Prenatal alcohol exposure and health at midlife: Self-reported health outcomes in two cohorts.

IF 3 Q2 SUBSTANCE ABUSE
Alcohol (Hanover, York County, Pa.) Pub Date : 2024-11-01 Epub Date: 2024-10-29 DOI:10.1111/acer.15441
C D Coles, Z R Shapiro, J A Kable, S A Stoner, G J Ritfeld, T M Grant
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Abstract

Background: The Developmental Origins of Health and Disease Hypothesis (DOHaD) suggests prenatal alcohol exposure (PAE) should have implications for adult physical and mental health. Since the health profile of older adults with PAE and diagnoses of fetal alcohol spectrum disorder (FASD) is unknown, the current study evaluates self-reported health problems of midlife adults with and without a history of PAE to describe these outcomes.

Methods: Participants (N = 357) recruited from longitudinal cohorts in Atlanta, GA and Seattle, WA completed a health survey assessing a range of physical conditions. Initial analysis compared the frequency of conditions between alcohol-exposed and nonexposed groups. To identify patterns within groups, 10 problem areas were subjected to latent class analysis (LCA). Finally, the direct effect of PAE on health outcomes was evaluated using multilevel modeling, controlling for effects of other factors.

Results: Compared with unexposed controls, individuals with PAE reported significantly higher frequencies of problems with hearing, dentition, heart, cancer, gastritis, kidney stones, bladder, diabetes, thyroid, skin, and seizures. LCA found that controls yielded two classes, with 45% reporting sleep and vision problems and 55% reporting sleep, vision, cardiovascular, endocrine, immune, and dental problems. The PAE group yielded three classes, with 13% endorsing few health problems, 43% reporting sleep, vision, immune, and dental problems, and 43% reporting sleep, vision, cardiovascular, urinary, endocrine, skin, immune, dental, and gastrointestinal problems. With multivariate analysis, controlling for other influences, PAE was associated directly with hearing, urinary, dental, and gastrointestinal problems. A similar pattern was found for alcohol-exposed individuals who did and did not meet criteria for fetal alcohol syndrome (FAS).

Discussion: Patients affected by alcohol may report greater frequency and range of health adversity. That PAE was only uniquely associated with a limited set of problems suggests that many health outcomes in midlife result from an initial vulnerability potentiated by postnatal stress resulting from other associated factors.

产前酒精暴露与中年健康:两个队列中自我报告的健康结果。
背景:健康与疾病的发展起源假说(DOHaD)认为,产前酒精暴露(PAE)会对成人的身心健康产生影响。由于患有产前酒精暴露和胎儿酒精谱系障碍(FASD)诊断的老年人的健康状况尚不清楚,本研究评估了有和没有产前酒精暴露史的中年人自我报告的健康问题,以描述这些结果:从佐治亚州亚特兰大市和华盛顿州西雅图市的纵向队列中招募的参与者(N = 357)完成了一项健康调查,评估了一系列身体状况。初步分析比较了接触酒精组和未接触酒精组的身体状况发生频率。为了确定组内的模式,对 10 个问题领域进行了潜类分析(LCA)。最后,使用多层次模型评估了 PAE 对健康结果的直接影响,并控制了其他因素的影响:结果:与未接触 PAE 的对照组相比,报告 PAE 患者在听力、牙齿、心脏、癌症、胃炎、肾结石、膀胱、糖尿病、甲状腺、皮肤和癫痫发作方面出现问题的频率明显更高。LCA 发现,对照组产生了两类问题,其中 45% 报告了睡眠和视力问题,55% 报告了睡眠、视力、心血管、内分泌、免疫和牙科问题。PAE 组有三个类别,13% 的人很少有健康问题,43% 的人有睡眠、视力、免疫和牙科问题,43% 的人有睡眠、视力、心血管、泌尿、内分泌、皮肤、免疫、牙科和肠胃问题。通过多变量分析,在控制了其他影响因素后,PAE 与听力、泌尿、牙科和胃肠道问题直接相关。讨论:受酒精影响的患者可能会报告更频繁地出现听力、泌尿、牙科和胃肠道问题:讨论:受酒精影响的患者可能会报告更多频率和范围的健康问题。PAE仅与有限的一组问题有独特的关联,这表明中年时期的许多健康结果都是由其他相关因素导致的产后压力所增强的最初脆弱性造成的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
5.40
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