Comorbidity of fetal alcohol spectrum disorder: a systematic review and meta-analysis

Popova, Svetlana; Lange, Shannon; Shield, Kevin D.; Mihic, Alanna; Chudley, Albert E.; Mukherjee, Raja; Bekmuradov, Dennis; Rehm, Jürgen

doi:10.1016/s0140-6736(15)01345-8

Cited by 441 publications

(340 citation statements)

References 67 publications

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“…Prevalence can then be multiplied with disability weights to derive burden (see above). Regarding fatal outcomes of FAS: while a recent study has found a life expectancy of 34 years 333, the overwhelming majority of these deaths are coded as resulting from comorbidities 57, and are not coded to FAS as a cause of death.Alcohol use of others can have marked impact on all unintentional injuries. For instance, drinking by a parental care‐giver increases the chances of unintentional injury to a toddler 334, and parental alcohol misuse is a powerful predictor of a child's traumatic brain injury 335.…”

Section: Resultsmentioning

confidence: 99%

The relationship between different dimensions of alcohol use and the burden of disease—an update

et al. 2017

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Background and aimsAlcohol use is a major contributor to injuries, mortality and the burden of disease. This review updates knowledge on risk relations between dimensions of alcohol use and health outcomes to be used in global and national Comparative Risk Assessments (CRAs).MethodsSystematic review of reviews and meta‐analyses on alcohol consumption and health outcomes attributable to alcohol use.For dimensions of exposure: volume of alcohol use, blood alcohol concentration and patterns of drinking, in particular heavy drinking occasions were studied. For liver cirrhosis, quality of alcohol was additionally considered. For all outcomes (mortality and/or morbidity): cause of death and disease/injury categories based on International Classification of Diseases (ICD) codes used in global CRAs; harm to others.ResultsIn total, 255 reviews and meta‐analyses were identified. Alcohol use was found to be linked causally to many disease and injury categories, with more than 40 ICD‐10 three‐digit categories being fully attributable to alcohol. Most partially attributable disease categories showed monotonic relationships with volume of alcohol use: the more alcohol consumed, the higher the risk of disease or death. Exceptions were ischaemic diseases and diabetes, with curvilinear relationships, and with beneficial effects of light to moderate drinking in people without heavy irregular drinking occasions. Biological pathways suggest an impact of heavy drinking occasions on additional diseases; however, the lack of medical epidemiological studies measuring this dimension of alcohol use precluded an in‐depth analysis. For injuries, except suicide, blood alcohol concentration was the most important dimension of alcohol use. Alcohol use caused marked harm to others, which has not yet been researched sufficiently.ConclusionsResearch since 2010 confirms the importance of alcohol use as a risk factor for disease and injuries; for some health outcomes, more than one dimension of use needs to be considered. Epidemiological studies should include measurement of heavy drinking occasions in line with biological knowledge.

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Section: Resultsmentioning

confidence: 99%

The relationship between different dimensions of alcohol use and the burden of disease—an update

et al. 2017

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“…Fetal Alcohol Syndrome is characterised by abnormal neural development, growth retardation, and craniofacial abnormalities which can be attributed to a known or suspected exposure to alcohol in utero (Astley, 2004). More recently, it is becoming apparent that the phenotypic consequences of prenatal ethanol exposure are not restricted to these phenotypes, with a recent literature review identifying greater than 400 conditions to be comorbid with FASDs (Popova et al, 2016). FASDs have also been associated with a number of secondary disabilities including disrupted school experiences, experiencing trouble with the law, confinement, inappropriate sexual behaviours, and alcohol or drug related problems (Streissguth et al, 2004).…”

Section: Evidence In Humansmentioning

confidence: 99%

“…Alcohol Spectrum Disorders in humans (Popova et al, 2016). Experimental animal models have shown the capacity for prenatal ethanol exposure to result in a range of phenotypes in the offspring.…”

Section: Introductionmentioning

confidence: 99%

A study of the consequences of early gestational ethanol and/or nicotine exposure in the mouse

Yamada¹

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The in utero environment is a critical determinant of the immediate and future health of the developing fetus. In Australia, two of the most commonly used drugs during pregnancy are alcohol and nicotine. Prolonged periods of gestational exposure to alcohol and nicotine, separately, have been associated with a range of adverse outcomes in the offspring, in both humans and experimental animal models. The consequences of ethanol and nicotine exposure restricted to early gestation on resultant offspring are poorly characterised, and few animal models exist to build greater understanding. Moreover, the immediate molecular changes associated with exposures to ethanol and/or nicotine restricted to early gestation has yet to be described.This thesis utilised mouse models of early gestational ethanol and/or nicotine exposure to explore the impact of each of these exposures on offspring growth, as well as their associated transcriptional and epigenetic changes. In each model, pregnant C57BL/6 dams were provided with ad libitum access to solutions of 10% ethanol and/or 100 µg/ml nicotine from fertilisation (0.5 dpc) to midgestation (8.5 dpc). The exposure window utilised in each of the models is developmentally equivalent to the first three to four weeks of a human pregnancy.Previously, our laboratory identified reduced growth, microcephaly, and gene expression changes in the liver and hippocampus of the postnatal offspring of the model of prenatal ethanol exposure utilised in this thesis. In contrast, at mid-gestation (9.5 dpc), there was no evidence of developmental delay (somite number), reduced growth (crown-rump length), or microcephaly.Further, a genome-wide gene expression microarray (targeting 30 855 genes) and a screen of the expression of 641 microRNAs, identified only one gene (Bcl11b) as differentially expressed in male 9.5 dpc whole embryos following the ethanol exposure. These data suggest that there is a delay between the ethanol exposure and the onset of adverse phenotypes -arguing that the embryo is somehow able to form a memory of the ethanol exposure. The absence of widespread transcriptional changes suggests that changes in embryonic mRNA and microRNA expression are unlikely to be major contributors to the memory of the exposure.A early gestational model of nicotine exposure was newly established in this thesis. This nicotine exposure resulted in an average serum cotinine (metabolite of nicotine) concentration similar to that reported in humans who smoke 10 to 15 cigarettes per day. This exposure was sufficient to induce a reduction in body size both at mid-gestation and postnatally, but not at late gestation. Furthermore, the increased expression of Zscan10 in the whole male 9.5 dpc embryo was identified and validated across multiple cohorts. Zscan10 encodes for a transcription factor expressed throughout development, with a proposed role in the regulation of progenitor cells. The increased expression of Zscan10 in the nicotine-exposed embryos was associated with a reduction in DNA methylation ...

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“…The term FASD encompasses different clinical subgroups depending on the condition and the degree of compromise, while Fetal Alcohol Syndrome -FAS is the most compromised subgroup with this clinical condition (2,3) , characterized according to the diagnostic triad: (1) deficits in growth, (2) facial characteristics, and (3) Central Nervous System (CNS) impairments invariably associated with gestational exposure to alcohol.…”

Section: Introductionmentioning

confidence: 99%

Narrativa oral de indivíduos com Transtorno do Espectro Alcoólico Fetal

Ganthous

Rossi

Giacheti

2017

CoDAS

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RESUMO Objetivo Investigar e comparar a narrativa oral de indivíduos com Transtorno do Espectro Alcoólico Fetal (TEAF) e de indivíduos com desenvolvimento típico de linguagem (DTL) e correlacionar o desempenho na narrativa oral com a pontuação do “4-Digit Diagnostic Code”. Método Participaram 20 indivíduos com TEAF, de ambos os gêneros, com idade cronológica entre seis e 16 anos e 20 indivíduos com DTL, semelhantes quanto ao gênero, idade e nível socioeconômico aos do grupo TEAF. A narrativa oral foi eliciada por meio do livro “Frog, where are you?” e analisada quanto aos aspectos macroestruturais, microestruturais e nível de coerência global. Os aspectos macroestruturais incluíram elementos típicos de história e os microestruturais incluíram palavras (total, palavras diferentes), unidades comunicativas (C-Units), diversidade lexical e extensão média dos C-Units. Resultados Desempenho inferior foi encontrado para o grupo TEAF em todos os aspectos macroestruturais, exceto para os marcadores linguísticos. Dentre os aspectos microestruturais, a diversidade lexical e a ocorrência de “C-Units” incompletos foram aspectos que diferenciaram os grupos TEAF e DTL. O grupo TEAF apresentou nível de coerência global inferior ao grupo DTL. Correlações negativas foram encontradas entre os aspectos macroestruturais e os itens características faciais e alterações no Sistema Nervoso Central. Conclusão O uso restrito de elementos estruturais típicos de história com níveis inferiores de coerência e vocabulário reduzido diferenciaram o TEAF do DTL. Estudos futuros poderão explorar se a associação entre o desempenho narrativo e os itens do “4-Digit Diagnostic Code” apresentam valor preditivo no desempenho narrativo dos indivíduos com TEAF.

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Comorbidity of fetal alcohol spectrum disorder: a systematic review and meta-analysis

Cited by 441 publications

References 67 publications

The relationship between different dimensions of alcohol use and the burden of disease—an update

The relationship between different dimensions of alcohol use and the burden of disease—an update

A study of the consequences of early gestational ethanol and/or nicotine exposure in the mouse

Narrativa oral de indivíduos com Transtorno do Espectro Alcoólico Fetal

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