-dependent decreases in both control and caffeine-treated groups. AMP hydrolysis increased with caffeine treatment in 7-days-old rats (75%); although there was no significant difference in AMP hydrolysis between control (non caffeine-treated) rats and 14- or 21-days caffeine-treated rats. ADP hydrolysis was not affected by caffeine treatment. Caffeine treatment in 7- and 14-days-old rats decreased ATP hydrolysis when compared to the control group (19% and 60% decrease, respectively), but 21-days-treated rats showed an increase in ATP hydrolysis (39%). Expression levels of NTPDase 1 and 5 decreased in hippocampi of caffeine-treated rats. The expression of 5'-nucleotidase was not affected after caffeine exposure. The changes observed in nucleotide hydrolysis and ectonucleotidases expression could promote subtle effects on normal neural development considering the neuromodulatory role of adenosine.
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Hammiche F, Laven JSE, van Mil N, de Cock M, de Vries JH, Lindemans J, Steegers EAP, Steegers-Theunissen RPM. Tailored preconceptional dietary and lifestyle counselling in a tertiary outpatient clinic in the Netherlands. Hum Reprod 2011; 26:2432-41. [DOI: 10.1093/humrep/der225] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Salihu HM, Kornosky JL, Lynch O, Alio AP, August EM, Marty PJ. Impact of prenatal alcohol consumption on placenta-associated syndromes. Alcohol 2011; 45:73-9. [PMID: 20598485 DOI: 10.1016/j.alcohol.2010.05.010] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2009] [Revised: 05/21/2010] [Accepted: 05/22/2010] [Indexed: 12/13/2022]
Abstract
The biology of placental and fetal development suggests that alcohol may play a significant role in increasing the risk of feto-infant morbidity and mortality, but study results are inconsistent and the mechanism remains poorly defined. Previous studies have not examined the risk of placenta-associated syndromes (PASs: defined as the occurrence of either placental abruption, placenta previa, preeclampsia, small for gestational age, preterm, or stillbirth) as a unique entity. Therefore, we sought to examine the relationship between prenatal alcohol use and the risk of PAS among singleton births in the Missouri maternally linked data files covering the period 1989-2005. Logistic regression with adjustment for intracluster correlation was used to generate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Compared with nondrinkers, drinkers were more likely to be smokers, 35 years of age or older, black, and multiparous. Drinkers had an increased risk of PAS (OR=1.26, 95% CI=1.22,1.31) when compared with their nondrinking counterparts. The risk of PAS was progressively amplified with increasing prenatal alcohol consumption (P for trend <.01). Women who reported consuming five or more alcoholic drinks per week had more than twofold increased risk of PASs, whereas women in the lowest drinking category (one to two drinks per week) had only a slight increased risk of PAS (OR=1.09, 95% CI=1.05, 1.14). Enhanced understanding of the mechanism by which prenatal alcohol consumption leads to PAS may aid in the development of more targeted interventions designed to prevent adverse pregnancy outcomes. Screening women for alcohol use may assist providers in protecting developing fetuses from the potential dangers of prenatal alcohol use.
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Conde A, Figueiredo B, Tendais I, Teixeira C, Costa R, Pacheco A, Rodrigues MC, Nogueira R. Mother's anxiety and depression and associated risk factors during early pregnancy: effects on fetal growth and activity at 20-22 weeks of gestation. J Psychosom Obstet Gynaecol 2010; 31:70-82. [PMID: 20236029 DOI: 10.3109/01674821003681464] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
To examine effects of mother's anxiety and depression and associated risk factors during early pregnancy on fetal growth and activity. Repeated measures of mother's anxiety (State-Anxiety Inventory (STAI-S)) and depression (Edinburgh Postnatal Depression Scale (EPDS)) and related socio demographics and substance consumption were obtained at the 1st and 2nd pregnancy trimesters, and fetus' (N = 147) biometric data and behavior was recorded during ultrasound examination at 20-22 weeks of gestation. Higher anxiety symptoms were associated to both lower fetal growth and higher fetal activity. While lower education, primiparity, adolescent motherhood, and tobacco consumption predicted lower fetal growth, coffee intake predicted lower fetal activity. Vulnerability of fetal development to mother's psychological symptoms as well as to other sociodemographic and substance consumption risk factors during early and mid pregnancy is suggested.
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Affiliation(s)
- Ana Conde
- School of Psychology, University of Minho, Braga, Portugal
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Differentiating prenatal exposure to methamphetamine and alcohol versus alcohol and not methamphetamine using tensor-based brain morphometry and discriminant analysis. J Neurosci 2010; 30:3876-85. [PMID: 20237258 DOI: 10.1523/jneurosci.4967-09.2010] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Here we investigate the effects of prenatal exposure to methamphetamine (MA) on local brain volume using magnetic resonance imaging. Because many who use MA during pregnancy also use alcohol, a known teratogen, we examined whether local brain volumes differed among 61 children (ages 5-15 years), 21 with prenatal MA exposure, 18 with concomitant prenatal alcohol exposure (the MAA group), 13 with heavy prenatal alcohol but not MA exposure (ALC group), and 27 unexposed controls. Volume reductions were observed in both exposure groups relative to controls in striatal and thalamic regions bilaterally and in right prefrontal and left occipitoparietal cortices. Striatal volume reductions were more severe in the MAA group than in the ALC group, and, within the MAA group, a negative correlation between full-scale intelligence quotient (FSIQ) scores and caudate volume was observed. Limbic structures, including the anterior and posterior cingulate, the inferior frontal gyrus (IFG), and ventral and lateral temporal lobes bilaterally, were increased in volume in both exposure groups. Furthermore, cingulate and right IFG volume increases were more pronounced in the MAA than ALC group. Discriminant function analyses using local volume measurements and FSIQ were used to predict group membership, yielding factor scores that correctly classified 72% of participants in jackknife analyses. These findings suggest that striatal and limbic structures, known to be sites of neurotoxicity in adult MA abusers, may be more vulnerable to prenatal MA exposure than alcohol exposure and that more severe striatal damage is associated with more severe cognitive deficit.
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Aliyu MH, Lynch O, Belogolovkin V, Zoorob R, Salihu HM. Maternal alcohol use and medically indicated vs. spontaneous preterm birth outcomes: a population-based study. Eur J Public Health 2010; 20:582-7. [DOI: 10.1093/eurpub/ckq036] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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