1
|
Orton SM, Millis K, Choate P. Epigenetics of Trauma Transmission and Fetal Alcohol Spectrum Disorder: What Does the Evidence Support? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6706. [PMID: 37681846 PMCID: PMC10487479 DOI: 10.3390/ijerph20176706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/23/2023] [Accepted: 08/30/2023] [Indexed: 09/09/2023]
Abstract
Fetal alcohol spectrum disorder (FASD) results from teratogenic impacts of alcohol consumption during pregnancy. Trauma and prenatal alcohol exposure (PAE) can both cause neurodevelopmental impairment, and it has been proposed that FASD can amplify effects of trauma. Certain PAE and trauma effects are mediated via epigenetic mechanisms. The objective of this review is to present the current evidence for epigenetics in trauma transmission as it relates to FASD, to help bridge a potential knowledge gap for social workers and related health professionals. We include a primer on epigenetic mechanisms and inheritance, followed by a summary of the current biomedical evidence supporting intergenerational and transgenerational epigenetic transmission of trauma, its relevance to FASD, the intersection with social transmission, and finally the application to social work. We propose potential models of transmission, considering where social and epigenetic pathways may intersect and/or compound across generations. Overall, we aim to provide a better understanding of epigenetic-trauma transmission for its application to health professions, in particular which beliefs are (and are not) evidence-based. We discuss the lack of research and challenges of studying epigenetic transmission in humans and identify the need for public health interventions and best practices that are based on the current evidence.
Collapse
Affiliation(s)
- Sarah M. Orton
- Faculty of Science and Technology, Department of Biology, Mount Royal University, Calgary, AB T3E 6K6, Canada;
| | - Kimberly Millis
- Faculty of Science and Technology, Department of Biology, Mount Royal University, Calgary, AB T3E 6K6, Canada;
| | - Peter Choate
- Faculty of Health, Community & Education, Department of Child Studies and Social Work, Mount Royal University, Calgary, AB T3E 6K6, Canada;
| |
Collapse
|
2
|
Nakitto R, Nzabona A, Wandera SO. Risk factors for intimate partner emotional violence among women in union in Uganda. FRONTIERS IN SOCIOLOGY 2023; 8:840154. [PMID: 37214596 PMCID: PMC10196348 DOI: 10.3389/fsoc.2023.840154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 03/27/2023] [Indexed: 05/24/2023]
Abstract
Introduction Despite the growing evidence of the prevalence of gender-based violence in Uganda, less is known about the factors influencing intimate partner emotional violence (IPEV) among married women in the country. This study investigated the social demographic factors associated with IPEV among married women aged 15 years and older. Data and methods The study used the 2016 Uganda Demographic Healthy Survey (UDHS) data. A weighted sample of 5,642 women who had been in a union was selected. A binary logistic regression model was fitted to analyze the predictors of IPEV. Results Almost four in 10 (38%) married women experienced IPEV. Witnessing parental violence (OR = 1.37, CI = 0.59-0.92), partner's controlling behavior (OR = 4.26, CI = 3.29-5.52), and attaining age 35+ (OR = 1.44, CI = 1.06-1.95) increased the odds of IPEV. Residing in rural areas (OR = 0.004, CI = 0.48-0.99) and having higher education (OR = 0.51, CI = 0.26-1.00) decreased the odds of IPEV. Conclusion and implications Witnessing parental violence, alcohol consumption, age, place of residence, partner's controlling behavior, and level of education influence IPEV among married women in Uganda. The findings have several implications including strengthening IPEV-prevention campaigns, women empowerment, and alcohol consumption regulations.
Collapse
Affiliation(s)
- Resty Nakitto
- Department of Population Studies, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, Kampala, Uganda
| | | | - Stephen Ojiambo Wandera
- Department of Population Studies, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, Kampala, Uganda
| |
Collapse
|
3
|
Oh SS, Kang B, Park J, Kim S, Park EC, Lee SH, Kawachi I. Racial/Ethnic Disparity in Association Between Fetal Alcohol Syndrome and Alcohol Intake During Pregnancy: Multisite Retrospective Cohort Study. JMIR Public Health Surveill 2023; 9:e45358. [PMID: 37083819 PMCID: PMC10147559 DOI: 10.2196/45358] [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: 01/05/2023] [Revised: 03/15/2023] [Accepted: 03/23/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Alcohol consumption during pregnancy is associated with a range of adverse birth-related outcomes, including stillbirth, low birth weight, preterm birth, and fetal alcohol syndrome (FAS). With more than 10% of women consuming alcohol during pregnancy worldwide, it is increasingly important to understand how racial/ethnic variations affect FAS onset. However, whether race and ethnicity inform FAS risk assessment when daily ethanol intake is controlled for remains unknown. OBJECTIVE This study aimed to assess racial/ethnic disparities in FAS risk associated with alcohol consumption during pregnancy. METHODS We used data from a longitudinal cohort study (the Collaborative Initiative on Fetal Alcohol Spectrum Disorders) at 5 hospital sites around the United States of 595 women who consumed alcohol during pregnancy from 2007 to 2017. Questionnaires, in-person interviews, and reviews of medical, legal, and social service records were used to gather data on average alcoholic content (AAC) during pregnancy. Self-reports of maternal race (American Indian/Alaska Native [AI/AN], Asian, Native Hawaiian or other Pacific Islander, Black or African American, White, more than one race, and other) and ethnicity (Hispanic/Latino or not Hispanic/Latino), as well as FAS diagnoses based on standardized dysmorphological criteria, were used for analysis. Log-binomial regression was used to examine the risk of FAS associated with each 1-gram increase in ethanol consumption during pregnancy, stratified by race/ethnicity. RESULTS A total of 3.4% (20/595) of women who reported consuming alcohol during pregnancy gave birth to a baby with FAS. Women who gave birth to a baby with FAS had a mean AAC of 32.06 (SD 9.09) grams, which was higher than that of women who did not give birth to a baby with FAS (mean 12.07, SD 15.87 grams). AI/AN mothers with FAS babies had the highest AAC (mean 42.62, SD 8.35 grams), followed by White (mean 30.13, SD 4.88 grams) and Black mothers (mean 27.05, SD 12.78 grams). White (prevalence ratio [PR] 1.10, 95% CI 1.03-1.19), Black (PR 1.13, 95% CI 1.04-1.23), and AI/AN (PR 1.10, 95% CI 1.00-1.21) mothers had 10% to 13% increased odds of giving birth to a baby with FAS given the same exposure to alcohol during pregnancy. Regardless of race, a 1-gram increase in AAC resulted in a 4% increase (PR 1.04, 95% CI 1.02-1.07) in the chance of giving birth to a baby with ≥2 facial anomalies (ie, short palpebral fissures, thin vermilion border of the upper lip, and smooth philtrum) and a 4% increase (PR 1.04, 95% CI 1.01-1.07) in the chance of deficient brain growth. CONCLUSIONS The risk of delivering a baby with FAS was comparable among White, Black, and AI/AN women at similar levels of drinking during pregnancy. Regardless of race, a 1-gram increase in AAC resulted in increased odds of giving birth to a baby with facial anomalies or deficient brain growth.
Collapse
Affiliation(s)
- Sarah Soyeon Oh
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, United States
- Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Bada Kang
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea
| | - Jewel Park
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - SangMin Kim
- Harvard Medical School, Boston, MA, United States
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Preventive Medicine and Public Health, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung Hee Lee
- College of Nursing and Brain Korea 21 Four Project, Yonsei University, Seoul, Republic of Korea
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, United States
| |
Collapse
|
4
|
D’aloisio G, Acevedo MB, Angulo-Alcalde A, Trujillo V, Molina JC. Moderate ethanol exposure during early ontogeny of the rat alters respiratory plasticity, ultrasonic distress vocalizations, increases brain catalase activity, and acetaldehyde-mediated ethanol intake. Front Behav Neurosci 2022; 16:1031115. [DOI: 10.3389/fnbeh.2022.1031115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/25/2022] [Indexed: 11/11/2022] Open
Abstract
Early ontogeny of the rat (late gestation and postnatal first week) is a sensitive period to ethanol’s positive reinforcing effects and its detrimental effects on respiratory plasticity. Recent studies show that acetaldehyde, the first ethanol metabolite, plays a key role in the modulation of ethanol motivational effects. Ethanol brain metabolization into acetaldehyde via the catalase system appears critical in modulating ethanol positive reinforcing consequences. Catalase system activity peak levels occur early in the ontogeny. Yet, the role of ethanol-derived acetaldehyde during the late gestational period on respiration response, ultrasonic vocalizations (USVs), and ethanol intake during the first week of the rat remains poorly explored. In the present study, pregnant rats were given a subcutaneous injection of an acetaldehyde-sequestering agent (D-penicillamine, 50 mg/kg) or saline (0.9% NaCl), 30 min prior to an intragastric administration of ethanol (2.0 g/kg) or water (vehicle) on gestational days 17–20. Respiration rates (breaths/min) and apneic episodes in a whole-body plethysmograph were registered on postnatal days (PDs) 2 and 4, while simultaneously pups received milk or ethanol infusions for 40-min in an artificial lactation test. Each intake test was followed by a 5-min long USVs emission record. On PD 8, immediately after pups completed a 15-min ethanol intake test, brain samples were collected and kept frozen for catalase activity determination. Results indicated that a moderate experience with ethanol during the late gestational period disrupted breathing plasticity, increased ethanol intake, as well brain catalase activity. Animals postnatally exposed to ethanol increased their ethanol intake and exerted differential affective reactions on USVs and apneic episodes depending on whether the experience with ethanol occur prenatal or postnatally. Under the present experimental conditions, we failed to observe, a clear role of acetaldehyde mediating ethanol’s effects on respiratory plasticity or affective states, nevertheless gestational acetaldehyde was of crucial importance in determining subsequent ethanol intake affinity. As a whole, results emphasize the importance of considering the participation of acetaldehyde in fetal programming processes derived from a brief moderate ethanol experience early in development, which in turn, argues against “safe or harmless” ethanol levels of exposure.
Collapse
|
5
|
Gualdoni GS, Pérez-Tito L, Barril C, Sobarzo C, Cebral E. Abnormal growth and morphogenesis of placenta at term is linked to adverse fetal development after perigestational alcohol consumption up to early gestation in mouse. Birth Defects Res 2022; 114:611-630. [PMID: 35775613 DOI: 10.1002/bdr2.2063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 05/20/2022] [Accepted: 06/13/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Gestation alcohol consumption produces fetal growth restriction and malformations by affecting the embryo-fetal development. Recently a relationship between abnormal placentation and fetal malformation and intrauterine growth retardation has been suggested. However, the effects of perigestational alcohol ingestion up to early pregnancy on the placenta at term and its association with fetal abnormalities are little known. METHODS In female mice, ethanol 10% in water was administered for 15 days previous and up to days 4 (D4), 8 (D8), or 10 (D10) of gestation (TF), and gestation continues without ethanol exposure. Control females (CF) received ethanol-free water. At day 18, feto-placental units and implantation sites were studied. RESULTS TF had increased resorptions and only fetuses from D8-TF and D10-TF had significantly increased weights versus CF. D4 and D10-TF-placentas had significantly reduced weights. All TF had increased junctional zone (JZ) and reduced labyrinth (Lab) areas (PAS-histology and morphometry) compared with CF. Fetuses with mainly with craniofacial abnormalities and skeletal defects (Alizarin red staining), significantly increase; while the fetal bone density (alizarin color intensity, ImageJ) was reduced in D4, D8 and D10-TF versus CF. Although all TF-placentas were histo-structural affected, TF-abnormal fetuses had the most severe placental anomalies, with junctional abundant glycogenic cells into the labyrinth, disorganized labyrinthine vascularization with signs of leukocyte infiltrates and feto-maternal blood mix. CONCLUSIONS Perigestational alcohol consumption up to early gestation induces at term fetal growth alterations, dysmorphology and defective skeleton, linked to deficient growth and abnormal morphogenesis of placenta, highlighting insight into the prenatal etiology of FASD.
Collapse
Affiliation(s)
- Gisela Soledad Gualdoni
- Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina.,Instituto de Biodiversidad y Biología Experimental y Aplicada (IBBEA), CONICET-Universidad de Buenos Aires, Buenos Aires, Argentina.,Departamento de Biodiversidad y Biología Experimental (DBBE), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Leticia Pérez-Tito
- Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Camila Barril
- Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina.,Instituto de Biodiversidad y Biología Experimental y Aplicada (IBBEA), CONICET-Universidad de Buenos Aires, Buenos Aires, Argentina.,Departamento de Biodiversidad y Biología Experimental (DBBE), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Cristian Sobarzo
- Facultad de Medicina, CONICET, Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas (INBIOMED), Buenos Aires, Argentina
| | - Elisa Cebral
- Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina.,Instituto de Biodiversidad y Biología Experimental y Aplicada (IBBEA), CONICET-Universidad de Buenos Aires, Buenos Aires, Argentina.,Departamento de Biodiversidad y Biología Experimental (DBBE), Universidad de Buenos Aires, Buenos Aires, Argentina
| |
Collapse
|
6
|
Pillay D, Ndou R. Intrauterine alcohol exposure delays growth and disturbs trabecular morphology in 3-week-old Sprague − Dawley rat femur. J ANAT SOC INDIA 2022. [DOI: 10.4103/jasi.jasi_183_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
7
|
The impact a Mediterranean Diet in the third trimester of pregnancy has on neonatal body fat percentage. J Dev Orig Health Dis 2021; 13:500-507. [PMID: 34658323 DOI: 10.1017/s2040174421000556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Maternal diet during pregnancy has long been recognised as an important determinant of neonatal outcomes and child development. Infant body composition is a potentially modifiable risk factor for predicting future health and metabolic disease. Utilising the Mediterranean Diet Score, this study focused on how different levels of Mediterranean Diet adherence (MDA) in pregnancy influence body fat percentage of the infant. Information on 458 pregnant women in their third trimester of pregnancy and their infants was obtained from The ORIGINS Project. The data included MDA score, body composition measurements using infant air displacement plethysmography (PEA POD), pregnancy, and birth information. Infants born to mothers with high MDA had a body fat percentage of 11.3%, whereas infants born to mothers with low MDA had a higher body fat percentage of 13.3% (p = 0.010). When adjusted for pre-pregnancy body mass index and infant sex, a significant result remained between high vs. low MDA and infant fat mass (FM) (2.5% less FM p = 0.016). This study suggests that high MDA in pregnancy was associated with a reduced body fat percentage in the newborn. Future studies are needed to understand whether small but significant changes in FM persist throughout childhood.
Collapse
|
8
|
Cook M, Leggat G, Pennay A. Change Over Time in Australian Newspaper Reporting of Drinking During Pregnancy: A Content Analysis (2000-2017). Alcohol Alcohol 2021; 55:690-697. [PMID: 32676647 DOI: 10.1093/alcalc/agaa072] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/18/2020] [Accepted: 06/23/2020] [Indexed: 11/12/2022] Open
Abstract
AIMS This paper analyses the content of news media messages on drinking during pregnancy in Australia over an 18-year period to understand whether and how the nature of messages communicated to women has changed over time. METHODS Factiva was used to search Australian newspapers from 2000 to 2017, resulting in a sample of 1394 articles from the 18 major national and state-based newspapers. Content analysis of articles was undertaken, and Poisson regression analysis was used to assess changes over time. RESULTS The largest number of articles on drinking during pregnancy was published in 2007. Themes that significantly increased over time included Harms to the Child (from 0.97% in 2008 to 29.69% in 2015) and Prevention Initiatives (from 0% in 2005 to 12.50% in 2017). Articles endorsing women not consuming alcohol during pregnancy significantly increased over time (from 20.69% in 2001 to 53.78% in 2013), matched by a decreasing trend in the proportion of articles presenting mixed advice (from 15.93% in 2009 to 0% in 2017). The largest number of articles adopted no position in relation to women's consumption. CONCLUSIONS A stronger abstinence message during pregnancy has been communicated through Australian newspaper media over time. The mixed messaging and large number of articles not endorsing a position on consumption may reflect the inconclusiveness of the evidence on harms from low to moderate levels of alcohol consumption during pregnancy. Opportunities remain for researchers to work with public health advocates to disseminate balanced messages based on evidence-based research.
Collapse
Affiliation(s)
- Megan Cook
- Centre for Alcohol Policy Research, La Trobe University, Plenty Rd & Kingsbury Dr Bundoora, Victoria 3086, Australia
| | - Geoffrey Leggat
- Centre for Alcohol Policy Research, La Trobe University, Plenty Rd & Kingsbury Dr Bundoora, Victoria 3086, Australia
| | - Amy Pennay
- Centre for Alcohol Policy Research, La Trobe University, Plenty Rd & Kingsbury Dr Bundoora, Victoria 3086, Australia
| |
Collapse
|
9
|
Leggat G, Livingston M, Kuntsche S, Callinan S. Changes in alcohol consumption during pregnancy and over the transition towards parenthood. Drug Alcohol Depend 2021; 225:108745. [PMID: 34051548 DOI: 10.1016/j.drugalcdep.2021.108745] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 03/18/2021] [Accepted: 03/22/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To examine pre- to postnatal changes in drinking for women and men and assess the role of education level in these changes. BACKGROUND The transition towards parenthood can contribute to significant shifts in alcohol consumption for women and men. Research has generally focused on pregnancy and short-term changes following childbirth, usually for mothers only. Socio-economic variation in the impact of childbirth and return to drinking postnatally is similarly understudied. METHOD Longitudinal alcohol consumption data for 2470 individuals (1248 female) who were pregnant, or the partner of a pregnant woman, were obtained from a representative, Australian survey for three years prior and following birth. Piecewise regression models, including an education-x-time interaction, assessed changes in drinking quantity and frequency. RESULTS Female usual quantity and frequency significantly declined during pregnancy, followed by significant postnatal increases in quantity, approaching pre-pregnancy levels, with similar trends across education levels. Male usual quantity increased following childbirth, save for those men with a high-school education. Having an undergraduate degree was associated with a significant postnatal increase in drinking frequency. CONCLUSION Further awareness of the risks associated with male-partner drinking could provide substantial public health benefits. Successful facilitation and implementation of interventions and harm reduction strategies for harmful drinking over the pre- to postnatal period could benefit from further consideration of socioeconomic status and education level, particularly for men.
Collapse
Affiliation(s)
- Geoffrey Leggat
- Centre for Alcohol Policy Research (CAPR), La Trobe University, Australia.
| | - Michael Livingston
- Centre for Alcohol Policy Research (CAPR), La Trobe University, Australia; National Drug Research Institute, Curtin University, Australia; Karolinska Institutet, Department of Clinical Neuroscience, Stockholm, Sweden.
| | - Sandra Kuntsche
- Centre for Alcohol Policy Research (CAPR), La Trobe University, Australia.
| | - Sarah Callinan
- Centre for Alcohol Policy Research (CAPR), La Trobe University, Australia.
| |
Collapse
|
10
|
Anunziata F, Macchione AF, Alcalde AA, Tejerina DN, Amigone JL, Wille-Bille A, Trujillo V, Molina JC. Ethanol's disruptive effects upon early breathing plasticity and blood parameters associated with hypoxia and hypercapnia. Exp Neurol 2021; 344:113796. [PMID: 34224736 DOI: 10.1016/j.expneurol.2021.113796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/16/2021] [Accepted: 07/01/2021] [Indexed: 10/20/2022]
Abstract
Early ethanol exposure affects respiratory neuroplasticity; a risk factor associated with the Sudden Infant Death Syndrome. High and chronic ethanol doses exert long-lasting effects upon respiratory rates, apneic episodes and ventilatory processes triggered by hypoxia. The present study was performed in 3-9-day-old rat pups. Respiratory processes under normoxic and hypoxic conditions were analyzed in pups intoxicated with different ethanol doses which were pre-exposed or not to the drug. A second major goal was to examine if acute and/or chronic early ethanol exposure affects blood parameters related with hypercapnic or hypoxic states. In Experiment 1, at postnatal day 9, animals previously treated with ethanol (2.0 g/kg) or vehicle (0.0 g/kg) were tested sober or intoxicated with 0.75, 1.37 or 2.00 g/kg ethanol. The test involved sequential air conditions defined as initial normoxia, hypoxia and recovery normoxia. Motor activity was also evaluated. In Experiment 2, blood parameters indicative of possible hypoxic and hypercapnic states were assessed as a function of early chronic or acute experiences with the drug. The main results of Experiment 1 were as follows: i) ethanol's depressant effects upon respiratory rates increased as a function of sequential treatment with the drug (sensitization); ii) ethanol inhibited apneic episodes even when employing the lowest dose at test (0.75 g/kg); iii) the hyperventilatory response caused by hypoxia negatively correlated with the ethanol dose administered at test; iv) ventilatory long-term facilitation (LTF) during recovery normoxia was observed in pups pre-exposed to the drug and in pups that received the different ethanol doses at test; v) self-grooming increased in pups treated with either 1.37 or 2.00 g/kg ethanol. The main result of Experiment 2 indicated that acute as well as chronic ethanol exposure results in acidosis-hypercapnia. The results indicate that early and brief experiences with ethanol are sufficient to affect different respiratory plasticity processes as well as blood biomarkers indicative of acidosis-hypercapnia. An association between the LTF process and the acidosis-hypercapnic state caused by ethanol seems to exist. The mentioned experiences with the drug are sufficient to result in an anomalous programming of respiratory patterns and metabolic conditions.
Collapse
Affiliation(s)
- Florencia Anunziata
- Instituto de Investigación Médica Mercedes y Martín Ferreyra, INIMEC-CONICET- Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Ana F Macchione
- Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina; Instituto de Investigaciones Psicológicas, IIPsi-CONICET-Universidad Nacional de Córdoba, Córdoba, Argentina.
| | - Asier Angulo Alcalde
- Instituto de Investigación Médica Mercedes y Martín Ferreyra, INIMEC-CONICET- Universidad Nacional de Córdoba, Córdoba, Argentina; Departamento de Procesos Psicológicos Básicos y su Desarrollo, Facultad de Psicología, Universidad del País Vasco UPV-EHU, Donostia-San Sebastián, Guipúzcoa, Spain
| | - David N Tejerina
- Laboratorio de Bioquímica Clínica, Hospital Privado de Córdoba, Córdoba, Argentina
| | - José L Amigone
- Laboratorio de Bioquímica Clínica, Hospital Privado de Córdoba, Córdoba, Argentina
| | - Aranza Wille-Bille
- Instituto de Investigación Médica Mercedes y Martín Ferreyra, INIMEC-CONICET- Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Verónica Trujillo
- Instituto de Investigación Médica Mercedes y Martín Ferreyra, INIMEC-CONICET- Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Juan C Molina
- Instituto de Investigación Médica Mercedes y Martín Ferreyra, INIMEC-CONICET- Universidad Nacional de Córdoba, Córdoba, Argentina; Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina.
| |
Collapse
|
11
|
Jawaid S, Strainic JP, Kim J, Ford MR, Thrane L, Karunamuni GH, Sheehan MM, Chowdhury A, Gillespie CA, Rollins AM, Jenkins MW, Watanabe M, Ford SM. Glutathione Protects the Developing Heart from Defects and Global DNA Hypomethylation Induced by Prenatal Alcohol Exposure. Alcohol Clin Exp Res 2021; 45:69-78. [PMID: 33206417 DOI: 10.1111/acer.14511] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 11/03/2020] [Accepted: 11/08/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Fetal alcohol spectrum disorder (FASD) is caused by prenatal alcohol exposure (PAE), the intake of ethanol (C2 H5 OH) during pregnancy. Features of FASD cover a range of structural and functional defects including congenital heart defects (CHDs). Folic acid and choline, contributors of methyl groups to one-carbon metabolism (OCM), prevent CHDs in humans. Using our avian model of FASD, we have previously reported that betaine, another methyl donor downstream of choline, prevents CHDs. The CHD preventions are substantial but incomplete. Ethanol causes oxidative stress as well as depleting methyl groups for OCM to support DNA methylation and other epigenetic alterations. To identify more compounds that can safely and effectively prevent CHDs and other effects of PAE, we tested glutathione (GSH), a compound that regulates OCM and is known as a "master antioxidant." METHODS/RESULTS Quail embryos injected with a single dose of ethanol at gastrulation exhibited congenital defects including CHDs similar to those identified in FASD individuals. GSH injected simultaneously with ethanol not only prevented CHDs, but also improved survival and prevented other PAE-induced defects. Assays of hearts at 8 days (HH stage 34) of quail development, when the heart normally has developed 4-chambers, showed that this single dose of PAE reduced global DNA methylation. GSH supplementation concurrent with PAE normalized global DNA methylation levels. The same assays performed on quail hearts at 3 days (HH stage 19-20) of development, showed no difference in global DNA methylation between controls, ethanol-treated, GSH alone, and GSH plus ethanol-treated cohorts. CONCLUSIONS GSH supplementation shows promise to inhibit effects of PAE by improving survival, reducing the incidence of morphological defects including CHDs, and preventing global hypomethylation of DNA in heart tissues.
Collapse
Affiliation(s)
- Safdar Jawaid
- From the, Division of Pediatric Cardiology, (SJ, JPS, GHK, MMS, AC, CAG, MWJ, MW, SMF), Department of Pediatrics, The Congenital Heart Collaborative, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Department of Biomedical Engineering, (SJ, MMS, AMR, MWJ), School of Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| | - James P Strainic
- From the, Division of Pediatric Cardiology, (SJ, JPS, GHK, MMS, AC, CAG, MWJ, MW, SMF), Department of Pediatrics, The Congenital Heart Collaborative, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Jun Kim
- From the, Division of Pediatric Cardiology, (SJ, JPS, GHK, MMS, AC, CAG, MWJ, MW, SMF), Department of Pediatrics, The Congenital Heart Collaborative, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | | | - Lars Thrane
- Department of Biomedical Engineering, (SJ, MMS, AMR, MWJ), School of Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| | - Ganga H Karunamuni
- From the, Division of Pediatric Cardiology, (SJ, JPS, GHK, MMS, AC, CAG, MWJ, MW, SMF), Department of Pediatrics, The Congenital Heart Collaborative, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Megan M Sheehan
- From the, Division of Pediatric Cardiology, (SJ, JPS, GHK, MMS, AC, CAG, MWJ, MW, SMF), Department of Pediatrics, The Congenital Heart Collaborative, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Department of Biomedical Engineering, (SJ, MMS, AMR, MWJ), School of Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| | - Amrin Chowdhury
- From the, Division of Pediatric Cardiology, (SJ, JPS, GHK, MMS, AC, CAG, MWJ, MW, SMF), Department of Pediatrics, The Congenital Heart Collaborative, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Brecksville-Broadview Heights High School, (AC), Broadview Heights, Ohio, USA
| | - Caitlyn A Gillespie
- From the, Division of Pediatric Cardiology, (SJ, JPS, GHK, MMS, AC, CAG, MWJ, MW, SMF), Department of Pediatrics, The Congenital Heart Collaborative, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Fisk University, (CAG), Nashville, Tennessee, USA
| | - Andrew M Rollins
- Department of Biomedical Engineering, (SJ, MMS, AMR, MWJ), School of Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| | - Michael W Jenkins
- From the, Division of Pediatric Cardiology, (SJ, JPS, GHK, MMS, AC, CAG, MWJ, MW, SMF), Department of Pediatrics, The Congenital Heart Collaborative, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Department of Biomedical Engineering, (SJ, MMS, AMR, MWJ), School of Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| | - Michiko Watanabe
- From the, Division of Pediatric Cardiology, (SJ, JPS, GHK, MMS, AC, CAG, MWJ, MW, SMF), Department of Pediatrics, The Congenital Heart Collaborative, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Stephanie M Ford
- From the, Division of Pediatric Cardiology, (SJ, JPS, GHK, MMS, AC, CAG, MWJ, MW, SMF), Department of Pediatrics, The Congenital Heart Collaborative, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| |
Collapse
|
12
|
Alcohol. Alcohol 2021. [DOI: 10.1016/b978-0-12-816793-9.00001-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
|
13
|
Baldacci S, Santoro M, Coi A, Mezzasalma L, Bianchi F, Pierini A. Lifestyle and sociodemographic risk factors for gastroschisis: a systematic review and meta-analysis. Arch Dis Child 2020; 105:756-764. [PMID: 32051127 DOI: 10.1136/archdischild-2019-318412] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/24/2020] [Accepted: 01/24/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND Gastroschisis is strongly associated with young maternal age. This association suggests the need for further investigations on non-genetic risk factors. Identifying these risk factors is a public health priority in order to develop prevention strategies aimed at reducing the prevalence and health consequences in offspring. OBJECTIVE To systematically assess and quantitatively synthesise the available epidemiological studies to evaluate the association between non-genetic risk factors and gastroschisis. METHODS Literature from PubMed, EMBASE and Scopus was searched for the period 1990-2018. Epidemiological studies reporting risk estimates between lifestyle and sociodemographic risk factors and gastroschisis were included. Two pairs of reviewers independently extracted information on study characteristics following Preferred Reporting Items for Systematic Reviews and Meta-Analyses and MOOSE (Meta-analysis Of Oservational Studies in Epidemiology) guidelines. Relative risk (RR) estimates were calculated across the studies and meta-analysis was performed using random-effects model. RESULTS We identified 58 studies. Meta-analyses were conducted on 29 studies. Maternal smoking (RR 1.56, 95% CI 1.40 to 1.74), illicit drug use (RR 2.14, 95% CI 1.48 to 3.07) and alcohol consumption (RR 1.40, 95% CI 1.13 to 1.70) were associated with an increased risk of gastroschisis. A decreased risk among black mothers compared with non-Hispanic white mothers (RR 0.49, 95% CI 0.38 to 0.63) was found. For Hispanic mothers no association was observed. CONCLUSIONS Exposure to smoking, illicit drugs and alcohol during pregnancy is associated with an increased risk of gastroschisis. A significantly decreased risk for black mothers was observed. Further epidemiological studies to assess the potential role of other environmental factors are strongly recommended. PROSPERO REGISTRATION NUMBER CRD42018104284.
Collapse
Affiliation(s)
- Silvia Baldacci
- Institute of Clinical Physiology National Research Council, Pisa, Italy
| | - Michele Santoro
- Institute of Clinical Physiology National Research Council, Pisa, Italy
| | - Alessio Coi
- Institute of Clinical Physiology National Research Council, Pisa, Italy
| | - Lorena Mezzasalma
- Institute of Clinical Physiology National Research Council, Pisa, Italy
| | - Fabrizio Bianchi
- Institute of Clinical Physiology National Research Council, Pisa, Italy.,Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Anna Pierini
- Institute of Clinical Physiology National Research Council, Pisa, Italy.,Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| |
Collapse
|
14
|
Weile LKK, Wu C, Hegaard HK, Kesmodel US, Henriksen TB, Ibsen IO, Nohr EA. Identification of Alcohol Risk Drinking Behaviour in Pregnancy Using a Web-Based Questionnaire: Large-Scale Implementation in Antenatal Care. Alcohol Alcohol 2020; 55:225-232. [DOI: 10.1093/alcalc/agz100] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 11/11/2019] [Accepted: 11/14/2019] [Indexed: 11/14/2022] Open
Abstract
AbstractAimsThis study aimed to examine the feasibility of a web-based questionnaire when collecting information on alcohol consumption in pregnancy to identify women with risk drinking behaviour, and to describe factors associated with risk drinking behaviour, and the use of specialized care for prenatal risk drinking.MethodsIn 2413 women referred to antenatal care at Odense University Hospital, Denmark, April–October 2018, self-reported alcohol intake was retrieved from a web-based questionnaire. Replies were screened for risk drinking behaviour: current intake of ≥7 drinks/week, ≥3 binge drinking episodes (intake of ≥5 drinks on a single occasion) in pregnancy, binge drinking after recognition of pregnancy and/or a TWEAK-score ≥ 2 points. Women with risk drinking behaviour were called to clarify the need for specialized care. A summary of the interview was obtained from the medical records.ResultsOverall, 2168 (90%) completed the questionnaire. Of 2097 women providing information on alcohol intake, 77 (4%) had risk drinking behaviour. Risk drinking was associated with higher alcohol intake prior to pregnancy, spontaneous conception, younger age, nulliparity and higher level of physical activity in pregnancy. Amongst 47 women with risk drinking behaviour reached by phone, five (11%, 95% CI 4–23%) accepted examinations of the child by paediatrician and child psychologist, and <3 (not further specified due to small numbers) were referred to specialized antenatal care.ConclusionsA web-based questionnaire was feasible when collecting information on alcohol consumption in pregnancy to identify risk drinking behaviour. Women with risk drinking behaviour had a low acceptance of referral to specialized care.
Collapse
Affiliation(s)
- Louise Katrine Kjaer Weile
- Department of Obstetrics and Gynaecology, Odense University Hospital, Sdr. Boulevard 29, DK-5000 Odense C, Denmark
- Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 19, DK-5000 Odense C, Denmark
- OPEN, Odense Patient data Explorative Network, Odense University Hospital, J.B. Winsløws Vej 9a, DK-5000 Odense C, Denmark
| | - Chunsen Wu
- Department of Obstetrics and Gynaecology, Odense University Hospital, Sdr. Boulevard 29, DK-5000 Odense C, Denmark
- Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 19, DK-5000 Odense C, Denmark
| | - Hanne Kristine Hegaard
- Department of Obstetrics, Copenhagen University Hospital (Rigshospitalet), Juliane Maries Vej 9, DK-2100 Copenhagen Ø, Denmark
- The Research Unit Women’s and Children’s Health, Section 7821 Juliane Marie Centre, Copenhagen University Hospital (Rigshospitalet), Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark
| | - Ulrik Schiøler Kesmodel
- Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 19, DK-5000 Odense C, Denmark
- Department of Clinical Medicine, Aalborg University, Søndre Skovvej 15, DK-9000 Aalborg, Denmark
- Department of Obstetrics and Gynaecology, Aalborg University Hospital, Reberbansgade 9, DK-9000 Aalborg, Denmark
| | - Tine Brink Henriksen
- Department of Paediatrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus N, Denmark
- Perinatal Epidemiology Research Unit, Department of Paediatrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus N, Denmark
| | - Inge Olga Ibsen
- Department of Obstetrics and Gynaecology, Odense University Hospital, Sdr. Boulevard 29, DK-5000 Odense C, Denmark
| | - Ellen Aagaard Nohr
- Department of Obstetrics and Gynaecology, Odense University Hospital, Sdr. Boulevard 29, DK-5000 Odense C, Denmark
- Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 19, DK-5000 Odense C, Denmark
| |
Collapse
|
15
|
Hendricks G, Malcolm-Smith S, Stein DJ, Zar HJ, Wedderburn CJ, Nhapi RT, Chivese T, Adnams CM, Donald KA. Prenatal alcohol exposure is associated with early motor, but not language development in a South African cohort. Acta Neuropsychiatr 2020; 32:1-8. [PMID: 31902391 PMCID: PMC7282868 DOI: 10.1017/neu.2019.51] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 11/26/2019] [Accepted: 12/10/2019] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To investigate the association of prenatal alcohol exposure (PAE) and early neurodevelopment in the first 2 years of life, adjusting for maternal socio-demographic and psychosocial factors, in the Drakenstein Child Health Study (DCHS), a South African birth cohort study. METHODS The DCHS comprises a population-based birth cohort of 1143 children, of which a subsample completed the Bayley Scales of Infant Development-III (BSID-III) at 6 (n = 260) and 24 months of age (n = 734). A subset of alcohol-exposed and -unexposed children was included in this analysis at age 6 (n = 52 exposed; n = 104 unexposed) and 24 months (n = 92 exposed; n = 184 unexposed). Multiple hierarchical regression was used to explore the associations of PAE with motor and language development. RESULTS PAE was significantly associated with decreased gross motor [odds ratio (OR) = 0.16, 95% confidence interval (CI) = 0.06-0.44, p = 0.001] or fine motor (OR = 0.16, 95% CI = 0.06-0.46, p = 0.001) functioning after adjusting for maternal socio-demographic and psychosocial factors at 6 months of age only. No significant effects were found in either receptive or expressive communication and cognitive outcomes at either time points. CONCLUSION PAE has potentially important consequences for motor development in the first 2 years of life, a period during which the most rapid growth and maturation occur. These findings highlight the importance of identifying high-risk families in order to provide preventive interventions, particularly in antenatal clinics and early intervention services.
Collapse
Affiliation(s)
- Gaironeesa Hendricks
- Department of Psychiatry and Mental Health, and SAMRC Unit on Risk and Resilience, University of Cape Town, Cape Town, South Africa
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
| | - Susan Malcolm-Smith
- Department of Psychology, Applied Cognitive Science and Experimental Neuropsychology Team, University of Cape Town, Cape Town, South Africa
| | - Dan J. Stein
- Department of Psychiatry and Mental Health, and SAMRC Unit on Risk and Resilience, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Heather J. Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- SAMRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Catherine J. Wedderburn
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Raymond T. Nhapi
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
| | - Tawanda Chivese
- Department of Population Health, College of Medicine, Qatar University, Doha, Qatar
| | - Colleen M. Adnams
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Kirsten A. Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
16
|
Bone-Loading Physical Activity and Alcohol Intake but not BMI Affect Areal Bone Mineral Density in Young College-Aged Korean Women: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16245063. [PMID: 31842273 PMCID: PMC6950177 DOI: 10.3390/ijerph16245063] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/09/2019] [Accepted: 12/09/2019] [Indexed: 12/12/2022]
Abstract
The purpose of this cross-sectional study was to determine the differences in areal bone mineral density (aBMD) based on alcohol consumption behaviors, bone-loading history as assessed by a bone-specific physical activity questionnaire (BPAQ), and the body mass index (BMI). College-aged female students (N = 112) were recruited from the universities in Seoul and Gyeonggi province, South Korea. The aBMD of the lumbar spine and non-dominant side of the proximal femur (total hip, TH; femoral neck, FN; femoral trochanter, FT) were measured using dual energy X-ray absorptiometry (DXA). Alcohol consumption was determined by the frequency and amount of alcohol intake during the past 12 months using a self-reported questionnaire. The X-scan plus II was used to measure height (cm), body mass (kg), fat-free mass (FFM, kg), and % body fat. Drinking two or more times alcohol per week was associated with greater aBMD of the TH (p = 0.04–0.002) and FN (p = 0.043) compared to a lower frequency of alcohol consumption and 2–4 times per month, respectively. Based on the drinking amount per occasion, there were no significant group differences (p > 0.05) in aBMD at any of the sites. The highest group of total BPAQ had greater aBMD of the TH, FN, and FT versus the lowest (p = 0.023–0.009) and mid of total BPAQ groups (p = 0.004–0.009). Additionally, the highest group had greater aBMD of the lumbar spine compared to the mid group (p = 0.001). No significant group differences in aBMD at any of the sites were noted based on the BMI (p > 0.05). Young college-aged women with greater bone-loading physical activity showed greater aBMD at the TH, FN, FT, and lumbar spine, while a moderate alcohol intake was associated with greater aBMD of the TH and FN. These findings have clinical implications for young women who may not participate in high-impact physical activity and are binge drinkers.
Collapse
|
17
|
Light drinking during pregnancy: Social advantages explain positive correlates with child and early adolescent adjustment. Addict Behav 2019; 98:106003. [PMID: 31415972 DOI: 10.1016/j.addbeh.2019.05.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 05/05/2019] [Accepted: 05/23/2019] [Indexed: 11/20/2022]
Abstract
Maternal heavy alcohol use during pregnancy is harmful to offspring's health and adjustment. However, findings from studies on lower levels of prenatal drinking are mixed; a few even predict positive cognitive and psychosocial outcomes. Given that alcohol is a neurotoxin and teratogen, scholars question developmental benefits and point to residual confounding as a potential explanation, particularly as light drinkers are positively selected with respect to health and socioeconomic status. Using prospective, intergenerational data from the nationally-representative Millennium Cohort Study (MCS) in the United Kingdom, we studied associations between mother's drinking during pregnancy and children's cognitive and psychosocial outcomes at ages 3, 5, 7, 11, and 14 years (n = 10,454). We included early life confounders (e.g., maternal education, health, smoking) and mother's cognitive ability, and assessed robustness of relationships across outcomes and alternate drinking classifications. Results of a series of multivariable regression models found no association between light drinking and cognitive and psychosocial outcomes up to and including the age of 14, after controlling for key confounders. Light drinking during pregnancy was linked to higher socioeconomic advantages (e.g., mothers' higher education, professional/managerial occupation, home ownership, cognitive scores), which together accounted for positive associations between light drinking and children's outcomes. Mother's cognitive ability was an especially important confounder.
Collapse
|
18
|
D'Souza S, Crawford CN, Buckley J, Underwood L, Peterson ER, Bird A, Morton SMB, Waldie KE. Antenatal determinants of early childhood talking delay and behavioural difficulties. Infant Behav Dev 2019; 57:101388. [PMID: 31634704 DOI: 10.1016/j.infbeh.2019.101388] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 10/03/2019] [Accepted: 10/04/2019] [Indexed: 11/26/2022]
Abstract
The determinants of talking delay alone or its comorbidity with behavioural difficulties was examined in 5768 two-year-old members of the Growing Up in New Zealand longitudinal study. Using the MacArthur-Bates Communicative Development inventories and the total difficulties score from the preschool Strengths and Difficulties Questionnaire, a composite measure was created so that children were categorised as showing no language or behavioural concerns (72.5%), behavioural only difficulties (6.1%), language only difficulties (18.1%), and comorbid language and behavioural difficulties (3.3%). Analyses revealed that antenatal factors such as maternal perceived stress, inadequate folate intake, vitamin intake, alcohol consumption during the first trimester and maternal smoking all had a significant effect on child outcomes. In particular, low multivitamin intake and perceived stress during pregnancy were associated with coexisting language and behavioural difficulties. These findings support international research in showing that maternal factors during pregnancy are associated with developmental outcomes in the early childhood period, and demonstrate these associations within a NZ context. Interventions which address maternal stress management and health behaviours during pregnancy could be beneficial to offspring development.
Collapse
Affiliation(s)
- Stephanie D'Souza
- School of Psychology, The University of Auckland, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand; Centre of Methods and Policy Application in the Social Sciences, University of Auckland, Auckland, New Zealand
| | | | - Jude Buckley
- School of Psychology, The University of Auckland, Auckland, New Zealand
| | - Lisa Underwood
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Elizabeth R Peterson
- School of Psychology, The University of Auckland, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Amy Bird
- School of Psychology, University of Wollongong, NSW, Australia
| | - Susan M B Morton
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand; School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Karen E Waldie
- School of Psychology, The University of Auckland, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand.
| |
Collapse
|
19
|
Schölin L, Hughes K, Bellis MA, Eriksson C, Porcellato L. “I think we should all be singing from the same hymn sheet” – English and Swedish midwives’ views of advising pregnant women about alcohol. DRUGS: EDUCATION, PREVENTION AND POLICY 2019. [DOI: 10.1080/09687637.2018.1478949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Lisa Schölin
- Liverpool John Moores Unviersity, Public Health Institute, Henry Cotton Campus, Liverpool, UK
| | - Karen Hughes
- Public Health Wales Directorate of Policy Research and International Development Public Health Wales, Wrexham, UK
- Bangor University College of Health and Behavioural Sciences, Bangor, UK
| | - Mark A. Bellis
- Public Health Wales Directorate of Policy Research and International Development Public Health Wales, Wrexham, UK
- Bangor University College of Health and Behavioural Sciences, Bangor, UK
| | - Charli Eriksson
- School of Health and Medical Sciences, Örebro Universitet, Örebro, Sweden
| | - Lorna Porcellato
- Liverpool John Moores Unviersity, Public Health Institute, Henry Cotton Campus, Liverpool, UK
| |
Collapse
|
20
|
Doherty E, Wiggers J, Wolfenden L, Anderson AE, Crooks K, Tsang TW, Elliott EJ, Dunlop AJ, Attia J, Dray J, Tully B, Bennett N, Murray H, Azzopardi C, Kingsland M. Antenatal care for alcohol consumption during pregnancy: pregnant women's reported receipt of care and associated characteristics. BMC Pregnancy Childbirth 2019; 19:299. [PMID: 31419964 PMCID: PMC6698023 DOI: 10.1186/s12884-019-2436-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 07/29/2019] [Indexed: 12/31/2022] Open
Abstract
Background Antenatal clinical guidelines recommend that during initial and subsequent antenatal visits all pregnant women: have their alcohol consumption assessed; be advised that it is safest not to consume alcohol during pregnancy and of the potential risks of consumption; and be offered referrals for further support if required. However, the extent to which pregnant women attending public antenatal services receive guideline recommended care at these visits, and the characteristics associated with its receipt, is unknown. The purpose of this study was to examine: 1) pregnant women’s reported receipt of guideline recommended care addressing alcohol consumption during pregnancy; 2) characteristics associated with the receipt of care; and 3) pregnant women’s acceptability of care. Methods From July 2017 – February 2018 a survey (telephone or online) was undertaken with 1363 pregnant women who had recently visited a public antenatal service in one health district in Australia. Receipt and acceptability of recommended care were assessed via descriptive statistics and associations via logistic regression analyses. Results At the initial antenatal visit, less than two thirds (64.3%) of pregnant women reported that they received an assessment of their alcohol consumption and just over one third (34.9%) received advice and referral appropriate to their self-reported level of alcohol consumption since pregnancy recognition. Less than 10% of women received such care at subsequent antenatal visits. Characteristics that significantly increased the odds of receiving all guideline elements at the initial antenatal visit included: less than university attainment (OR = 1.93; 95% CI:1.12, 3.34), not residing in an advantaged area (OR = 2.11; 95% CI:1.17, 3.79), first pregnancy (OR = 1.91; 95% CI:1.22, 2.99) and regional/rural service location (OR = 2.38; 95% CI:1.26, 4.48); and at subsequent visits: younger age (OR = 0.91; 95% CI:0.84, 0.99) and Aboriginal origin (OR = 3.17; 95% CI:1.22, 8.24). Each of the recommended care elements were highly acceptable to pregnant women (88.3–99.4%). Conclusions Although care for alcohol consumption is both recommended by clinical guidelines and highly acceptable to pregnant women, its receipt in public antenatal services is suboptimal. There is a need and an opportunity for interventions to support antenatal care providers to routinely and consistently provide such care to all pregnant women.
Collapse
Affiliation(s)
- Emma Doherty
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW, 2287, Australia. .,School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia. .,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.
| | - John Wiggers
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW, 2287, Australia.,School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW, 2287, Australia.,School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Amy E Anderson
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Kristy Crooks
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW, 2287, Australia.,Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Tracey W Tsang
- Faculty of Medicine and Health and Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia.,Sydney Children's Hospital Network, Kids' Research Institute, Westmead, New South Wales, Australia
| | - Elizabeth J Elliott
- Faculty of Medicine and Health and Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia.,Sydney Children's Hospital Network, Kids' Research Institute, Westmead, New South Wales, Australia
| | - Adrian J Dunlop
- Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, New South Wales, Australia
| | - John Attia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Julia Dray
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Belinda Tully
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW, 2287, Australia
| | - Nicole Bennett
- Maternity and Gynaecology John Hunter Hospital, New Lambton Heights, New South Wales, Australia
| | - Henry Murray
- Maternity and Gynaecology John Hunter Hospital, New Lambton Heights, New South Wales, Australia
| | - Carol Azzopardi
- Maternity and Gynaecology John Hunter Hospital, New Lambton Heights, New South Wales, Australia
| | - Melanie Kingsland
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW, 2287, Australia.,School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| |
Collapse
|
21
|
Ceulemans M, Van Calsteren K, Allegaert K, Foulon V. Health products' and substance use among pregnant women visiting a tertiary hospital in Belgium: A cross-sectional study. Pharmacoepidemiol Drug Saf 2019; 28:1231-1238. [PMID: 31342605 DOI: 10.1002/pds.4862] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 05/07/2019] [Accepted: 06/27/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE To investigate the prevalence and type of health products used among pregnant women visiting a tertiary hospital in Belgium, as well as who advises these products, where women buy these products, which determinants are associated with medication and pregnancy vitamin intake, and preconception lifestyle changes such as folic acid intake and substance use. METHODS A cross-sectional study was performed at the outpatient obstetrics clinics of the University Hospital Leuven, Belgium between November 2016 and March 2017. All pregnant women 18 years and older and understanding Dutch, French, or English were asked to participate in an online survey. RESULTS In total, 379 pregnant women participated. Prevalence of medication use during the preceding week was 52%. Paracetamol (14%), levothyroxine (13%), and antacids (9%) were the most frequently used medicines. Pregnancy vitamins were used by 86% of women, and 97% had used a pregnancy vitamin somewhere during pregnancy. Only 56% initiated folic acid supplementation at least 1 month before pregnancy. Preconception use of folic acid among women following assisted reproductive technology was 73%. Inappropriate use of health products was observed among 3% of women. Prevalence of alcohol use and/or smoking during the preceding week was 6%. Alcohol and smoking cessation mainly occurred after pregnancy diagnosis. CONCLUSION Pregnant women living in Belgium frequently use medicines, pregnancy vitamins, and other health products. Preconception lifestyle changes such as folic acid intake and alcohol and smoking cessation are poorly implemented. Public campaigns and interventions are needed to improve preconception care and counselling.
Collapse
Affiliation(s)
- Michael Ceulemans
- Department of Pharmaceutical and Pharmacological Sciences, Clinical Pharmacology and Pharmacotherapy, KU Leuven, Leuven, Belgium
| | - Kristel Van Calsteren
- Department of Obstetrics and Gynecology, University Hospital Gasthuisberg Leuven, Leuven, Belgium.,Department of Development and Regeneration, Woman and Child, KU Leuven, Leuven, Belgium
| | - Karel Allegaert
- Department of Development and Regeneration, Woman and Child, KU Leuven, Leuven, Belgium.,Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Veerle Foulon
- Department of Pharmaceutical and Pharmacological Sciences, Clinical Pharmacology and Pharmacotherapy, KU Leuven, Leuven, Belgium
| |
Collapse
|
22
|
Keyes KM, Jager J, Mal-Sarkar T, Patrick ME, Rutherford C, Hasin D. Is There a Recent Epidemic of Women's Drinking? A Critical Review of National Studies. Alcohol Clin Exp Res 2019; 43:1344-1359. [PMID: 31074877 DOI: 10.1111/acer.14082] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 05/02/2019] [Indexed: 12/17/2022]
Abstract
Alcohol consumption is increasing in the United States, as is alcohol-attributable mortality. Historically, men have had higher rates of alcohol consumption than women, though evidence for birth cohort effects on gender differences in alcohol consumption and alcohol-related harm suggests that gender differences may be diminishing. We review studies using U.S. national data that examined time trends in alcohol consumption and alcohol-related harm since 2008. Utilizing a historical-developmental perspective, here we synthesize and integrate the literature on birth cohort effects from varying developmental periods (i.e., adolescence, young adulthood, middle adulthood, and late adulthood), with a focus on gender differences in alcohol consumption. Findings suggest that recent trends in gender differences in alcohol outcomes are heterogeneous by developmental stage. Among adolescents and young adults, both males and females are rapidly decreasing alcohol consumption, binge and high-intensity drinking, and alcohol-related outcomes, with gender rates converging because males are decreasing consumption faster than females. This pattern does not hold among adults, however. In middle adulthood, consumption, binge drinking, and alcohol-related harms are increasing, driven largely by increases among women in their 30s and 40s. The trend of increases in consumption that are faster for women than for men appears to continue into older adult years (60 and older) across several studies. We conclude by addressing remaining gaps in the literature and offering directions for future research.
Collapse
Affiliation(s)
- Katherine M Keyes
- Department of Epidemiology, Columbia University, New York, New York.,Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
| | - Justin Jager
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, Arizona
| | | | - Megan E Patrick
- Institute for Translational Research in Children's Mental Health, University of Minnesota, Minneapolis, Minnesota
| | | | - Deborah Hasin
- Department of Epidemiology, Columbia University, New York, New York
| |
Collapse
|
23
|
He H, Xiong Y, Li B, Zhu Y, Chen H, Ao Y, Wang H. Intrauterine programming of the glucocorticoid-insulin-like growth factor 1 (GC-IGF1) axis mediates glomerulosclerosis in female adult offspring rats induced by prenatal ethanol exposure. Toxicol Lett 2019; 311:17-26. [PMID: 31039417 DOI: 10.1016/j.toxlet.2019.04.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 03/06/2019] [Accepted: 04/21/2019] [Indexed: 10/26/2022]
Abstract
Prenatal ethanol exposure (PEE) causes intrauterine growth retardation (IUGR), and the occurrence of glomerulosclerosis is closely related to IUGR. This study aimed to confirm the kidney toxic effect of PEE and explore its intrauterine programming mechanism in female offspring. The Wistar female fetuses on gestational day (GD) 20 and the adult offspring at postnatal week 24 were anesthetized and decapitated. The adult offspring kidneys in the PEE group displayed glomerular hyperplasia and glomerulosclerosis. Blood urea nitrogen (BUN) and the BUN / Serum creatinine (Scr) concentration ratio in the PEE group was increased significantly compared to the control group (P<0.01, P<0.05). Meanwhile, the renal glucocorticoid-activation system was inhibited, whereas the insulin-like growth factor 1 (IGF1) signaling pathway was activated in the female adult offspring of the PEE group. In the fetal kidney of the PEE group, pathological observation showed kidney dysplasia, and the gene expression of the glial-cell-line-derived neurotrophic factor/tyrosine kinase receptor (GDNF/c-Ret) signaling pathway was reduced compared to that of the control group. Moreover, the glucocorticoid-activation system was activated, whereas the IGF1 signaling pathway was inhibited in the fetal kidneys of the PEE group. In conclusion, PEE caused fetal kidney dysplasia and adult glomerulosclerosis in the female offspring rats, and the intrauterine programming alteration of glucocorticoid-insulin-like growth factor 1 (GC-IGF1) axis might be involved in fetal-originated glomerulosclerosis.
Collapse
Affiliation(s)
- Hangyuan He
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan, 430071, China; Department of Orthopaedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Ying Xiong
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan, 430071, China
| | - Bin Li
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan, 430071, China; Department of Orthopaedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Yanan Zhu
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China
| | - Haiyun Chen
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China
| | - Ying Ao
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China.
| | - Hui Wang
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China.
| |
Collapse
|
24
|
Effects of prenatal alcohol exposure on language, speech and communication outcomes: a review longitudinal studies. Acta Neuropsychiatr 2019; 31:74-83. [PMID: 30449293 PMCID: PMC7056946 DOI: 10.1017/neu.2018.28] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The aim of this paper was to provide a systematic review and update on the available longitudinal studies on the impact of prenatal alcohol exposure (PAE) on language, speech and communication development, as well as associated potential environmental confounders during the preschool period. METHODS A literature search was restricted to English, full-text, peer-reviewed, longitudinal studies in from 1970 until present: PUBMed, Scopus, Web of Science {C-e Collection, Biological Abstracts, KCI-Kean Journal Database, Russian Science Citation Index, SciELO Citation Index, Zoological Rec-d}, Academic Search Premier (Africa-Wide Information, CINAHL, MEDLINE, PsycINFO. Keywords included: prenatal alcohol exposure (PAE); speech or language or communication outcomes; neurocognitive or neurodevelopment or neurobehavioral or neurobehavioural; infant or baby or toddler or preschooler; longitudinal or follow-up. The inclusion criteria included (i) longitudinal cohorts with at least 2 time-points; (ii) association of light, moderate or heavy PAE on language, speech or communication delay, development or disorder; (iii) environmental confounders; (iv) infants up to preschool age. RESULTS Six studies satisfied the threshold for inclusion. Three studies reported that PAE was significantly associated with receptive or expressive delay. These studies demonstrated lower scores on either receptive or expressive communication in the alcohol group in comparison to the non-alcohol group, even after controlling for environmental factors up to 36 months. CONCLUSION Evidence from the longitudinal studies reviewed suggest that PAE influenced delays in receptive and expressive communication up to 36 months. Contextual risk factors played a significant role in language development over time and especially as children approached school age.
Collapse
|
25
|
Schölin L, Hughes K, Bellis MA, Eriksson C, Porcellato L. Exploring practices and perceptions of alcohol use during pregnancy in England and Sweden through a cross-cultural lens. Eur J Public Health 2019; 28:533-537. [PMID: 29206945 DOI: 10.1093/eurpub/ckx208] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Background Qualitative studies have aimed to understand why some women continue to drink during pregnancy; however, there is a lack of comparative cross-cultural research. We aimed to explore perceptions and practices of alcohol use during pregnancy in England and Sweden. Methods Semi-structured interviews were conducted with 21 parents in Merseyside, England and 22 parents in Örebro County, Sweden. Interviews were audio recorded, transcribed verbatim and translated. Data were analyzed using thematic analysis. Results The majority of women in both countries abstained from alcohol when they found out they were pregnant, despite alcohol being part of many social contexts before pregnancy. Nine of the seventeen English women drank at some point during pregnancy, typically on special occasions. Most parents felt women should modify their alcohol intake when they become mothers, though several English parents argued that responsible motherhood did not necessarily equate to abstinence. Swedish parents held strong opinions against drinking during pregnancy and argued that any amount of alcohol could harm the foetus. English parents' opinions were divided; some were skeptical of whether low to moderate drinking was associated with risks. Conclusions Practices and attitudes towards alcohol use during pregnancy and views on foetal rights and responsibilities of pregnant women differed in England and Sweden. Shared social norms around drinking may be shaped within the policy context of pregnancy drinking guidelines, determining whether women consume alcohol or not.
Collapse
Affiliation(s)
- Lisa Schölin
- Nursing Studies, School of Health in Social Science, University of Edinburgh, Edinburgh, UK.,Public Health Institute, Liverpool John Moores University, 15-21 Webster Street, Liverpool, UK
| | - Karen Hughes
- Public Health Wales, Hadyn Ellis Building, Cardiff University, Maindy Road, Cardiff, UK
| | - Mark A Bellis
- Public Health Wales, Hadyn Ellis Building, Cardiff University, Maindy Road, Cardiff, UK
| | - Charli Eriksson
- School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Lorna Porcellato
- Public Health Institute, Liverpool John Moores University, 15-21 Webster Street, Liverpool, UK
| |
Collapse
|
26
|
Prevalence of Fetal Alcohol Exposure by Analysis of Meconium Fatty Acid Ethyl Esters; A National Canadian Study. Sci Rep 2019; 9:2298. [PMID: 30783158 PMCID: PMC6381181 DOI: 10.1038/s41598-019-38856-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 01/09/2019] [Indexed: 01/02/2023] Open
Abstract
Our study aimed to estimate the prevalence of heavy fetal alcohol exposure through the analysis of meconium FAEEs as an objective biomarker of fetal exposure. We conducted a study on meconium samples collected nationwide through the Maternal-Infant Research on Environmental Chemicals (MIREC) Study Group. FAEE in meconium was quantified by an established headspace solid-phase microextraction coupled with gas chromatography-mass spectrometry (SPME GC-MS). Out of 1315 samples collected in 10 Canadian obstetric units coast to coast between 2008-2011, the estimated prevalence of positive meconium FAEE ranged between 1.16% and 2.40%, translating into at least 1800 new cases of FASD in Canada each year. Positive maternal self- reports of heavy alcohol use were tenfold lower (0.24%). Use of meconium FAEE revealed tenfold more cases of heavy exposure to maternal drinking than did maternal reports. The use of objective measures of maternal alcohol exposure is critical in accurately estimating risks and in monitoring effective prevention of FASD.
Collapse
|
27
|
Terband H, Spruit M, Maassen B. Speech Impairment in Boys With Fetal Alcohol Spectrum Disorders. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 27:1405-1425. [PMID: 30398563 DOI: 10.1044/2018_ajslp-17-0013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 05/11/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Fetal alcohol spectrum disorders (FASD) are a highly prevalent spectrum of patterns of congenital defects resulting from prenatal exposure to alcohol. Approximately 90% of the cases involve speech impairment. Yet, to date, no detailed symptom profiles nor dedicated treatment plans are available for this population. PURPOSE This study set out to chart the speech and speech motor characteristics in boys with FASD to profile the concomitant speech impairment and identify possible underlying mechanisms. METHOD Ten boys with FASD (4.5-10.3 years old) and 26 typically developing children (4.1-8.7 years old; 14 boys, 12 girls) participated in the study. Speech production and perception, and oral motor data were collected by standardized tests. RESULTS The boys with FASD showed reduced scores on all tasks as well as a deviant pattern of correlations between production and perception tasks and intelligibility compared with the typically developing children. Speech motor profiles showed specific problems with nonword repetition and tongue control. CONCLUSIONS Findings indicate that the speech impairment in boys with FASD results from a combination of deficits in multiple subsystems and should be approached as a disorder rather than a developmental delay. The results suggest that reduced speech motor planning/programming, auditory discrimination, and oral motor abilities should be considered in long-term, individually tailored treatment.
Collapse
Affiliation(s)
- Hayo Terband
- Utrecht Institute of Linguistics - OTS, Utrecht University, the Netherlands
| | - Manon Spruit
- Utrecht Institute of Linguistics - OTS, Utrecht University, the Netherlands
- Logopedie & Stottertherapie, Lingen, Germany
| | - Ben Maassen
- Centre for Language and Cognition & University Medical Centre, University of Groningen, the Netherlands
| |
Collapse
|
28
|
Goldfeld S, D'Abaco E, Bryson H, Mensah F, Price AM. Surveying social adversity in pregnancy: The antenatal risk burden experienced by Australian women. J Paediatr Child Health 2018; 54:754-760. [PMID: 29442394 DOI: 10.1111/jpc.13860] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 11/21/2017] [Accepted: 12/04/2017] [Indexed: 11/29/2022]
Abstract
AIM Many, varied, antenatal risk factors can adversely impact children's health, behaviour and cognition. Understanding the antenatal risk factors experienced by women can help identify which families are most likely to benefit from additional early supports; however, there is a dearth of published Australian antenatal risk data. This study aimed to determine the prevalence and co-occurrence of a broad range of risk factors in a community-based sample of pregnant Australian women. METHODS A brief risk factor survey (10 items, including age, social support, health, smoking, stress or anxious mood, education, household income, employment) completed by pregnant women attending the antenatal clinic waiting rooms of 10 public maternity hospitals, which were selected for their provision of care to areas with fewer socio-economic resources in the states of Victoria and Tasmania, between May 2013 and August 2014. RESULTS A total of 5586 women participated, with an average age of 29.0 years and gestation of 26.9 weeks. The most prevalent antenatal risk factors were poorer global health (38.9%), not finishing high school (33.5%) and smoking (14.9%), all proportions higher than the general population. Most women reported at least one risk factor (68.6%), with 21.5% reporting ≥3. There was a high degree of co-occurrence between risk factors, especially the three most prevalent. CONCLUSIONS This study reveals the considerable and varied risk burden experienced by Australian women during pregnancy. By understanding where need is greatest and tailoring support accordingly, risk factor assessment provides an opportunity to address equity through health care, ultimately optimising the future developmental outcomes of all children.
Collapse
Affiliation(s)
- Sharon Goldfeld
- Population Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Centre for Community Child Health, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Elise D'Abaco
- Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
| | - Hannah Bryson
- Population Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Centre for Community Child Health, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Fiona Mensah
- Centre for Community Child Health, Royal Children's Hospital, Melbourne, Victoria, Australia.,Clinical Sciences and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Anna Mh Price
- Population Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Centre for Community Child Health, Royal Children's Hospital, Melbourne, Victoria, Australia
| |
Collapse
|
29
|
Giglia RC, Symons M, Shaw T. The provision of alcohol and breastfeeding information by maternal health practitioners in the Australian setting. Aust N Z J Obstet Gynaecol 2018; 59:258-264. [PMID: 29926916 DOI: 10.1111/ajo.12837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 05/17/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND In the 2009 National Health and Medical Research Council (NHMRC) Australian Guidelines to Reduce Health Risks from Drinking, a guideline specific to lactating women was included. For the first time the effect of alcohol at this important developmental stage was nationally and internationally acknowledged. AIMS To determine the degree to which maternal health practitioners adopted an Australian national policy guideline (Guideline 4B) on alcohol and breastfeeding into their everyday health practice and the factors associated with adoption. MATERIALS AND METHODS A convenience sample of participants completed an online survey based on the Nursing Practice Questionnaire (NPQ) to elicit measures of knowledge, awareness and practice implementation. RESULTS In total, 240 maternal health practitioners completed the online survey. All statistical analyses clearly indicated a higher adoption of Guideline 4B by the child health nurses, midwives and general practitioners (GPs) than was the case for paediatricians and obstetricians. A mean adoption score (range 0-4) indicative of 'some' practice implementation of 3.13, 3.04 and 2.73 was obtained by child health nurses, midwives and GPs, respectively. Obstetricians and paediatricians scored a mean of 2.0, indicating they remain to be 'persuaded about the practice' of incorporating discussions around alcohol and breastfeeding into their practice. CONCLUSION Despite the existence of a national alcohol guideline for breastfeeding women, maternal health practitioners are not incorporating this advice into their everyday practice with lactating women. Opportunities exist for all maternal practitioners along the reproductive continuum to protect long-term breastfeeding duration using an evidence-based harm minimisation approach to alcohol consumption.
Collapse
Affiliation(s)
- Roslyn Carmel Giglia
- FASD Research Australia Centre of Research Excellence, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Martyn Symons
- FASD Research Australia Centre of Research Excellence, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Thérèse Shaw
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| |
Collapse
|
30
|
Ojeda L, Nogales F, Murillo L, Carreras O. The role of folic acid and selenium against oxidative damage from ethanol in early life programming: a review. Biochem Cell Biol 2018; 96:178-188. [DOI: 10.1139/bcb-2017-0069] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
There are disorders in children, covered by the umbrella term “fetal alcohol spectrum disorder” (FASD), that occur as result of alcohol consumption during pregnancy and lactation. They appear, at least in part, to be related to the oxidative stress generated by ethanol. Ethanol metabolism generates reactive oxygen species and depletes the antioxidant molecule glutathione (GSH), leading to oxidative stress and lipid and protein damage, which are related to growth retardation and neurotoxicity, thereby increasing the incidence of FASD. Furthermore, prenatal and postnatal exposure to ethanol in dams, as well as increasing oxidation in offspring, causes malnutrition of several micronutrients such as the antioxidant folic acid and selenium (Se), affecting their metabolism and bodily distribution. Although abstinence from alcohol is the only way to prevent FASD, it is possible to reduce its harmful effects with a maternal dietary antioxidant therapy. In this review, folic acid and Se have been chosen to be analyzed as antioxidant intervention systems related to FASD because, like ethanol, they act on the methionine metabolic cycle, being related to the endogenous antioxidants GSH and glutathione peroxidase. Moreover, several birth defects are related to poor folate and Se status.
Collapse
Affiliation(s)
- Luisa Ojeda
- Department of Physiology, Faculty of Pharmacy, Seville University, Seville, Spain
- Department of Physiology, Faculty of Pharmacy, Seville University, Seville, Spain
| | - Fátima Nogales
- Department of Physiology, Faculty of Pharmacy, Seville University, Seville, Spain
- Department of Physiology, Faculty of Pharmacy, Seville University, Seville, Spain
| | - Luisa Murillo
- Department of Physiology, Faculty of Pharmacy, Seville University, Seville, Spain
- Department of Physiology, Faculty of Pharmacy, Seville University, Seville, Spain
| | - Olimpia Carreras
- Department of Physiology, Faculty of Pharmacy, Seville University, Seville, Spain
- Department of Physiology, Faculty of Pharmacy, Seville University, Seville, Spain
| |
Collapse
|
31
|
Zhu Y, Zuo N, Li B, Xiong Y, Chen H, He H, Sun Z, Hu S, Cheng H, Ao Y, Wang H. The expressional disorder of the renal RAS mediates nephrotic syndrome of male rat offspring induced by prenatal ethanol exposure. Toxicology 2018; 400-401:9-19. [PMID: 29548890 DOI: 10.1016/j.tox.2018.03.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 03/03/2018] [Accepted: 03/12/2018] [Indexed: 12/11/2022]
Abstract
This study aimed to prove that prenatal ethanol exposure (PEE) can induce nephrotic syndrome in male rat offspring and to explore the underlying intrauterine programming mechanisms. Pregnant Wistar rats were intragastrically administered ethanol (4 g/kg d) from gestational day (GD) 9 to GD 20, and the male fetuses were delivered by cesarean section at GD20 and the male adult offspring were euthanized at postnatal week (PW) 24. In vitro, the primary metanephric mesenchyme cells were treated with ethanol at concentrations of 15-60 mM. The results indicated that the kidneys of adult offspring in the PEE group exhibited glomerulosclerosis as well as interstitial fibrosis. The levels of serum creatinine and urine protein were elevated; the serum total cholesterol level was increased and the serum albumin concentration was reduced. In the fetal kidney, developmental retardation was presented in the PEE group via pathological examinations, accompanied by the expressional inhibition of the glial-cell-line-derived neurotrophic factor/c-ret tyrosine kinase receptor (GDNF/c-ret) signaling pathway. Although serum angiotensin II (Ang II) level and the gene expression of renal angiotensin-converting enzyme (ACE) were increased in the PEE group, the expression of renal angiotensin II type 2 receptor (AT2R) was significantly inhibited, accompanied by a reduction in the H3K27ac level on the AT2R gene promoter. In the non-classical renin-angiotensin system (RAS), the expression of renal angiotensin converting enzyme 2 (ACE2) and Mas receptor (MasR) were inhibited in the PEE group. The above changes of the classical and non-classical RAS all sustained from utero to adulthood. In vitro, ethanol elevated the gene expression of ACE and angiotensin II type 1a receptor (AT1aR) whereas it reduced the expression of AT2R, ACE2, and MasR, accompanied by a reduction in the H3K27ac level on AT2R gene promoter. Taken together, these results suggested that PEE can induce fetal kidney developmental retardation and adult nephrotic syndrome, and direct regulation of ethanol to the renal RAS was involved in the mechanism of nephrotic syndrome induced by PEE.
Collapse
Affiliation(s)
- Yanan Zhu
- Department of Pharmacology, School of Basic Medical Science of Wuhan University, Wuhan, 430071, China
| | - Na Zuo
- Department of Pharmacology, School of Basic Medical Science of Wuhan University, Wuhan, 430071, China
| | - Bin Li
- Department of Pharmacology, School of Basic Medical Science of Wuhan University, Wuhan, 430071, China
| | - Ying Xiong
- Department of Pharmacology, School of Basic Medical Science of Wuhan University, Wuhan, 430071, China
| | - Haiyun Chen
- Department of Pharmacology, School of Basic Medical Science of Wuhan University, Wuhan, 430071, China
| | - Hangyuan He
- Department of Pharmacology, School of Basic Medical Science of Wuhan University, Wuhan, 430071, China
| | - Zhaoxia Sun
- Department of Pharmacology, School of Basic Medical Science of Wuhan University, Wuhan, 430071, China
| | - Shuangshuang Hu
- Department of Pharmacology, School of Basic Medical Science of Wuhan University, Wuhan, 430071, China
| | - Hui Cheng
- Department of Nephrology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Ying Ao
- Department of Pharmacology, School of Basic Medical Science of Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disorder, Wuhan, 430071, China.
| | - Hui Wang
- Department of Pharmacology, School of Basic Medical Science of Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disorder, Wuhan, 430071, China.
| |
Collapse
|
32
|
Praestegaard C, Kesmodel PS, Kesmodel US. Is TWEAK a valid screening questionnaire to identify alcohol risk drinkers among pregnant women in Denmark? Acta Obstet Gynecol Scand 2018; 97:483-490. [PMID: 29383707 DOI: 10.1111/aogs.13314] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 01/19/2018] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Identification of pregnant alcohol risk drinkers is crucial to prevent adverse birth outcomes. The TWEAK screening instrument has shown promising results for identifying risk drinkers. However, as the effectiveness of the screening questionnaire has only been investigated among American women with mainly low socioeconomic status, we aimed to investigate the ability of TWEAK to identify alcohol risk drinkers among pregnant Danish women. MATERIAL AND METHODS During 2000, Danish-speaking women referred to the Midwife Center at Aarhus University Hospital (n = 1554) and Fredericia Hospital (n = 499) for routine antenatal care were invited to participate in the study at their first visit. The women were interviewed about their periconceptional and current drinking habits including average weekly alcohol consumption and binge drinking. Additionally, the women were also asked the questions related to the TWEAK questionnaire. RESULTS We found that the sensitivity of TWEAK to identify periconceptional risk drinking was quite low, but its ability to identify risk drinkers during pregnancy was marginally higher. Our results suggested that older age (odds ratio 1.46, 95% confidence interval 0.95-2.23), current smoking (odds ratio 2.33, 95% confidence interval 1.63-3.33), being single (odds ratio 2.38, 95% confidence interval 1.38-4.11) and a TWEAK score with a cut-off score of ≥1 (odds ratio 2.75, 95% confidence interval 2.02-3.76) increased the risk of high-risk drinking during pregnancy. CONCLUSIONS In a Danish setting, TWEAK does not seem as an optimal screening tool to identify periconceptional risk drinkers but it may be useful in identifying high-risk drinking during pregnancy.
Collapse
Affiliation(s)
- Camilla Praestegaard
- Department of Obstetrics & Gynecology, Herlev University Hospital, Herlev, Denmark
| | - Pia S Kesmodel
- Department of Obstetrics & Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Ulrik S Kesmodel
- Department of Obstetrics & Gynecology, Herlev University Hospital, Herlev, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
33
|
Mukherjee RA, Hollins S, Turk J. Psychiatric comorbidity in foetal alcohol syndrome. PSYCHIATRIC BULLETIN 2018. [DOI: 10.1192/pb.30.5.194-c] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
34
|
Moffat AK, Redmond G. Is having a family member with chronic health concerns bad for young people's health? Cross-sectional evidence from a national survey of young Australians. BMJ Open 2017; 7:e013946. [PMID: 28062472 PMCID: PMC5223635 DOI: 10.1136/bmjopen-2016-013946] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 11/29/2016] [Accepted: 12/09/2016] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Young people's perspectives on the association between having a family member with a chronic health concern (FHC) and their own health are under-researched. This study used young people's reports to assess the prevalence of FHCs and their association with negative health outcomes, with an aim of identifying potential inequalities between marginalised and non-marginalised young people. Family cohesion was examined as a moderating factor. DESIGN Cross-sectional data from the Australian Child Wellbeing Project survey were used. Respondents were asked whether someone in their family experienced one or more FHCs (disability, mental illness or drug/alcohol addiction). In addition, their experience of different psychosomatic symptoms (headache, sleeplessness, irritability, etc), aspects of family relationships and social and economic characteristics (disability, materially disadvantaged and Indigenous) were documented. SETTING Nationally representative Australian sample. PARTICIPANTS 1531 students in school years 4 and 6 and 3846 students in year 8. RESULTS A quarter of students reported having an FHC (years 4 and 6: 23.96% (95% CI 19.30% to 28.62%); year 8: 25.35% (95% CI 22.77% to 27.94%)). Significantly, more students with FHCs than those without reported experiencing 2 or more negative health symptoms at least weekly (OR=1.78; 95% CI 1.19 to 2.65; p<0.01). However, an independent relationship between FHCs and symptom load was only found in the case of FHC-drug/alcohol addiction. Marginalised students and students reporting low family cohesion had an increased prevalence of FHCs and notably higher symptom loads where FHCs were present. Level of family cohesion did not impact the relationship between FHCs and symptom load. CONCLUSIONS The burden of FHCs is inequitably distributed between marginalised and non-marginalised groups, and between young people experiencing different levels of family cohesion. More work is required regarding appropriate targets for community and family-level interventions to support young people in the context of FHCs.
Collapse
Affiliation(s)
- Anna K Moffat
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Gerry Redmond
- School of Social and Policy Studies, Flinders University, Adelaide, South Australia, Australia
| |
Collapse
|
35
|
Abstract
Public health policy on alcohol is changing in many countries. This article reviews public health messages with regard to alcohol in Australia, Canada, the United Kingdom (UK) and the United States (US) and highlights the common as well as the different messages delineated. The messages from these four countries are then compared with those of certain other developed and developing countries. Some of the significant differences include definitions of moderate alcohol consumption, the consumption of alcohol by women, underage consumption, and advice to abstainers, which may reflect differences in the characteristics of consumers among countries. Central to the current debate is the concern that incomplete, inconsistent or misleading messages on alcohol consumption could lead to an increase in alcohol abuse, misuse and hence harm, or, conversely, to abstention by particular population groups.
Collapse
|
36
|
Gaccioli F, Lager S. Placental Nutrient Transport and Intrauterine Growth Restriction. Front Physiol 2016; 7:40. [PMID: 26909042 PMCID: PMC4754577 DOI: 10.3389/fphys.2016.00040] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 01/28/2016] [Indexed: 01/30/2023] Open
Abstract
Intrauterine growth restriction refers to the inability of the fetus to reach its genetically determined potential size. Fetal growth restriction affects approximately 5–15% of all pregnancies in the United States and Europe. In developing countries the occurrence varies widely between 10 and 55%, impacting about 30 million newborns per year. Besides having high perinatal mortality rates these infants are at greater risk for severe adverse outcomes, such as hypoxic ischemic encephalopathy and cerebral palsy. Moreover, reduced fetal growth has lifelong health consequences, including higher risks of developing metabolic and cardiovascular diseases in adulthood. Numerous reports indicate placental insufficiency as one of the underlying causes leading to altered fetal growth and impaired placental capacity of delivering nutrients to the fetus has been shown to contribute to the etiology of intrauterine growth restriction. Indeed, reduced expression and/or activity of placental nutrient transporters have been demonstrated in several conditions associated with an increased risk of delivering a small or growth restricted infant. This review focuses on human pregnancies and summarizes the changes in placental amino acid, fatty acid, and glucose transport reported in conditions associated with intrauterine growth restriction, such as maternal undernutrition, pre-eclampsia, young maternal age, high altitude and infection.
Collapse
Affiliation(s)
- Francesca Gaccioli
- Department of Obstetrics and Gynaecology, University of Cambridge Cambridge, UK
| | - Susanne Lager
- Department of Obstetrics and Gynaecology, University of Cambridge Cambridge, UK
| |
Collapse
|
37
|
Kiecker C. The chick embryo as a model for the effects of prenatal exposure to alcohol on craniofacial development. Dev Biol 2016; 415:314-325. [PMID: 26777098 DOI: 10.1016/j.ydbio.2016.01.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 10/28/2015] [Accepted: 01/13/2016] [Indexed: 12/15/2022]
Abstract
Prenatal exposure to ethanol results in fetal alcohol spectrum disorder (FASD), a syndrome characterised by a broad range of clinical manifestations including craniofacial dysmorphologies and neurological defects. The characterisation of the mechanisms by which ethanol exerts its teratogenic effects is difficult due to the pleiotropic nature of its actions. Different experimental model systems have been employed to investigate the aetiology of FASD. Here, I will review studies using these different model organisms that have helped to elucidate how ethanol causes the craniofacial abnormalities characteristic of FASD. In these studies, ethanol was found to impair the prechordal plate-an important embryonic signalling centre-during gastrulation and to negatively affect the induction, migration and survival of the neural crest, a cell population that generates the cartilage and most of the bones of the skull. At the cellular level, ethanol appears to inhibit Sonic hedgehog signalling, alter levels of retionoic acid activity, trigger a Ca(2+)-CamKII-dependent pathway that antagonises WNT signalling, affect cytoskeletal dynamics and increase oxidative stress. Embryos of the domestic chick Gallus gallus domesticus have played a central role in developing a working model for the effects of ethanol on craniofacial development because they are easily accessible and because key steps in craniofacial development are particularly well established in the avian embryo. I will finish this review by highlighting some potential future avenues of fetal alcohol research.
Collapse
Affiliation(s)
- Clemens Kiecker
- MRC Centre for Developmental Neurobiology, 4th Floor, Hodgkin Building, Guy's Hospital Campus, King's College London, UK.
| |
Collapse
|
38
|
Profiling ethanol-targeted transcription factors in human carcinoma cell-derived embryoid bodies. Gene 2015; 576:119-25. [PMID: 26456191 DOI: 10.1016/j.gene.2015.09.085] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 09/22/2015] [Accepted: 09/29/2015] [Indexed: 12/16/2022]
Abstract
Fetal alcohol spectrum disorder is a collective term that represents fetal abnormalities associated with maternal alcohol consumption. Prenatal alcohol exposure and related anomalies are well characterized, but the molecular mechanism behind this phenomenon is not yet understood. Few insights have been gained from genetic and epigenetic studies of fetal alcohol spectrum disorder. Our aim was to profile the important molecular regulators of ethanol-related alterations of the genome. For this purpose, we have analyzed the gene expression pattern of human carcinoma cell-derived embryoid bodies in the absence or presence of ethanol. A cDNA microarray analysis was used to profile mRNA expression in embryoid bodies at day 7 with or without ethanol treatment. A total of 493 differentially expressed genes were identified in response to 50 mM ethanol exposure. Of these, 111 genes were up-regulated, and 382 were down-regulated. Gene ontology term enrichment analysis revealed that these genes are involved in important biological processes: neurological system processes, cognition, behavior, sensory perception of smell, taste and chemical stimuli and synaptic transmission. Similarly, the enrichment of disease-related genes included relevant categories such as neurological diseases, developmental disorders, skeletal and muscular disorders, and connective tissue disorders. Furthermore, we have identified a group of 26 genes that encode transcription factors. We validated the relative gene expression of several transcription factors using quantitative real time PCR. We hope that our study substantially contributes to the understanding of the molecular mechanisms underlying the pathology of alcohol-mediated anomalies and facilitates further research.
Collapse
|
39
|
Tearne JE, Allen KL, Herbison CE, Lawrence D, Whitehouse AJO, Sawyer MG, Robinson M. The association between prenatal environment and children's mental health trajectories from 2 to 14 years. Eur Child Adolesc Psychiatry 2015; 24:1015-24. [PMID: 25431038 DOI: 10.1007/s00787-014-0651-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Accepted: 11/12/2014] [Indexed: 11/26/2022]
Abstract
The prenatal period is recognised as a critical period for later behavioural development. This study aimed to elucidate how an adverse prenatal environment, as defined by the presence of a number of known prenatal risk factors, would influence mental health trajectories in children to 14 years of age. The Raine Study provided comprehensive data from 2,900 pregnancies. Offspring were followed up at ages 2, 5, 8, 10, and 14 years using the Child Behaviour Checklist (CBCL). We used linear mixed regression models with random intercept and slope (random effects models) to examine the extent to which the predictor variables considered influenced changes in continuous CBCL total, internalising, and externalising T scores from ages 2 to 14. In the final multivariate models, increased offspring CBCL T scores were significantly predicted by the mother not finishing high school, smoking during pregnancy, having a total family income below the poverty line, being diagnosed with gestational hypertension and experiencing stressful life events during pregnancy. Conversely, as maternal age increased, CBCL T scores were significantly decreased. Child age also significantly interacted with maternal education, total family income, and maternal stressful life events, such that these variables predicted increases in CBCL scores from age 2 to age 10, and from age 2 to age 14 years. In the Raine Study sample, children who experienced adverse prenatal environments experienced increased levels of problem behaviours in childhood, and more problematic mental health trajectories. Maternal health risk behaviours and other psychosocial variables more commonly affected child behaviour than obstetric complications.
Collapse
Affiliation(s)
- Jessica E Tearne
- Telethon Kids Institute, The University of Western Australia, Perth, Australia,
| | | | | | | | | | | | | |
Collapse
|
40
|
Mutch RC, Watkins R, Bower C. Fetal alcohol spectrum disorders: notifications to the Western Australian Register of Developmental Anomalies. J Paediatr Child Health 2015; 51:433-6. [PMID: 25412883 DOI: 10.1111/jpc.12746] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/26/2014] [Indexed: 11/29/2022]
Abstract
AIM There is increasing attention on fetal alcohol spectrum disorders (FASD) in Australia, but there are limited data on their birth prevalence. Our aim was to report on the birth prevalence of FASD in Western Australia. METHODS Data on notified cases of FASD born in Western Australia 1980-2010 were identified from the Western Australian Register of Developmental Anomalies. Tabulated denominator data were obtained from the Midwives Notification System. Prevalence rates per 1000 births were calculated by demographic variables. Prevalence ratios (PRs) and 95% confidence intervals (CIs) of Aboriginal compared with non-Aboriginal prevalence rates were calculated. PRs were also calculated to compare rates for births 2000-2010 with 1980-1989. RESULTS Two hundred ten cases of FASDs were identified: a birth prevalence of 0.26/1000 births (95% CI 0.23-0.30). The majority of cases reported were Aboriginal (89.5%), a rate of 4.08/1000, compared with 0.03/1000 in notified non-Aboriginal cases, giving a PR of 139 (95% CI 89-215). The prevalence of FASD in 2000-2010 was over twice that in 1980-1989 for both Aboriginal (PR 2.37; CI 1.60-3.51) and non-Aboriginal (PR 2.13; CI 0.68-6.69) children. CONCLUSIONS There has been a twofold increase in FASD notifications in Western Australia over the last 30 years. Population surveillance data such as these are valuable in advocating for and monitoring the effectiveness of preventive activities and diagnostic and management services.
Collapse
Affiliation(s)
- Raewyn C Mutch
- Paediatric and Adolescent Medicine/Refugee Health, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
| | | | | |
Collapse
|
41
|
Onset of maternal psychiatric disorders after the birth of a child with intellectual disability: a retrospective cohort study. J Psychiatr Res 2015; 61:223-30. [PMID: 25499469 DOI: 10.1016/j.jpsychires.2014.11.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 11/17/2014] [Accepted: 11/18/2014] [Indexed: 01/22/2023]
Abstract
Mothers of a child with intellectual disability (ID) have more psychiatric disorders after the birth of their child than other mothers. However, it is unclear if this is because they have more psychiatric disorders before the birth or if the increase is related to the burden of caring for the child. We aimed to calculate the rate of new psychiatric disorders in mothers after the birth of their eldest child with ID born between 1983 and 2005 and to compare these with rates in women with a child with no ID or autism spectrum disorder (ASD) born during the same period. By linking data from Western Australian population-based registries, we selected women with no psychiatric history who survived the birth of their live-born child (N = 277,559) and compared rates of psychiatric disorders for women with a child with ID and women without a child with or ASD. Negative binomial regression with STATA 12 was used for all analyses. Mothers of children with mild-moderate ID of unknown cause had around two to three and a half times the rate of psychiatric disorders of mothers of children without ID or ASD. Mothers of children with Down syndrome and no pre-existing psychiatric disorder showed resilience and had no impairments in their mental health. Interventions and services are needed for mothers of other children with ID to improve their mental health. Further research is implicated to explore the mental health of mothers of children with ID and a pre-existing psychiatric disorder.
Collapse
|
42
|
Young JK, Giesbrecht HE, Eskin MN, Aliani M, Suh M. Nutrition implications for fetal alcohol spectrum disorder. Adv Nutr 2014; 5:675-92. [PMID: 25398731 PMCID: PMC4224205 DOI: 10.3945/an.113.004846] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Prenatal alcohol exposure produces a multitude of detrimental alcohol-induced defects in children collectively known as fetal alcohol spectrum disorder (FASD). Children with FASD often exhibit delayed or abnormal mental, neural, and physical growth. Socioeconomic status, race, genetics, parity, gravidity, age, smoking, and alcohol consumption patterns are all factors that may influence FASD. Optimal maternal nutritional status is of utmost importance for proper fetal development, yet is often altered with alcohol consumption. It is critical to determine a means to resolve and reduce the physical and neurological malformations that develop in the fetus as a result of prenatal alcohol exposure. Because there is a lack of information on the role of nutrients and prenatal nutrition interventions for FASD, the focus of this review is to provide an overview of nutrients (vitamin A, docosahexaenoic acid, folic acid, zinc, choline, vitamin E, and selenium) that may prevent or alleviate the development of FASD. Results from various nutrient supplementation studies in animal models and FASD-related research conducted in humans provide insight into the plausibility of prenatal nutrition interventions for FASD. Further research is necessary to confirm positive results, to determine optimal amounts of nutrients needed in supplementation, and to investigate the collective effects of multiple-nutrient supplementation.
Collapse
Affiliation(s)
- Jennifer K Young
- Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Heather E Giesbrecht
- Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Michael N Eskin
- Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Michel Aliani
- Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Miyoung Suh
- Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| |
Collapse
|
43
|
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.
Collapse
|
44
|
Kavanagh PS, Payne JS. Education, safe drinking practices and fetal alcohol spectrum disorder in the Kimberley region of Western Australia. J Paediatr Child Health 2014; 50:701-6. [PMID: 24909631 DOI: 10.1111/jpc.12615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/02/2014] [Indexed: 11/28/2022]
Abstract
AIM There are alarming rates of fetal alcohol spectrum disorder (FASD) in the Kimberley region of Western Australia despite numerous international studies demonstrating the links between alcohol consumption during pregnancy and FASD. The aim of this research was to help determine factors that may be associated with correct knowledge about safe drinking practices during pregnancy, with these factors used to help inform future interventions. METHOD Ninety-nine residents (40 males, 59 females, 39% of which self-identified as Indigenous) from the Kimberley region (Broome and smaller remote communities) completed a survey examining knowledge of currently recommended safe drinking practices during pregnancy and knowledge of the outcomes for children with FASD over a period of approximately 2 months. RESULTS The results revealed that education level (i.e. not completing high school through to completing university) is the biggest predictor (β = 0.44, P < 0.01) of knowledge of safe drinking practices during pregnancy, and having heard of FASD (β = 0.67, P < 0.001) was the biggest predictor of knowledge of outcomes for children with FASD. Other variables such as age, sex, Indigenous status and income level were not as important. CONCLUSIONS These findings suggest that early education regarding the consequences of alcohol consumption for women of childbearing age should be paramount in this or similar communities. Suggestions for targeted interventions are discussed in light of these findings.
Collapse
Affiliation(s)
- Phillip S Kavanagh
- School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, South Australia, Australia
| | | |
Collapse
|
45
|
Lucas BR, Latimer J, Pinto RZ, Ferreira ML, Doney R, Lau M, Jones T, Dries D, Elliott EJ. Gross motor deficits in children prenatally exposed to alcohol: a meta-analysis. Pediatrics 2014; 134:e192-209. [PMID: 24913787 DOI: 10.1542/peds.2013-3733] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Gross motor (GM) deficits are often reported in children with prenatal alcohol exposure (PAE), but their prevalence and the domains affected are not clear. The objective of this review was to characterize GM impairment in children with a diagnosis of fetal alcohol spectrum disorder (FASD) or "moderate" to "heavy" maternal alcohol intake. METHODS A systematic review with meta-analysis was conducted. Medline, Embase, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, PEDro, and Google Scholar databases were searched. Published observational studies including children aged 0 to ≤18 years with (1) an FASD diagnosis or moderate to heavy PAE, or a mother with confirmed alcohol dependency or binge drinking during pregnancy, and (2) GM outcomes obtained by using a standardized assessment tool. Data were extracted regarding participants, exposure, diagnosis, and outcomes by using a standardized protocol. Methodological quality was evaluated by using Strengthening the Reporting of Observational Studies in Epidemiology guidelines. RESULTS The search recovered 2881 articles of which 14 met the systematic review inclusion criteria. The subjects' mean age ranged from 3 days to 13 years. Study limitations included failure to report cutoffs for impairment, nonstandardized reporting of PAE, and small sample sizes. The meta-analysis pooled results (n = 10) revealed a significant association between a diagnosis of FASD or moderate to heavy PAE and GM impairment (odds ratio: 2.9; 95% confidence interval: 2.1-4.0). GM deficits were found in balance, coordination, and ball skills. There was insufficient data to determine prevalence. CONCLUSIONS The significant results suggest evaluation of GM proficiency should be a standard component of multidisciplinary FASD diagnostic services.
Collapse
Affiliation(s)
- Barbara R Lucas
- Discipline of Paediatrics and Child Health, The University of Sydney, The Children's Hospital at Westmead, Westmead, Australia;The George Institute for Global Health, Sydney Medical School, andPoche Centre for Indigenous Health, Sydney Medical School, The University of Sydney, Sydney, Australia;Physiotherapy Department, and
| | - Jane Latimer
- The George Institute for Global Health, Sydney Medical School, and
| | - Rafael Z Pinto
- Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, Sydney, Australia;Departamento de Fisioterapia, Faculdade de Ciências e Tecnologia, UNESP - Univ Estadual Paulista, Presidente Prudente, Brazil
| | | | - Robyn Doney
- School of Public Health, Curtin University, Western Australia, Australia
| | - Mandy Lau
- The George Institute for Global Health, Sydney Medical School, and
| | - Taryn Jones
- Department of Health Professions, Faculty of Human Sciences, Macquarie University, Sydney, Australia; and
| | | | - Elizabeth J Elliott
- Discipline of Paediatrics and Child Health, The University of Sydney, The Children's Hospital at Westmead, Westmead, Australia;The George Institute for Global Health, Sydney Medical School, andThe Sydney Children's Hospital Networks (Westmead), Westmead, Australia
| |
Collapse
|
46
|
Aberrant Behavioral and Neurobiologic Profiles in Rodents Exposed to Ethanol or Red Wine Early in Development. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2014. [DOI: 10.1007/s40474-014-0023-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
47
|
Feltes BC, de Faria Poloni J, Nunes IJG, Bonatto D. Fetal alcohol syndrome, chemo-biology and OMICS: ethanol effects on vitamin metabolism during neurodevelopment as measured by systems biology analysis. OMICS-A JOURNAL OF INTEGRATIVE BIOLOGY 2014; 18:344-63. [PMID: 24816220 DOI: 10.1089/omi.2013.0144] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Fetal alcohol syndrome (FAS) is a prenatal disease characterized by fetal morphological and neurological abnormalities originating from exposure to alcohol. Although FAS is a well-described pathology, the molecular mechanisms underlying its progression are virtually unknown. Moreover, alcohol abuse can affect vitamin metabolism and absorption, although how alcohol impairs such biochemical pathways remains to be elucidated. We employed a variety of systems chemo-biology tools to understand the interplay between ethanol metabolism and vitamins during mouse neurodevelopment. For this purpose, we designed interactomes and employed transcriptomic data analysis approaches to study the neural tissue of Mus musculus exposed to ethanol prenatally and postnatally, simulating conditions that could lead to FAS development at different life stages. Our results showed that FAS can promote early changes in neurotransmitter release and glutamate equilibrium, as well as an abnormal calcium influx that can lead to neuroinflammation and impaired neurodifferentiation, both extensively connected with vitamin action and metabolism. Genes related to retinoic acid, niacin, vitamin D, and folate metabolism were underexpressed during neurodevelopment and appear to contribute to neuroinflammation progression and impaired synapsis. Our results also indicate that genes coding for tubulin, tubulin-associated proteins, synapse plasticity proteins, and proteins related to neurodifferentiation are extensively affected by ethanol exposure. Finally, we developed a molecular model of how ethanol can affect vitamin metabolism and impair neurodevelopment.
Collapse
Affiliation(s)
- Bruno César Feltes
- Centro de Biotecnologia da Universidade Federal do Rio Grande do Sul , Departamento de Biologia Molecular e Biotecnologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | | |
Collapse
|
48
|
Naseer MI, Ullah I, Rasool M, Ansari SA, Sheikh IA, Bibi F, Chaudhary AG, Al-Qahtani MH, Kim MO. Downregulation of dopamine D₁ receptors and increased neuronal apoptosis upon ethanol and PTZ exposure in prenatal rat cortical and hippocampal neurons. Neurol Sci 2014; 35:1681-8. [PMID: 24810836 DOI: 10.1007/s10072-014-1812-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 04/23/2014] [Indexed: 10/25/2022]
Abstract
The objective of this study was to evaluate the effect of ethanol and pentylenetetrazol (PTZ) on the expression of dopamine receptors (D1R) and to observe the apoptotic neurodegeneration in prenatal rat cortical and hippocampal neurons at gestational days (GD) 17.5. In the present study, ethanol (100 mM) and PTZ (15 mM) were exposed to the prenatal rat cortical and hippocampal neuronal cell cultures for 1 h. For mRNA RT-PCR and for protein Western blot analysis was done to elucidate D1R, Bax, Bak, Bcl-2 and cleaved caspase-3 expression upon ethanol and PTZ exposure in neuronal cell cultures. Furthermore, ethanol and PTZ-induced apoptotic neurodegeneration was also observed using TUNEL staining and propidium iodide (PI) used as counter stain under confocal microscopy. The results of present study showed that ethanol and PTZ exposure significantly decreased D1R expression and induced neuronal death by significantly increasing the expression of pro-apoptotic Bax, Bak and decreasing anti-apoptotic protein Bcl-2 leading to the apoptosis by increasing cleaved caspase-3 expression in cortical and hippocampal primary neuronal cell cultures. Our findings indicated that ethanol and PTZ exposure to the prenatal neurons showed not only downregulation of D1R but also causes neuronal apoptosis in the developing rat brain. Further, this explains the possibility of higher risk of developmental disturbances and malformations during early developmental stage.
Collapse
Affiliation(s)
- Muhammad Imran Naseer
- Center of Excellence in Genomic Medicine and Research (CEGMR), King Abdulaziz University, Jeddah, 21589, Saudi Arabia,
| | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Abstract
Developmental coordination disorder (DCD) affects around 5% of children and commonly overlaps with other developmental disorders including: attention deficit hyperactivity disorder (ADHD), autism spectrum disorders (ASDs) and specific language impairment (SLI). There is evidence to demonstrate the wide-ranging impact on all areas of functioning including psychiatric and learning domains. There is increasing evidence of the continuing impact into adulthood and the long-term negative effects on relationships and employment. There is a need for early identification and intervention to limit the likelihood of these secondary consequences from emerging. This paper addresses the diagnosis of DCD.
Collapse
Affiliation(s)
- Amanda Kirby
- The Dyscovery Centre, University of South Wales, , Newport, UK
| | | | | |
Collapse
|
50
|
Stewart M, Glowatski K. Front-Line Police Perceptions of Fetal Alcohol Spectrum Disorder in a Canadian Province. ACTA ACUST UNITED AC 2014. [DOI: 10.1350/pojo.2014.87.1.648] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This paper reports findings from police interviews regarding understandings of Fetal Alcohol Spectrum Disorder (FASD) including the challenges this presents at the front line. The project investigates police perceptions, as individuals with FASD can have disproportionate contact with justice systems. Inconsistent with expectations, officers expressed understandings of FASD. Police reported the need for more training or information for when they encounter individuals with FASD. Practice-oriented solutions, including training developed and delivered by experienced officers, is posited to respond to unmet needs. The findings offer new insight into officer perceptions that has practical implications for front-line training and practice. To date there is limited research on how police understand FASD. This project helps fill the gap. The research has value beyond discussions of FASD. Similar to the challenges of working with persons with mental illness, there is a need for innovative front-line approaches to better address divergent client needs.
Collapse
|