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Das U, Thomas JD, Tarale P, Soja J, Inkelis S, Chambers C, Sarkar DK. Altered circadian expression of clock genes and clock-regulatory epigenetic modifiers in saliva of children with fetal alcohol spectrum disorders. Sci Rep 2024; 14:19886. [PMID: 39191924 DOI: 10.1038/s41598-024-71023-z] [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: 05/29/2024] [Accepted: 08/23/2024] [Indexed: 08/29/2024] Open
Abstract
Prenatal alcohol-exposed (AE) infants and children often demonstrate disrupted sleep patterns, including more frequent awakenings, reduced total sleep time, and more night-to-night sleep variability. Despite the strong connection between sleep patterns and circadian rhythmicity, relatively little is known about circadian rhythm disruptions in individuals with AE. Recently, several reports demonstrated that evaluating the expression patterns of human clock genes in biological fluids could reveal an individual's circadian phenotype. Human saliva offers an emerging and easily available physiological sample that can be collected non-invasively for core-clock gene transcript analyses. We compared the expression patterns of core-clock genes and their regulatory genes in salivary samples of children aged 6-10 years-old with and without AE during the light cycle between ZT0-ZT11. We isolated the RNA from the samples and measured the expression patterns of core clock genes and clock regulating genes using the human specific primers with quantitative real-time PCR. Analysis of core clock genes expression levels in saliva samples from AE children indicates significantly altered levels in expression of core-clock BMAL1, CLOCK, PER1-3 and CRY1,2, as compared to those in age-matched control children. We did not find any sex difference in levels of clock genes in AE and control groups. Cosinor analysis was used to evaluate the rhythmic pattern of these clock genes, which identified circadian patterns in the levels of core clock genes in the control group but absent in the AE group. The gene expression profile of a salivary circadian biomarker ARRB1 was rhythmic in saliva of control children but was arhythmic in AE children. Altered expression patterns were also observed in clock regulatory genes: NPAS2, NFL3, NR1D1, DEC1, DEC2, and DBP, as well as chromatin modifiers: MLL1, P300, SIRT1, EZH2, HDAC3, and ZR1D1, known to maintain rhythmic expression of core-clock genes. Overall, these findings provide the first evidence that AE disturbs the circadian patten expression of core clock genes and clock-regulatory chromatin modifiers in saliva.
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Affiliation(s)
- Ujjal Das
- The Endocrine Program, Department of Animal Sciences, Rutgers, The State University of New Jersey, 67 Poultry Farm Lane, New Brunswick, NJ, USA
| | - Jennifer D Thomas
- Department of Psychology, College of Sciences, San Diego State University, San Diego, CA, USA
| | - Prashant Tarale
- The Endocrine Program, Department of Animal Sciences, Rutgers, The State University of New Jersey, 67 Poultry Farm Lane, New Brunswick, NJ, USA
| | - Jackie Soja
- Department of Psychology, College of Sciences, San Diego State University, San Diego, CA, USA
| | - Sarah Inkelis
- Department of Psychology, College of Sciences, San Diego State University, San Diego, CA, USA
| | - Christina Chambers
- Department of Pediatrics at University of California at San Diego, and Rady Children's Hospital, San Diego, CA, USA
| | - Dipak K Sarkar
- The Endocrine Program, Department of Animal Sciences, Rutgers, The State University of New Jersey, 67 Poultry Farm Lane, New Brunswick, NJ, USA.
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Maher BS, Bitsko RH, Claussen AH, O'Masta B, Cerles A, Holbrook JR, Mahmooth Z, Chen-Bowers N, Rojo ALA, Kaminski JW, Rush M. Systematic Review and Meta-analysis of the Relationship Between Exposure to Parental Substance Use and Attention-Deficit/Hyperactivity Disorder in Children. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:291-315. [PMID: 37976008 PMCID: PMC11098969 DOI: 10.1007/s11121-023-01605-2] [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] [Accepted: 10/17/2023] [Indexed: 11/19/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is characterized by persistent patterns of inattention, hyperactivity, and impulsiveness. Among US children and adolescents aged 3-17 years, 9.4% have a diagnosis of ADHD. Previous research suggests possible links between parental substance use and ADHD among children. We conducted a systematic review and meta-analysis of 86 longitudinal or retrospective studies of prenatal or postnatal alcohol, tobacco, or other parental substance use and substance use disorders and childhood ADHD and its related behavioral dimensions of inattention and hyperactivity-impulsivity. Meta-analyses were grouped by drug class and pre- and postnatal periods with combined sample sizes ranging from 789 to 135,732. Prenatal exposure to alcohol or tobacco and parent substance use disorders were consistently and significantly associated with ADHD among children. Other parental drug use exposures resulted in inconsistent or non-significant findings. Prevention and treatment of parental substance use may have potential for impacts on childhood ADHD.
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Affiliation(s)
- Brion S Maher
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rebecca H Bitsko
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Angelika H Claussen
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Joseph R Holbrook
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Naomi Chen-Bowers
- Office Policy, Performance, and Evaluation, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop: H 21-11, Atlanta, GA, 30329, USA
| | | | - Jennifer W Kaminski
- Office Policy, Performance, and Evaluation, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop: H 21-11, Atlanta, GA, 30329, USA.
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Chu JTW, McCormack J, Jiang Y, Walsh D, Wilson H, Marsh S, Langridge F, Bullen C. Investigating the relationship between prenatal alcohol exposure and children's behavioural and emotional development: analysis of the Growing Up in New Zealand study. Alcohol Alcohol 2024; 59:agae029. [PMID: 38678371 PMCID: PMC11055961 DOI: 10.1093/alcalc/agae029] [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: 04/18/2023] [Revised: 03/19/2024] [Accepted: 04/07/2024] [Indexed: 04/29/2024] Open
Abstract
AIMS To examine the relationship between prenatal alcohol exposure (PAE) and children's behavioural and emotional development in a large generalizable sample of women and their children in Aotearoa New Zealand. METHODS Using data from the Growing Up in New Zealand longitudinal cohort, we investigated the relationship between maternal PAE and behavioural and emotional development in 8-year-old children. We explored secondary outcomes including measures of language, executive function, academic achievement, and adaptive behaviour. RESULTS We found no significant differences in the measures of behavioural and emotional development in children 8 years old based on alcohol consumption. No significant differences in behavioural and emotional development were found based on amount of PAE and when PAE occurred, despite controlling for a range of potential confounding factors, such as neighbourhood deprivation and maternal health measures. PAE was associated with significantly higher scores for parent-rated oral language indicating better oral language. In Māori mothers, PAE was significantly associated with an increased risk of higher scores on two of the Strengths and Difficulties Questionnaire subscales. CONCLUSIONS We did not find an association between PAE and behavioural and emotional development in children aged 8 years. PAE and behavioural and emotional development are difficult to measure accurately, and the moderating variables between them are complex. Future analyses will require larger cohorts of mothers and their children using precise measures of PAE and outcomes to enable more precise estimates of association.
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Affiliation(s)
- Joanna Ting Wai Chu
- Social and Community Health, School of Population Health, The University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland 1142, New Zealand
- Centre for Arts and Social Transformation, Faculty of Arts and Social Work, The University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland 1142, New ZealandNew Zealand
| | - Jessica McCormack
- Food Science, University of Otago, PO Box 56, Dunedin 9054, New Zealand
| | - Yannan Jiang
- Social and Community Health, School of Population Health, The University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland 1142, New Zealand
| | - Daniel Walsh
- Statistics, Faculty of Science, The University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland 1142, New Zealand
| | - Holly Wilson
- Social and Community Health, School of Population Health, The University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland 1142, New Zealand
| | - Samantha Marsh
- Social and Community Health, School of Population Health, The University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland 1142, New Zealand
| | - Fiona Langridge
- Department of Paediatrics, Child and Youth Health, The University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland 1142, New Zealand
| | - Chris Bullen
- National Institute for Health Innovation, School of Population Health, The University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland 1142, New Zealand
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Pruner M, Jirikowic T, Baylor C, Astley Hemingway S. Concerns and Strengths: Caregiver Perceptions of Their Infant/Toddler with Prenatal Alcohol Exposure. CHILDREN (BASEL, SWITZERLAND) 2023; 10:544. [PMID: 36980102 PMCID: PMC10047822 DOI: 10.3390/children10030544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/14/2023]
Abstract
Caregiver-reported assessments provide opportunities for caregivers to share concerns and identify the strengths of their infant/toddler regarding prenatal alcohol exposure (PAE). These insights may reveal under-recognized concerns and inform a strengths-based approach to early intervention. The purpose of this study was to describe the type and frequency of caregiver-reported concerns and strengths in a sample of infants/toddlers at the time of their fetal alcohol spectrum disorder (FASD) diagnostic evaluation. Caregivers' concerns and strengths were identified in the context of two parent-report questionnaires, the Infant Toddler Sensory Profile and Child Behavior Checklist/1½-5. By using content analysis, caregivers' open-ended responses were identified, coded, and analyzed. The frequencies of all the coded concerns and strengths were counted. The data were compared across the two age groups (<2 years and ≥2 years) and caregiver status. Caregivers (n = 117) identified numerous concerns and strengths across multiple categories. The most frequently reported concerns were related to aggressive behavior, language/communication, and sensory processing. The most frequently reported strengths were related to happiness, sociability, and love. The type of concerns and strengths reported were relatively consistent across age and caregiver status. These findings reinforce the value of caregivers' perspectives and offer a reminder to practitioners that infants/toddlers with PAE and their caregivers have many strengths that can be harnessed, in addition to a range of challenges that must be addressed.
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Affiliation(s)
- Misty Pruner
- Center on Human Development and Disability, University of Washington, Seattle, WA 98195, USA
| | - Tracy Jirikowic
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA 98195, USA
| | - Carolyn Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA 98195, USA
| | - Susan Astley Hemingway
- Department of Epidemiology, Department of Pediatrics, University of Washington, Seattle, WA 98195, USA
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Chu JTW, McCormack J, Marsh S, Wells A, Wilson H, Bullen C. Impact of prenatal alcohol exposure on neurodevelopmental outcomes: a systematic review. Health Psychol Behav Med 2022; 10:973-1002. [PMID: 36238426 PMCID: PMC9553152 DOI: 10.1080/21642850.2022.2129653] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 09/20/2022] [Indexed: 11/04/2022] Open
Abstract
Background Prenatal exposure to alcohol (PAE) represents a significant public health concern. Previous research linking PAE to neurodevelopmental outcomes has been mixed and often has limited focus on residual confounding or moderating factors. Methods A systematic review of prospective cohort studies (n = >1000) assessing the impact of PAE on neurodevelopmental outcomes was undertaken (neurophysiology, motor skills, cognition, language, academic achievement, memory, attention, executive function, affect regulation, and adaptive behaviour, social skills, or communication). Electronic searches of EMBASE, Medline, CINAHL, and Psychinfo were conducted in May 2021. A quality assessment was conducted using an adapted version of the Newcastle-Ottawa Scale (NOS). Results Thirty longitudinal cohort studies met the inclusion criteria. Evidence of the impact of PAE was mixed across domains. We found no evidence that PAE affects executive function, but there were impacts on motor skills, cognition, language, academic achievement, attention, affect regulation, and adaptive behaviour. The most consistent adverse effect was on affect regulation (nine out of thirteen studies, six of which found an association between heavy alcohol consumption or binge drinking during pregnancy). We found no protective factors. Few studies controlled for variables in the postnatal environment. Discussion This review was unable to conclude a safe level of alcohol consumption during pregnancy. Methodological improvements are needed to improve the quality and consistency in which PAE is studied. Further research into residual confounding variables is vital, including a greater focus on the postpartum environment.
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Affiliation(s)
- Joanna Ting Wai Chu
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Jessica McCormack
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Samantha Marsh
- Social and Community Health, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Alesha Wells
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Holly Wilson
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Chris Bullen
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
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Asp J, Bergman L, Lager S, Axelsson O, Wikström A, Hesselman S. Alcohol exposure prior to pregnancy-does hazardous consumption affect placenta- and inflammatory-mediated pregnancy outcomes? A Swedish population-based cohort study. Acta Obstet Gynecol Scand 2022; 101:1386-1394. [PMID: 36073360 PMCID: PMC9812091 DOI: 10.1111/aogs.14451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 07/14/2022] [Accepted: 08/24/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Alcohol consumption during pregnancy is related to severe birth complications such as low birthweight, preterm birth and birth defects. During the last decade, the Alcohol Use Disorders Identification Test (AUDIT) has been used as a screening tool in Swedish maternal healthcare units to identify hazardous, pre-pregnancy alcohol use. However, evaluation of the screening with AUDIT, as well as adverse maternal or neonatal outcomes, has not been assessed at a national level. MATERIAL AND METHODS This was a population-based cohort study of 530 458 births from 2013 to 2018 using demographic, reproductive and maternal health data from the Swedish Pregnancy Register. Self-reported alcohol consumption in the year before pregnancy, measured as AUDIT scores, was categorized into moderate (6-13 points) and high-risk (14-40 points) consumption, with low-risk (0-5 points) consumption as the reference group. Associations with pregnancy- and birth outcomes were explored with logistic regressions using generalized estimating equation models, adjusting for maternal and socioeconomic characteristics. Estimates are presented as adjusted odds ratios (aORs) with 95% confidence intervals (CIs). RESULTS High-risk and moderate pre-pregnancy alcohol consumption was associated with preeclampsia, preterm birth and birth of an infant small for gestational age (SGA), but these associations were nonsignificant after adjustments. Prior moderate-risk (aOR 1.29, 95% CI 1.17-1.42) and high-risk consumption (aOR 1.62, 95% CI 1.17-2.25) increased the likelihood of intrapartum and neonatal infections. CONCLUSIONS Apart from identifying hazardous alcohol consumption prior to pregnancy and the offer of counseling, screening with the AUDIT in early pregnancy indicates a high risk of inflammatory-/placenta-mediated pregnancy and birth outcomes. For most outcomes, AUDIT was not an independent contributor when adjusting for confounding factors. Hazardous alcohol use prior to pregnancy was independently linked to intrapartum and neonatal infections; conditions associated with morbidity and long-term sequalae. These associations may be explained by alcohol-induced changes in the maternal or fetal immune system in early pregnancy or persistent alcohol intake during pregnancy, or may depend on unidentified confounding factors.
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Affiliation(s)
- Joline Asp
- Center for Clinical Research SörmlandUppsala UniversityEskilstunaSweden,Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - Lina Bergman
- Department of Women's and Children's HealthUppsala UniversityUppsalaSweden,Department of Obstetrics and GynecologyInstitute of Clinical Science, Sahlgrenska Academy, University of GothenburgGothenburgSweden,Department of Obstetrics and GynecologyStellenbosch UniversityStellenboschSouth Africa
| | - Susanne Lager
- Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - Ove Axelsson
- Center for Clinical Research SörmlandUppsala UniversityEskilstunaSweden,Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | | | - Susanne Hesselman
- Department of Women's and Children's HealthUppsala UniversityUppsalaSweden,Center for Clinical Research DalarnaFalunSweden
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Kautz-Turnbull C, Petrenko CLM. A meta-analytic review of adaptive functioning in fetal alcohol spectrum disorders, and the effect of IQ, executive functioning, and age. Alcohol Clin Exp Res 2021; 45:2430-2447. [PMID: 34694016 DOI: 10.1111/acer.14728] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/16/2021] [Accepted: 10/19/2021] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Fetal alcohol spectrum disorders (FASD) are highly prevalent developmental disabilities associated with prenatal alcohol exposure. In addition to varied strengths and unique talents, people with FASD experience significant challenges, including in adaptive functioning. Adaptive functioning refers to skills related to everyday life such as communication, practical skills, and social skills. For the current review, we aimed to understand how adaptive functioning in FASD compares to that of alcohol nonexposed individuals and those with attention deficit-hyperactivity disorder (ADHD). Additionally, we investigated how this relationship may change based on IQ, executive functioning, and age. METHOD The current review was registered in the International Prospective Register of Systematic Reviews. Studies were eligible for inclusion if they measured adaptive functioning and included an FASD group and at least one eligible comparison group. Articles available in May 2021 in PubMed, PsycInfo, Scopus, and ProQuest Dissertations were searched. Publication bias was assessed using Egger's regression and three-level random effects models were computed for all domains of adaptive functioning. Possible moderation by IQ, executive functioning, and age were investigated when heterogeneity analyses were significant. A post hoc moderation analysis of recruitment method was also completed. RESULTS Thirty studies were included. Individuals with FASD had significantly lower adaptive functioning than other groups, with effect sizes ranging from 1.04 to 1.35 compared to alcohol nonexposed groups and from 0.30 to 0.43 compared to ADHD groups. No significant moderating effects were found for IQ or age; executive functioning significantly moderated communication skills in FASD compared to the alcohol nonexposed group. Recruitment method significantly affected this relationship, with larger effect sizes on average found for clinically identified samples than at-risk or population samples. CONCLUSIONS Individuals with FASD have impairments in adaptive functioning relative to alcohol nonexposed and ADHD groups, regardless of IQ, executive functioning, or age. Limitations of the review include small sample sizes in some comparisons and a limited age range.
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Ward N, Correia H, McBride N. Maternal psycho-social risk factors associated with maternal alcohol consumption and Fetal Alcohol Spectrum Disorder: a systematic review. Arch Gynecol Obstet 2021; 304:1399-1407. [PMID: 34468822 DOI: 10.1007/s00404-021-06206-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 08/23/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Fetal Alcohol Spectrum Disorder (FASD) is a preventable range of neurocognitive disorders associated with the biological mother's consumption of alcohol during pregnancy. However, on average, 45% of Australian women continue to consume alcohol during pregnancy resulting in a high rate of alcohol-exposed pregnancies and risk of FASD. This level of exposure is higher than the estimated global average of alcohol-exposed pregnancies (9.8%). This systematic literature review aims to identify demographic, health and psycho-social variables associated with alcohol consumption during pregnancy which may lead to FASD. METHODS Using PRISMA principles, this systematic literature review reports on psycho-social factors which increase the risk of alcohol consumption during pregnancy thereby increasing the risk of FASD. RESULTS Fourteen studies were accepted into this review. Studies were conducted across several countries and included a total of 386,067 cases. Seven studies were case-controlled and seven were cross-sectional design. Multiple studies identified the significance of prior mental illness, anxiety, depression, exposure to abuse and/or domestic violence and alcohol consumption behaviours of partners and family members as strong predictors of risky alcohol consumption during pregnancy and therefore associated risk of FASD. CONCLUSION Clinical services may be able to use the evidence-based findings from this review to improve assessment and treatment services for vulnerable women to reduce alcohol-exposed pregnancies.
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Affiliation(s)
- Naomi Ward
- School of Psychology and Exercise Sciences, Murdoch University, Perth, WA, Australia
| | - Helen Correia
- School of Psychology and Exercise Sciences, Murdoch University, Perth, WA, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, WA, Australia.
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Schaidhauer FG, Caetano HA, da Silva GP, da Silva RS. Contributions of Zebrafish Studies on the Behavioural Consequences of Early Alcohol Exposure: A Systematic Review. Curr Neuropharmacol 2021; 20:579-593. [PMID: 33913405 DOI: 10.2174/1570159x19666210428114317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/17/2021] [Accepted: 04/22/2021] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND The consequences of mild to severe exposure to alcohol during brain development is still a matter of debate and scientific investigation. The long-term behavioural effects of ethanol exposure have been related to impaired social skills and cognition. Zebrafish have become a suitable animal model to investigate the effects of early ethanol exposure because it is very feasible to promote drug delivery during early development. OBJECTIVE The goal of the current report is to review existing behavioural studies addressing the impact of early alcohol exposure using zebrafish to determine whether these models resemble the behavioural effects of early alcohol exposure in humans. METHODS A comprehensive search of biomedical databases was performed using the operation order: "ZEBRAFISH AND BEHAV* AND (ETHANOL OR ALCOHOL)". The eligibility of studies was determined using the PICOS strategy, contemplating the population as zebrafish, intervention as exposure to ethanol, comparison with a non-exposed control animal, and outcomes as behavioural parameters. RESULTS The systematic search returned 29 scientific articles as eligible. The zebrafish is presented as a versatile animal model that is useful to study FASD short and long-term behaviour impairments, such as anxiety, impaired sociability, aggressiveness, learning problems, memory impairment, seizure susceptibility, sleep disorders, motivational problems, and addiction. CONCLUSION This systematic review serves to further promote the use of zebrafish as a model system to study the pathophysiological and behavioural consequences of early alcohol exposure.
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Affiliation(s)
- Flávia Gheller Schaidhauer
- Laboratório de Neuroquímica e Psicofarmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Higor Arruda Caetano
- Laboratório de Neuroquímica e Psicofarmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Guilherme Pietro da Silva
- Laboratório de Neuroquímica e Psicofarmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rosane Souza da Silva
- Laboratório de Neuroquímica e Psicofarmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Finanger T, Spigset O, Gråwe RW, Andreassen TN, Løkken TN, Aamo TO, Bratt GE, Tømmervik K, Langaas VS, Finserås K, Salvesen KÅB, Skråstad RB. Phosphatidylethanol as Blood Biomarker of Alcohol Consumption in Early Pregnancy: An Observational Study in 4,067 Pregnant Women. Alcohol Clin Exp Res 2021; 45:886-892. [PMID: 33586791 DOI: 10.1111/acer.14577] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 02/08/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND The teratogenic effects of alcohol are well documented, but there is a lack of screening methods to detect alcohol use during pregnancy. Phosphatidylethanol 16:0/18:1 (PEth) is a specific and sensitive biomarker reflecting alcohol intake up to several weeks after consumption. The aim of this study was to investigate the prevalence of positive PEth values as an indicator of early prenatal alcohol exposure in a general population of pregnant women. METHODS Rhesus typing is routinely performed in Norway in all pregnancies around gestational week 12. Rhesus-negative women have an additional test taken around week 24. Blood samples submitted to St. Olav University Hospital in Trøndelag, Norway, for Rhesus typing during the period September 2017 to October 2018 were collected. A total of 4,533 whole blood samples from 4,067 women were analyzed for PEth (limit of quantification of 0.003 µM). RESULTS Fifty-eight women had a positive PEth sample. Of these, 50 women were positive around gestational week 12, 3 women were positive around week 24, and in 5 cases, the timing was unknown. There were no significant differences in proportions of women with positive PEth values related to age, or rural versus urban residency. CONCLUSION In an unselected pregnant population in Norway, 1.4% had a positive PEth sample around gestational week 12, whereas 0.4% had a positive sample around week 24. The use of PEth as an alcohol biomarker should be further investigated as a diagnostic tool in the antenatal setting.
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Affiliation(s)
- Trine Finanger
- Clinic of Substance Use and Addiction Medicine, St. Olav University Hospital, Trondheim, Norway.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology - NTNU, Trondheim, Norway
| | - Olav Spigset
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology - NTNU, Trondheim, Norway.,Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway
| | - Rolf W Gråwe
- Department of Research and Development, Division of Mental Health, St. Olav University Hospital, Trondheim, Norway.,Department of Mental Health, Norwegian University of Science and Technology - NTNU, Trondheim, Norway
| | - Trine N Andreassen
- Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway
| | - Trine N Løkken
- Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway
| | - Trond O Aamo
- Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway
| | - Guro E Bratt
- Clinic of Laboratory Medicine, St. Olav University Hospital, Trondheim, Norway
| | - Kristin Tømmervik
- Clinic of Substance Use and Addiction Medicine, St. Olav University Hospital, Trondheim, Norway
| | - Vibeke S Langaas
- Department of Immunology and Transfusion Medicine, St. Olav University Hospital, Trondheim, Norway
| | - Kristin Finserås
- Department of Immunology and Transfusion Medicine, St. Olav University Hospital, Trondheim, Norway
| | - Kjell Å B Salvesen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology - NTNU, Trondheim, Norway.,Department of Obstetrics and Gynecology, St. Olav University Hospital, Trondheim, Norway
| | - Ragnhild B Skråstad
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology - NTNU, Trondheim, Norway.,Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway
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Candelaria-Cook FT, Schendel ME, Flynn L, Hill DE, Stephen JM. Altered Resting-State Neural Oscillations and Spectral Power in Children with Fetal Alcohol Spectrum Disorder. Alcohol Clin Exp Res 2020; 45:117-130. [PMID: 33164218 DOI: 10.1111/acer.14502] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 09/16/2020] [Accepted: 10/27/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Consumption of alcohol during pregnancy impacts fetal development and may lead to a variety of physical, cognitive, and behavioral abnormalities in childhood collectively known as fetal alcohol spectrum disorder (FASD). The FASD spectrum includes children with fetal alcohol syndrome (FAS), partial fetal alcohol syndrome (pFAS), and alcohol-related neurodevelopmental disorder (ARND). Children with a FASD or prenatal alcohol exposure (PAE) have impaired white matter, reduced structural volumes, impaired resting-state functional connectivity when measured with fMRI, and spectral hypersynchrony as infants. Magnetoencephalography (MEG) provides high temporal resolution and good spatial precision for examining spectral power and connectivity patterns unique from fMRI. The impact of PAE on MEG resting-state spectral power in children remains unknown. METHODS We collected 2 minutes of eyes-open and eyes-closed resting-state data in 51 children (8 to 12 years of age) with 3 subgroups included: 10 ARND/PAE, 15 FAS/pFAS, and 26 controls (TDC). MEG data were collected on the Elekta Neuromag system. The following spectral metrics were compared between subgroups: power, normalized power, half power, 95% power, and Shannon spectral entropy (SSE). MEG spectral data were correlated with behavioral measures. RESULTS Our results indicate children with FAS/pFAS had reduced spectral power and normalized power, particularly within the alpha frequency band in sensor parietal and source superior parietal and lateral occipital regions, along with elevated half power, 95% power, and SSE. We also found select hemisphere specific effects further indicating reduced corpus callosum connectivity in children with a FASD. Interestingly, while the ARND/PAE subgroup had significant differences from the FAS/pFAS subgroup, in many cases spectral data were not significantly different from TDC. CONCLUSIONS Our results were consistent with previous studies and provide new insight into resting-state oscillatory differences both between children with FAS and TDC, and within FASD subgroups. Further understanding of these resting-state variations and their impact on cognitive function may help provide early targets for intervention and enhance outcomes for individuals with a FASD.
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Affiliation(s)
| | - Megan E Schendel
- From the, The Mind Research Network, (FTC, MES, LF, JMS), Albuquerque, New Mexico, USA
| | - Lucinda Flynn
- From the, The Mind Research Network, (FTC, MES, LF, JMS), Albuquerque, New Mexico, USA
| | - Dina E Hill
- Psychiatry, (DH), University of New Mexico, Albuquerque, New Mexico, USA
| | - Julia M Stephen
- From the, The Mind Research Network, (FTC, MES, LF, JMS), Albuquerque, New Mexico, USA
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12
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Brown J, Asp E, Carter MN, Spiller V, Bishop-Deaton D. Suggestibility and confabulation among individuals with Fetal Alcohol Spectrum Disorder: A review for criminal justice, forensic mental health, and legal interviewers. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2020; 73:101646. [PMID: 33246222 DOI: 10.1016/j.ijlp.2020.101646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 06/19/2020] [Accepted: 11/03/2020] [Indexed: 06/11/2023]
Abstract
Fetal Alcohol Spectrum Disorders (FASD) are conditions arising from prenatal alcohol exposure which results in a range of neurodevelopmental deficits in areas including cognition, memory, language, executive functioning, emotional regulation, and adaptive functioning. Deficits in various neurodevelopmental areas can range from mild to severe, depending on many factors including the quantity and timing of alcohol exposure during the prenatal development period. During interviews in criminal justice, forensic mental health, and legal contexts (e.g., criminal investigations, cross examination, victim interviews, interviews for lawsuits, forensic evaluations, pre-sentence investigations), deficits associated with FASD may elevate the risk of suggestibility and confabulation. These issues can result in negative jurisprudence-related outcomes, including impulsive Miranda rights waivers, incorrect assumptions of competency, inaccurate or incomplete information gathering, misinterpretation of intent, witness reliability issues, court ordered treatment completion problems, probation and parole violations, false confessions, and false accusations. The aim of the present article is to explain the context in which these issues can arise and provide criminal justice, forensic mental health, and legal professionals with key guidelines that can assist in minimizing suggestibility and confabulation when interviewing persons with FASD. We hope that the suggestions and strategies presented in this article will reduce potential obstructions of justice and enhance the quality of information obtained from individuals impacted by FASD. A brief discussion is also provided to identify additional research and training opportunities needed to clarify "best practices" for professionals tasked with evaluating the challenges facing this unique population.
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Affiliation(s)
- Jerrod Brown
- American Institute for the Advancement of Forensic Studies, St. Paul, MN, USA.
| | - Erik Asp
- Department of Neurology, University of Iowa, Iowa City, IA, USA; Department of Psychology, Hamline University, St. Paul, MN, USA; Wesley & Lorene Artz Cognitive Neuroscience Research Center, Hamline University, St. Paul, MN, USA
| | - Megan N Carter
- University of Washington, Seattle, WA, USA; Department of Social and Health Services, Special Commitment Center, Steilacoom, WA, USA
| | | | - Deanna Bishop-Deaton
- College of Social and Behavioral Sciences, School of Forensic Psychology, Walden University, USA
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13
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Abstract
AbstractIt is well established that high-dose alcohol consumption during pregnancy increases the risk for a plethora of adverse offspring outcomes. These include neurodevelopmental, cognitive and social deficits, as well as psychiatric illnesses, such as depression and anxiety. However, much less evidence is available on the effects of low- and early-dose alcohol exposure on mental health outcomes, regardless of the accumulating evidence that mental health outcomes should be considered in the context of the Developmental Origins of Health and Disease hypothesis. This review will discuss the evidence that indicates low-dose and early prenatal alcohol exposure can increase the risk of mental illness in offspring and discuss the mechanistic pathways that may be involved.
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14
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Skogsdal Y, Fadl H, Cao Y, Karlsson J, Tydén T. An intervention in contraceptive counseling increased the knowledge about fertility and awareness of preconception health-a randomized controlled trial. Ups J Med Sci 2019; 124:203-212. [PMID: 31495254 PMCID: PMC6758707 DOI: 10.1080/03009734.2019.1653407] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Background: Reproductive life plan counseling (RLPC) is a tool to encourage women and men to reflect upon their reproduction, to avoid unintended pregnancies and negative health behavior that can threaten reproduction. The aim was to evaluate the effect of RLPC among women attending contraceptive counseling. Outcomes were knowledge about fertility and awareness of preconception health, use of contraception, and women's experience of RLPC. Material and methods: Swedish-speaking women, aged 20-40 years, were randomized to intervention group (IG) or control group (CG). Participants (n = 1,946) answered a questionnaire before and two months after (n = 1,198, 62%) the consultation. All women received standard contraceptive counseling, and the IG also received the RLPC, i.e. questions on reproductive intentions, information about fertility, and preconception health. Results: Women in the IG increased their knowledge about fertility: age and fertility, chances of getting pregnant, fecundity of an ovum, and chances of having a child with help of IVF. They also increased their awareness of factors affecting preconception health, such as to stop using tobacco, to refrain from alcohol, to be of normal weight, and to start with folic acid before a pregnancy. The most commonly used contraceptive method was combined oral contraceptives, followed by long-acting reversible contraception. Three out of four women (76%) in the IG stated that the RLPC should be part of the routine in contraceptive counseling. Conclusions: Knowledge about fertility and awareness of preconception health increased after the intervention. The RLPC can be recommended as a tool in contraceptive counseling.
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Affiliation(s)
- Yvonne Skogsdal
- Maternal Health Care Unit, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- CONTACT Yvonne Skogsdal Maternal Health Care Unit, Region Örebro County, Box 1613, SE-701 16, Örebro, Sweden
| | - Helena Fadl
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Yang Cao
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Jan Karlsson
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Tanja Tydén
- Department of Women’s and Children’s Health, Akademiska Sjukhuset, Uppsala, Sweden
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15
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Mattson SN, Bernes GA, Doyle LR. Fetal Alcohol Spectrum Disorders: A Review of the Neurobehavioral Deficits Associated With Prenatal Alcohol Exposure. Alcohol Clin Exp Res 2019; 43:1046-1062. [PMID: 30964197 DOI: 10.1111/acer.14040] [Citation(s) in RCA: 167] [Impact Index Per Article: 33.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/03/2019] [Indexed: 11/26/2022]
Abstract
In utero alcohol exposure can disrupt the development of the fetal brain and result in a wide range of neurobehavioral outcomes collectively known as fetal alcohol spectrum disorders (FASD). This paper provides a comprehensive review of the cognitive and behavioral outcomes of prenatal alcohol exposure, including domains of general intelligence, executive functioning, language development, learning and memory, adaptive functioning, academic performance, and concurrent psychopathology. In addition, the current status of the neurobehavioral profile of FASD and its potential as a diagnostic tool will be discussed.
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Affiliation(s)
- Sarah N Mattson
- Center for Behavioral Teratology and Department of Psychology, San Diego State University, San Diego, California
| | - Gemma A Bernes
- Center for Behavioral Teratology and Department of Psychology, San Diego State University, San Diego, California
| | - Lauren R Doyle
- Center for Behavioral Teratology and Department of Psychology, San Diego State University, San Diego, California
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16
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Easey KE, Dyer ML, Timpson NJ, Munafò MR. Prenatal alcohol exposure and offspring mental health: A systematic review. Drug Alcohol Depend 2019; 197:344-353. [PMID: 30827758 PMCID: PMC6446223 DOI: 10.1016/j.drugalcdep.2019.01.007] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 11/26/2018] [Accepted: 01/08/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND High levels of alcohol use in pregnancy have been shown to be associated with negative physical health consequences in offspring. However, the literature is less clear on the association of alcohol use in pregnancy and offspring mental health, specifically for low levels of prenatal alcohol exposure. We conducted a systematic review to evaluate studies examining this association. METHODS Studies were identified by searching PsycINFO, PubMed and Web of Science, and were included if they examined alcohol use during pregnancy as an exposure and offspring mental health at age 3 or older as an outcome. We excluded non-English language publications and studies of fetal alcohol syndrome. RESULTS Thirty-three studies were included and were categorized by mental health outcomes: anxiety/depression, emotional problems, total internalizing problems, total problem score, and conduct disorder. Over half of the analyses reported a positive association of prenatal alcohol exposure and offspring mental health problems. CONCLUSIONS Our review suggests that maternal alcohol use during pregnancy is associated with offspring mental health problems, even at low to moderate levels of alcohol use. Future investigation using methods that allow stronger causal inference is needed to further investigate if these associations shown are causal.
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Affiliation(s)
- Kayleigh E Easey
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, UK; MRC Integrative Epidemiology Unit, University of Bristol, UK.
| | - Maddy L Dyer
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, UK; MRC Integrative Epidemiology Unit, University of Bristol, UK
| | - Nicholas J Timpson
- MRC Integrative Epidemiology Unit, University of Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Marcus R Munafò
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, UK; MRC Integrative Epidemiology Unit, University of Bristol, UK
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17
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Subramoney S, Eastman E, Adnams C, Stein DJ, Donald KA. The Early Developmental Outcomes of Prenatal Alcohol Exposure: A Review. Front Neurol 2018; 9:1108. [PMID: 30619064 PMCID: PMC6305542 DOI: 10.3389/fneur.2018.01108] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 12/04/2018] [Indexed: 02/05/2023] Open
Abstract
Aim: This paper systematically reviews the literature on the effects of prenatal alcohol exposure on early child development from birth to 5 years with the aim to synthesize the developmental outcomes associated with prenatal alcohol exposure, and inform further research to improve our knowledge of the manifestations of prenatal alcohol exposure. Methods: Electronic databases (MEDLINE, Psych INFO, and Psych ARTICLES) were searched to find papers on the developmental outcomes of prenatal alcohol exposure in neonates, infants and toddlers and pre-school aged children. Studies were selected based on participants self-reporting alcohol consumption during pregnancy (either prospectively or retrospectively) and/or children being diagnosed with FASD based on a standardized assessment that includes a dysmorphology examination. The search was limited to peer-reviewed, English language studies involving human subjects, up to 5.5 years old. Results: Out of the 1,684 titles screened, a total of 71 papers were identified as relevant and included in this review. The majority of studies were prospective longitudinal studies. A range of assessment modalities (or tools) was used to determine neurodevelopmental outcomes of prenatal exposure to alcohol in the age group under review, the most frequently described being the Bayley Scales of Infant and Toddler Development (BSID) (n = 19). Studies varied in terms of the dose, frequency, and timing of alcohol consumption during pregnancy and methodology used to assess alcohol consumption. Findings demonstrate extensive evidence for poor global developmental outcomes in children prenatally exposed to alcohol, particularly with moderate to severe levels of prenatal alcohol exposure. Conclusion: The outcomes related to lower levels of prenatal alcohol exposure as well as outcomes in specific developmental domains, are poorly understood. Further research should aim to clarify the more subtle or less easily measurable manifestations of prenatal alcohol exposure on early development when the potential for greatest impact of interventions is highest.
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Affiliation(s)
- Sivenesi Subramoney
- Division of Developmental Pediatrics, Department of Pediatrics, and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Emma Eastman
- Division of Developmental Pediatrics, Department of Pediatrics, and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Colleen Adnams
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Dan J. Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Unit on Risk and Resilience in Mental Disorders, South African Medical Research Council (SAMRC), Cape Town, South Africa
| | - Kirsten A. Donald
- Division of Developmental Pediatrics, Department of Pediatrics, and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
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18
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Schoeps A, Peterson ER, Mia Y, Waldie KE, Underwood L, D'Souza S, Morton SMB. Prenatal alcohol consumption and infant and child behavior: Evidence from the Growing Up in New Zealand Cohort. Early Hum Dev 2018; 123:22-29. [PMID: 30036725 DOI: 10.1016/j.earlhumdev.2018.06.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 06/26/2018] [Accepted: 06/27/2018] [Indexed: 01/16/2023]
Abstract
BACKGROUND High levels of alcohol exposure during pregnancy can damage developing brains and influence child behavior and learning. AIM To examine the effects of lower levels of alcohol and very early exposure to alcohol on infant temperament and child behavior. STUDY DESIGN, SUBJECTS, AND OUTCOME MEASURES The Growing Up in New Zealand study involves a prospective birth cohort of 6822 pregnant women of whom 6156 provided information on their child's temperament using the Infant Behavior Questionnaire-Revised (IBQ-R VSF) at 9 months and their child's behavior using the Strengths and Difficulties Questionnaire at 2 years. RESULTS A series of adjusted linear regression models controlling for socio-demographic factors found alcohol consumption during pregnancy was most consistently related to Lower Positive Affect, Affiliation/Regulation, and Orienting Capacity temperament scores. Mothers who stopped drinking after becoming aware of their pregnancy, but had an unplanned pregnancy (hence may have a baby exposed to alcohol for longer), also reported infants with lower Orienting Capacity, Affiliation/Regulation, and Fear temperament scores compared to those that did not drink. Children whose mothers drank four or more drinks per week during pregnancy were more likely to report their child as having conduct problems, with higher total difficulties scores at age 2. CONCLUSIONS Alcohol consumption during pregnancy has a negative effect especially on infant temperament, even if small amounts of alcohol are consumed. Our findings have implications for men and women who drink, medical professionals, and for the availability of contraception to those who drink, but do not plan to get pregnant.
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Affiliation(s)
- Anja Schoeps
- Institute of Public Health, University of Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany.
| | - Elizabeth R Peterson
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, University of Auckland, Private Bag 92019, Auckland, New Zealand.
| | - Yasmine Mia
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, New Zealand.
| | - Karen E Waldie
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, University of Auckland, Private Bag 92019, Auckland, New Zealand.
| | - Lisa Underwood
- Centre for Longitudinal Research - He Ara ki Mua, University of Auckland, Private Bag 92019, Auckland, New Zealand.
| | - Stephanie D'Souza
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, University of Auckland, Private Bag 92019, Auckland, New Zealand.
| | - Susan M B Morton
- Centre for Longitudinal Research - He Ara ki Mua, University of Auckland, Private Bag 92019, Auckland, New Zealand; School of Population Health, University of Auckland, Private Bag 92019, Auckland, New Zealand.
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19
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Ruisch IH, Buitelaar JK, Glennon JC, Hoekstra PJ, Dietrich A. Pregnancy risk factors in relation to oppositional-defiant and conduct disorder symptoms in the Avon Longitudinal Study of Parents and Children. J Psychiatr Res 2018; 101:63-71. [PMID: 29550610 DOI: 10.1016/j.jpsychires.2018.02.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 02/19/2018] [Accepted: 02/22/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Pregnancy factors have been implicated in offspring oppositional-defiant disorder (ODD) and conduct disorder (CD) symptoms. Literature still holds notable limitations, such as studying only a restricted set of pregnancy factors, use of screening questionnaires which assess broadly defined outcome measures, and lack of control for disruptive behavior comorbidity and genetic confounds. We aimed to address these gaps by prospectively studying a broad range of pregnancy factors in relation to both offspring ODD and CD symptomatology in the Avon Longitudinal Study of Parent and Children. METHODS Outcomes were ODD and CD symptom scores at age 7;9 years using the Development and Well-Being Assessment interview. We analyzed maternal (N ≈ 6300) and teacher ratings (N ≈ 4400) of ODD and CD scores separately using negative binomial regression in multivariable models. Control variables included comorbid attention-deficit/hyperactivity disorder symptoms, ODD or CD symptoms as appropriate, and genetic risk scores based on an independent CD genome-wide association study. RESULTS Higher ODD symptom scores were linked to paracetamol use (IRR = 1.24 [98.3% confidence interval 1.05-1.47], P = 0.002, teacher ratings) and life events stress (IRR = 1.22 [1.07-1.39], P = 0.002, maternal ratings) during pregnancy. Higher CD symptom scores were linked to maternal smoking (IRR = 1.33 [1.18-1.51], P < 0.001, maternal ratings), life events stress (IRR = 1.24 [1.11-1.38], P < 0.001, maternal ratings) and depressive symptoms (IRR = 1.14 [1.01-1.30], P = 0.006, maternal ratings) during pregnancy. CONCLUSIONS Common and potentially preventable pregnancy risk factors were independently related to both offspring ODD and CD symptomatology in children from the general population. Future studies should further address genetic confounds and confounding by environmental factors later in life.
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Affiliation(s)
- I Hyun Ruisch
- University of Groningen, University Medical Center Groningen, Department of Child and Adolescent Psychiatry, Hanzeplein 1, 9713GZ Groningen, The Netherlands.
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA Nijmegen, The Netherlands; Karakter Child and Adolescent Psychiatry University Centre, Reinier Postlaan 12, 6525 GC Nijmegen, The Netherlands.
| | - Jeffrey C Glennon
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA Nijmegen, The Netherlands.
| | - Pieter J Hoekstra
- University of Groningen, University Medical Center Groningen, Department of Child and Adolescent Psychiatry, Hanzeplein 1, 9713GZ Groningen, The Netherlands.
| | - Andrea Dietrich
- University of Groningen, University Medical Center Groningen, Department of Child and Adolescent Psychiatry, Hanzeplein 1, 9713GZ Groningen, The Netherlands.
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20
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Sarman I. Review shows that early foetal alcohol exposure may cause adverse effects even when the mother consumes low levels. Acta Paediatr 2018; 107:938-941. [PMID: 29341271 DOI: 10.1111/apa.14221] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 12/17/2017] [Accepted: 01/11/2018] [Indexed: 12/21/2022]
Abstract
AIM Studies are increasingly focusing on the effects of prenatal alcohol exposure (PAE) on child health. The aim of this review was to provide paediatricians with new insights to help them communicate key messages about avoiding alcohol during pregnancy. METHODS Inspired by the 7th International Conference on Fetal Alcohol Spectrum Disorder, which focused on integrating research, policy and practice, we studied English language papers published since 2010 on how early PAE triggered epigenetic mechanisms that had an impact on the development of some chronic diseases. We also report the findings of a human study using three-dimensional photography of the face to explore associations between PAE and craniofacial phenotyping. RESULTS Animal models with different alcohol exposure patterns show that early PAE may lead to long-term chronic effects, due to developmental programming for some adult diseases in cardiovascular, metabolic and renal systems. The study with three-dimensional photographing is very promising in helping paediatricians to understand how even small amounts of PAE can affect craniofacial phenotyping. CONCLUSION Even low levels of PAE can cause adverse foetal effects and not just in the brain. It is not currently possible to determine a safe period and level when alcohol consumption would not affect the foetus.
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Affiliation(s)
- Ihsan Sarman
- Department of Clinical Science and Education; Karolinska Institutet; Sachs’ Children's Hospital; Stockholm Sweden
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21
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Khoury JE, Jamieson B, Milligan K. Risk for Childhood Internalizing and Externalizing Behavior Problems in the Context of Prenatal Alcohol Exposure: A Meta-Analysis and Comprehensive Examination of Moderators. Alcohol Clin Exp Res 2018; 42:1358-1377. [PMID: 29852057 DOI: 10.1111/acer.13805] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 05/16/2018] [Indexed: 11/28/2022]
Abstract
Prenatal alcohol exposure (PAE) is associated with a constellation of physical, neurocognitive, and behavioral abnormalities in offspring. The presence of internalizing (e.g., anxiety, mood disorders) and externalizing (e.g., oppositional defiant and conduct disorders) behavior problems has devastating and often long-lasting impacts on children, adolescents, and their families. The present meta-analysis explored the strength of the association between PAE and behavior problems, as well as factors that increase or mitigate risk. The current meta-analysis included 65 studies comparing children and adolescents with PAE to non- or light-exposed controls and attention-deficit/hyperactivity disorder (ADHD) samples, on a variety of internalizing and externalizing behavior outcomes. Results indicated that individuals with PAE are at increased risk for internalizing (d = 0.71, medium effect) and externalizing (d = 0.90, large effect) problems compared to control samples. The occurrence of total behavior problems was similar to that seen in ADHD samples. The strength of the association between internalizing and externalizing behavior problems and PAE was significantly moderated by several distinct sample characteristics, such as sample age, socioeconomic status, severity of exposure, and type of behavior problem. These findings further our understanding of the behavior problems experienced by children and adolescents with PAE.
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Affiliation(s)
| | | | - Karen Milligan
- Department of Psychology, Ryerson University, Toronto, Canada
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22
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Reid N, Petrenko CLM. Applying a Developmental Framework to the Self-Regulatory Difficulties of Young Children with Prenatal Alcohol Exposure: A Review. Alcohol Clin Exp Res 2018; 42:987-1005. [PMID: 29672859 DOI: 10.1111/acer.13756] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 04/08/2018] [Indexed: 12/31/2022]
Abstract
Prenatal alcohol exposure (PAE) can be associated with significant difficulties in self-regulatory abilities. As such, interventions have been developed that focus on improving varying aspects of self-regulation for this population. The application of a multilevel theoretical framework that describes the development of self-regulation during early childhood could further advance the field. First, this framework could assist in elucidating mechanisms in the trajectories of early adjustment problems in this population and, second, informing the development of more precise assessment and interventions for those affected by PAE. The aims of the current review were to provide an overview of the self-regulatory framework proposed by Calkins and colleagues (e.g., Calkins, 2007; Calkins and Fox, 2002); examine the self-regulatory difficulties that are commonly experienced during infancy (i.e., 0 to 2 years) and early childhood (i.e., 3 to 8 years) in children with PAE in the context of the developmental framework; and describe how the framework can inform the development of future assessment and intervention provision for young children with PAE. The application of a developmental framework, such as proposed by Calkins and colleagues, allows for a systematic and theoretically driven approach to assessment and intervention programs for young children with PAE.
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Affiliation(s)
- Natasha Reid
- Centre for Child Health Research, University of Queensland, Brisbane, Queensland
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23
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Fetal alcohol spectrum disorders: Zebrafish in the analysis of the milder and more prevalent form of the disease. Behav Brain Res 2017; 352:125-132. [PMID: 28988969 DOI: 10.1016/j.bbr.2017.10.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 10/03/2017] [Accepted: 10/04/2017] [Indexed: 02/08/2023]
Abstract
Fetal Alcohol Spectrum Disorders (FASD) represent a large unmet medical need. Exposure of the developing human embryo to alcohol can lead to life-long suffering. Despite the well documented deleterious effects of alcohol on the developing fetus, pregnant women continue to drink alcohol, and FASD remains the leading cause of preventable mental retardation and other behavioral abnormalities. Particularly prevalent are the milder forms of the disease cluster, representing children who do not show obvious physical signs and who may be undiagnosed or misdiagnosed. To develop treatment and diagnostic tools, researchers have turned to animal models. The zebrafish is becoming one of the leading biomedical research organisms that may facilitate discovery of the biological mechanisms underlying this disease and the identification of biomarkers that may be used for diagnosis. Here we review the latest advances of this field, mostly focussing on the discoveries made in our own laboratory and others with zebrafish employed to analyze the effects of moderate to low level of exposure to alcohol. We argue that the zebrafish represents unique advantages, and adding information obtained with this species to the mix of other animal models will significantly increase translational relevance of animal biomedical research for the analysis of human FASD.
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24
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Sundelin-Wahlsten V, Hallberg G, Helander A. Higher alcohol consumption in early pregnancy or low-to-moderate drinking during pregnancy may affect children's behaviour and development at one year and six months. Acta Paediatr 2017; 106:446-453. [PMID: 27859634 DOI: 10.1111/apa.13664] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 10/01/2016] [Accepted: 11/07/2016] [Indexed: 02/01/2023]
Abstract
AIM It is unclear whether low-to-moderate alcohol consumption during pregnancy affects child development. This study examined the effects that a mother's self-reported alcohol consumption had on her pregnancy and her child's birth, behaviour and development. METHODS We asked 291 Swedish women to report their alcohol consumption before and during pregnancy using the Alcohol Use Disorders Identification Test (AUDIT); provide data on their pregnancy, labour and neonatal period; and complete a child behaviour and development questionnaire when their child was one year and six months of age. The mothers were separated into four subgroups based on their AUDIT scores. RESULTS There were no group differences in gestational length, but children were shorter at birth if their mother drank during pregnancy. Mothers with the highest alcohol consumption before pregnancy were generally younger and more likely to smoke, have unplanned pregnancies and have children who displayed behavioural problems than controls who reported abstinence before and during pregnancy. Mothers who drank more during pregnancy than before were more likely to have had abortions and unplanned pregnancies and less likely to breastfeed for more than six months. CONCLUSION Our results suggested that low-to-moderate alcohol consumption during pregnancy may negatively influence a child's development and behaviour in several ways.
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Affiliation(s)
- Viveka Sundelin-Wahlsten
- Unit of Child and Adolescent Psychiatry; Department of Neuroscience; Uppsala University; Uppsala Sweden
| | - Gunilla Hallberg
- Unit of Obstetrics and Gynecology; Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | - Anders Helander
- Department of Laboratory Medicine; Karolinska Institutet; Stockholm Sweden
- Karolinska University Laboratory Huddinge; Stockholm Sweden
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May PA, Marais AS, de Vries MM, Kalberg WO, Buckley D, Hasken JM, Adnams CM, Barnard R, Joubert B, Cloete M, Tabachnick B, Robinson LK, Manning MA, Jones KL, Bezuidenhout H, Seedat S, Parry CDH, Hoyme HE. The continuum of fetal alcohol spectrum disorders in a community in South Africa: Prevalence and characteristics in a fifth sample. Drug Alcohol Depend 2016; 168:274-286. [PMID: 27736681 PMCID: PMC5086258 DOI: 10.1016/j.drugalcdep.2016.09.025] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 09/01/2016] [Accepted: 09/02/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND The prevalence and characteristics of the continuum of diagnoses within fetal alcohol spectrum disorders (FASD) were researched in a fifth sample in a South African community. METHODS An active case ascertainment approach was employed among all first grade learners in this community (n=862). Following individual examination by clinical geneticists/dysmorphologists, cognitive/behavioral testing, and maternal interviews, final diagnoses were made in multidisciplinary case conferences. RESULTS Physical measurements, cardinal facial features of FAS, and total dysmorphology scores clearly differentiated diagnostic categories in a consistent, linear fashion, from severe to mild. Neurodevelopmental delays and behavioral problems were significantly worse for each of the FASD diagnostic categories, although not as consistently linear across diagnostic groups. Alcohol use was documented by direct report from the mother in 71% to 100% of cases in specific diagnostic groups. Significant distal maternal risk factors in this population are: advanced maternal age at pregnancy; low height, weight, and body mass index (BMI); small head circumference; low education; low income; and rural residence. Even when controlling for socioeconomic status, prenatal drinking correlates significantly with total dysmorphology score, head circumference, and five cognitive and behavioral measures. In this community, FAS occurs in 59-79 per 1,000 children, and total FASD in 170-233 per 1,000 children, or 17% to 23%. CONCLUSIONS Very high rates of FASD continue in this community where entrenched practices of regular binge drinking co-exist with challenging conditions for childbearing and child development in a significant portion of the population.
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Affiliation(s)
- Philip A May
- The University of North Carolina at Chapel Hill, Nutrition Research Institute, United States; Stellenbosch University, Faculty of Medicine and Health Sciences, South Africa; The University of New Mexico, Center on Alcoholism, Substance Abuse and Addictions, United States.
| | - Anna-Susan Marais
- Stellenbosch University, Faculty of Medicine and Health Sciences, South Africa
| | - Marlene M de Vries
- Stellenbosch University, Faculty of Medicine and Health Sciences, South Africa
| | - Wendy O Kalberg
- The University of New Mexico, Center on Alcoholism, Substance Abuse and Addictions, United States
| | - David Buckley
- The University of New Mexico, Center on Alcoholism, Substance Abuse and Addictions, United States
| | - Julie M Hasken
- The University of North Carolina at Chapel Hill, Nutrition Research Institute, United States
| | - Colleen M Adnams
- University of Cape Town, Department of Psychiatry and Mental Health, South Africa
| | - Ronel Barnard
- Stellenbosch University, Faculty of Medicine and Health Sciences, South Africa
| | - Belinda Joubert
- Stellenbosch University, Faculty of Medicine and Health Sciences, South Africa
| | - Marise Cloete
- Stellenbosch University, Faculty of Medicine and Health Sciences, South Africa
| | | | - Luther K Robinson
- State University of New York, Buffalo, Department of Pediatrics, United States
| | - Melanie A Manning
- Stanford University School of Medicine, Departments of Pathology and Pediatrics, United States
| | - Kenneth Lyons Jones
- University of California San Diego School of Medicine, Department of Pediatrics, United States
| | - Heidre Bezuidenhout
- Stellenbosch University, Faculty of Medicine and Health Sciences, South Africa
| | - Soraya Seedat
- Stellenbosch University, Faculty of Medicine and Health Sciences, South Africa
| | - Charles D H Parry
- Stellenbosch University, Faculty of Medicine and Health Sciences, South Africa; South African Medical Research Council, South Africa
| | - H Eugene Hoyme
- Sanford Research, University of South Dakota Sanford School of Medicine, Department of Pediatrics, United States; The University of Arizona College of Medicine, Department of Pediatrics and the Center for Applied Genetics and Genomic Medicine, United States
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Ulrich F, Petermann F. Consequences and Possible Predictors of Health-damaging Behaviors and Mental Health Problems in Pregnancy - A Review. Geburtshilfe Frauenheilkd 2016; 76:1136-1156. [PMID: 27904164 PMCID: PMC5123885 DOI: 10.1055/s-0042-118180] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 09/13/2016] [Accepted: 09/25/2016] [Indexed: 12/29/2022] Open
Abstract
In recent decades, the understanding of the short and longer term effects of health-damaging behaviors and mental health problems in pregnant women and the underlying mechanisms of these behaviors and illnesses has significantly increased. In contrast, little is known about the factors affecting individual pregnant women which contribute to health-damaging behaviors and mental illness. The aim of this paper was therefore to summarize the current state of research into the consequences of nicotine and alcohol consumption, malnutrition, excessive weight gain or obesity, and impaired mental health (depression and anxiety) during pregnancy. In addition, the characteristics of pregnant women which increase their risk of developing such behaviors or mental disorders are described. A better knowledge of these risks should make it easier for clinicians to identify cases at risk early on and put measures of support in place. A review of the literature has shown that certain characteristics of pregnant women (e.g. her relationship with her partner, a previous history of mental illness prior to pregnancy) are associated with various health-damaging behaviors as well as with impaired mental health. Affected women often show an accumulated psychosocial stress which was already present prior to the pregnancy and which may persist even after the birth of the child.
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Affiliation(s)
- F. Ulrich
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen, Bremen, Germany
| | - F. Petermann
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen, Bremen, Germany
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Melchior M, Chollet A, Glangeaud-Freudenthal N, Saurel-Cubizolles MJ, Dufourg MN, van der Waerden J, Sutter-Dallay AL. Tobacco and alcohol use in pregnancy in France: the role of migrant status: the nationally representative ELFE study. Addict Behav 2015; 51:65-71. [PMID: 26233939 DOI: 10.1016/j.addbeh.2015.07.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 07/06/2015] [Accepted: 07/22/2015] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Tobacco and alcohol use in pregnancy are modifiable yet frequent risk factors of poor perinatal outcomes. We examined whether characteristics associated with substance use in pregnancy vary between native and migrant women, who often differ in terms of socio-demographic characteristics. METHODS Data come from a nationally representative sample of children born in France in 2011 (ELFE study, n=18,014). Maternal substance use in pregnancy (tobacco: ≥1 cigarette/day, alcohol: ≥1 time, binge drinking: ≥3 units of alcohol on one occasion) was assessed using survey methodology by a) trained interviewers and b) self-reports. Migration status was determined based on country of birth (native-born vs. migrant). The sample included 2330 migrant women, predominantly from North Africa (35.4% - primarily Algeria and Morocco), Sub-Saharan Africa (27.3% - primarily Senegal, Ivory Coast, the Congo and Cameroun), Europe (20.2% - primarily Portugal and Germany) and Asia (10.2% - primarily Turkey). Characteristics potentially associated with substance use included socio-demographics (maternal age, number of children, relationship status, educational attainment, employment status), health (psychological difficulties, incomplete prenatal care) and partner's characteristics (migration status, employment). RESULTS Compared to the native-born, migrant women had lower levels of tobacco smoking (8.8 vs. 21.9%) and alcohol use (23.4 vs. 40.7%), but not binge drinking (2.9 vs. 3.3%). Unfavorable socioeconomic circumstances were associated with tobacco smoking in native-born women only. Single parenthood was associated with alcohol use only in migrant women. In migrant women, co-occurring use of another substance and psychological difficulties were more strongly associated with use of tobacco, alcohol or binge drinking than in native-born women. CONCLUSIONS Migrant women have less favorable socioeconomic characteristics than native women but are generally less likely to use tobacco and alcohol in pregnancy. However those who experience single-parenthood need special attention, as they are disproportionately likely to use psychoactive substances which put them and their children at risk of poor health outcomes.
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Niclasen J, Andersen AMN, Strandberg-Larsen K, Teasdale TW. Is alcohol binge drinking in early and late pregnancy associated with behavioural and emotional development at age 7 years? Eur Child Adolesc Psychiatry 2014; 23:1175-80. [PMID: 24390718 DOI: 10.1007/s00787-013-0511-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 12/22/2013] [Indexed: 11/24/2022]
Abstract
The purpose of this study was to investigate associations of maternal binge drinking in early and late pregnancy with child behavioural and emotional development at age seven. It was hypothesised that late exposure is associated with more negative outcomes than early exposure. Differences were expected on the continuous outcome measures, but not on above cutoff scale scores. Data were derived from the Danish National Birth Cohort. Three exposure groups were defined according to binge drinking from three interviews regarding binge episodes in early, middle and late pregnancy. A 'no binge' group included women with no binge episodes reported in any of the interviews, the 'early bingers' reported episodes in the first interview only, and the 'late bingers' in the last part of pregnancy only. The outcome measure was the Strengths and Difficulties Questionnaire (SDQ) used as continuous externalising/internalising scores and above cutoff hyperactivity/inattention, conduct, emotional and peer problems scores. Only women with full information concerning binge drinking from the three interviews, together with full-scale SDQ information on their children at age seven and being term-born, were included in the study (N = 37,315). After adjustment for maternal education, psychiatric diagnoses, age and smoking, children exposed to binge drinking in early and late pregnancy had significantly higher mean externalizing scores at age seven than unexposed children, an effect albeit much less for early binge drinking (relative change in mean 1.02, CI 1.00-1.05) than for late binge drinking (relative change in mean 1.21, CI 1.04-1.42). No associations were observed for any of the above cutoff outcomes. Exposure to binge drinking in early and late pregnancy is associated with elevated externalising scores, particularly so in late pregnancy. No increased risk for any of the above cutoff scale scores was observed.
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Affiliation(s)
- Janni Niclasen
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353, Copenhagen K, Denmark,
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Muggli E, Cook B, O'Leary C, Forster D, Halliday J. Increasing accurate self-report in surveys of pregnancy alcohol use. Midwifery 2014; 31:e23-8. [PMID: 25467595 DOI: 10.1016/j.midw.2014.11.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 10/01/2014] [Accepted: 11/03/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND pregnancy alcohol research relies on self-reports of alcohol consumption. Reporting bias may contribute to ambiguous and conflicting findings on fetal effects of low to moderate pregnancy alcohol exposure. OBJECTIVE this study aimed to identify the determinants which would enable women to provide accurate data in surveys of alcohol use in pregnancy. DESIGN AND PARTICIPANTS six focus groups were held with a total of 26 pregnant women and new mothers. Participants reviewed a set of alcohol survey questions followed by a guided discussion. Transcripts were analysed using inductive content analysis. SETTING public hospital antenatal clinics and Mother & Child Health Centres, Melbourne, Victoria, Australia. FINDINGS women's emotional responses were generally favourable, although the potential for anxiety and fear of judgement was acknowledged. Barriers to accurate self-report were recall, complexity and use of subjective language. Facilitators were appropriate drink choices, occasional drinking options and contextualising of questions. Confidentiality and survey method, including a preference for methods other than face-to face, were also important factors. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE questions embedded in clear context may reduce anxiety around questions about alcohol use in pregnancy. Methods using shorter recall periods, a list of drinks choices, measures of special occasion drinking and minimising complex and subjective language will increase accurate self-report. A setting perceived as confidential and anonymous may reduce a desire to provide socially acceptable answers.
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Affiliation(s)
- Evelyne Muggli
- Murdoch Childrens Research Institute, Parkville 3052, Vic., Australia; Department of Paediatrics, The University of Melbourne, 3010 Vic., Australia.
| | - Brendan Cook
- Murdoch Childrens Research Institute, Parkville 3052, Vic., Australia; Central Australian Aboriginal Congress, Alice Springs, 0870 NT, Australia
| | | | - Della Forster
- La Trobe University, Melbourne 3000, Vic., Australia; Midwifery and Maternity Services Research, The Royal Women׳s Hospital, Parkville, 3052 Vic., Australia
| | - Jane Halliday
- Murdoch Childrens Research Institute, Parkville 3052, Vic., Australia; Department of Paediatrics, The University of Melbourne, 3010 Vic., Australia
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Melchior M. Psychopathologie et addiction des parents, situation sociale, et comportement de l’enfant. Eur Psychiatry 2014. [DOI: 10.1016/j.eurpsy.2014.09.217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
La consommation de tabac et d’alcool au cours de la grossesse peut augmenter les risques de santé pour l’enfant à court et plus long terme (petit poids de naissance, prématurité, difficultés cognitives et psychologiques) [1–5]. Les facteurs associés, qui incluent les difficultés sociales et économiques des familles (chômage, faibles revenus, absence du conjoint) [6], les difficultés psychologiques [1,7] et les consommations de tabac et d’alcool de l’entourage [1,8], sont mal connus chez les femmes migrantes. Nous avons examiné les facteurs associés aux consommations de tabac (≥ 1 cigarette/jour) et d’alcool (≥ 1 fois; binge drinking) des femmes de la cohorte ELFE en fonction de leur statut migratoire à partir de données recueillies à la maternité en 2011 (n = 18,316).Les femmes nées en France consommaient plus que celles nées à l’étranger (tabac : 21,9 vs. 8,8 %; alcool : 40,4 vs. 22,9 %) mais les niveaux de binge drinking étaient comparables (3,2 vs. 2,9 %). Les consommations de tabac et d’alcool étaient associées aux caractéristiques démographiques, socio-économiques, de santé, et du père de l’enfant, avec des spécificités en fonction du statut migratoire : chez les femmes nées à l’étranger les consommations d’alcool sont associées aux fait de ne pas vivre avec un conjoint (OR ajusté : toute consommation : 2,20; binge drinking : 3,06); par contre une situation socioéconomique défavorable est associée à un niveau élevé de tabagisme et de binge drinking seulement chez les femmes nées en France. Les niveaux de consommations de tabac et alcool sont faibles lorsque le père de l’enfant est migrant, surtout chez les migrantes.Au total, pour tenter de diminuer les niveaux de consommation de tabac et d’alcool au cours de la grossesse, les professionnels de santé et de prévention devraient tenir compte de multiples facteurs dont certains varient selon le statut migratoire des femmes.
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Abstract
Prenatal alcohol exposure (PAE) is one of the most prevalent and modifiable risk factors for somatic, behavioral, and neurological abnormalities. Affected individuals exhibit a wide range of such features referred to as fetal alcohol spectrum disorders (FASD). These are characterized by a more or less specific pattern of minor facial dysmorphic features, growth deficiency and central nervous system symptoms. Nevertheless, whereas the diagnosis of the full-blown fetal alcohol syndrome does not pose a major challenge, only a tentative diagnosis of FASD can be reached if only mild features are present and/or maternal alcohol consumption during pregnancy cannot be verified. The respective disorders have lifelong implications. The teratogenic mechanisms induced by PAE can lead to various additional somatic findings and structural abnormalities of cerebrum and cerebellum. At the functional level, cognition, motor coordination, attention, language development, executive functions, memory, social perception and emotion processing are impaired to a variable extent. The long-term development is characterized by disruption and failure in many domains; an age-adequate independency is frequently not achieved. In addition to primary prevention, individual therapeutic interventions and tertiary prevention are warranted; provision of extensive education to affected subjects and their caregivers is crucial. Protective environments are often required to prevent negative consequences such as delinquency, indebtedness or experience of physical/sexual abuse.
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Changes in beverage consumption from pre-pregnancy to early pregnancy in the Norwegian Fit for Delivery study. Public Health Nutr 2014; 18:1187-96. [PMID: 25221910 DOI: 10.1017/s136898001400189x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To describe changes in consumption of different types of beverages from pre-pregnancy to early pregnancy, and to examine associations with maternal age, educational level and BMI. DESIGN Cross-sectional design. Participants answered an FFQ at inclusion into a randomized controlled trial, the Fit for Delivery (FFD) trial, in median gestational week 15 (range: 9-20), reporting current consumption and in retrospect how often they drank the different beverages pre-pregnancy. SETTING Eight local antenatal clinics in southern Norway from September 2009 to February 2013. SUBJECTS Five hundred and seventy-five healthy pregnant nulliparous women. RESULTS Pre-pregnancy, 27 % reported drinking alcohol at least once weekly, compared with none in early pregnancy (P<0.001). The percentage of women drinking coffee (38 % v. 10 %, P<0.001), sugar-sweetened beverages (10 % v. 6 %, P=0.011) and artificially sweetened beverages (12 % v. 9 %, P=0.001) at least daily decreased significantly from pre-pregnancy to early pregnancy, while the percentage of women who reported to drink water (85 % v. 92 %, P<0.001), fruit juice (14 % v. 20 %, P=0.001) and milk (37 % v. 42 %, P=0.001) at least daily increased significantly. From pre-pregnancy to early pregnancy higher educated women reduced their consumption frequency of coffee significantly more than women with lower education. Older women reduced their consumption frequency of coffee and artificially sweetened beverages and increased their consumption frequency of fruit juice and milk significantly more than younger women. CONCLUSIONS There is a significant change in beverage consumption from pre-pregnancy to early pregnancy among Norwegian nulliparous women.
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Alvik A. Variables predicting low infant developmental scores: Maternal age above 30 years is a main predictor. Scand J Public Health 2013; 42:113-9. [DOI: 10.1177/1403494813510225] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aim: To explore variables predicting low developmental scores in 6-month-old infants in a population-based study. Methods: In a longitudinal study representative of pregnant women in Oslo, Norway, questionnaires were answered at 17 and 30 weeks of pregnancy and 6 months after term; N = 1053 after exclusions (women with non-Scandinavian ethnicity, twin births, infants <5.0 or >7.0 months corrected age, and birth weight <2.5 kg), and data were collected from the Norwegian Birth Registry. Measures included sociodemographic variables, maternal mental health and pregnancy life style, data concerning the birth/newborn, and the Ages and Stages Questionnaires (ASQ) for 6-month-olds. Logistic regression analyses were used to identify variables predicting an ASQ score ≤15th percentile. Results: In adjusted analyses, only increasing maternal age and infant having older siblings predicted a low score on ASQ Total. These variables also predicted low scores on several ASQ areas (i.e. Communication, Gross motor, Fine motor, Problem-solving and Personal social), together with maternal major lifetime depression and feeling lonely. Protective variables were increasing infant birth weight (Gross motor) and pregnancy smoking (Communication). Other maternal sociodemographic variables, and infant sex, had no predictive power. Already at a maternal age of 31, the mean age of the pregnant women, the possibility of a low infant score increased significantly. Conclusions: In this population-based study, higher maternal age, having older siblings, and a history of maternal major lifetime depression, mainly predicts low developmental scores in 6-month-old infants.
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Affiliation(s)
- Astrid Alvik
- Institute of Clinical Medicine, University of Oslo, Olso, Norway and Child and Adolescent Mental Health Research Unit, Oslo University Hospital, Oslo, Norway
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