2016-2022年有和未诊断出胎儿酒精谱系障碍的儿童先天性心脏缺陷患病率

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence Pub Date : 2025-07-12 DOI:10.1016/j.drugalcdep.2025.112790

Amanda N. Dorsey , Karrie F. Downing , Nicholas P. Deputy , Mary Kate Weber , Penelope P. Howards

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引用次数: 0

摘要

背景：怀孕期间饮酒可能是一些先天性心脏缺陷（CHDs）的危险因素，但胎儿酒精谱系障碍（FASDs）儿童中冠心病的患病率尚不清楚。我们使用了两个行政数据库来探讨美国患有和不患有fasd的儿童中冠心病的患病率。方法：我们将2016-2022年Merative™MarketScan®多州医疗补助和商业数据限制在≤17岁且连续入组≥1年的儿童，并提供完整的心理健康和药物使用服务数据。采用对数二项患病率比（pr）和95%置信区间（ci），通过FASD状态、总体和年龄组计算冠心病患病率。在匹配入组时间、入组开始时的年龄和年份后，重复分析。在医疗补助样本中，我们还根据人口统计学特征进行分层，并分别分析严重和非严重冠心病诊断。多维偏倚分析考虑了未测量的产前烟草暴露的影响。结果在医疗补助样本的8732345名儿童中，5.2%的fasd患儿和1.0%的非fasd患儿患有冠心病（匹配队列PR = 3.4 [CI: 2.8, 4.1]）。当按性别、种族和民族分层，以及仅观察严重或非严重冠心病时，pr相似。在商业索赔样本的10,567,765名儿童中，3.0%患有fasd， 0.6%没有fasd的儿童患有冠心病（匹配队列PR= 4.6 [CI: 3.3, 6.4]）。结论在两个行政数据库样本中，有fasd的儿童冠心病发生率高于无fasd的儿童。提高提供者对冠心病作为一种潜在的FASD合并症的认识可能会改善冠心病的及时护理。

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Prevalence of congenital heart defects among children with and without diagnosed fetal alcohol spectrum disorders, 2016–2022

Background

Alcohol use during pregnancy might be a risk factor for some congenital heart defects (CHDs), but CHD prevalence among children with fetal alcohol spectrum disorders (FASDs) is not well understood. We used two administrative databases to explore CHD prevalence among U.S. children with and without FASDs.

Methods

We limited 2016–2022 Merative™ MarketScan® Multi-State Medicaid and Commercial data to children ≤ 17 years old with ≥ 1 year of continuous enrollment with complete data on mental health and substance use services. CHD prevalence was calculated by FASD status, overall and by age group, using log-binomial prevalence ratios (PRs) and 95 % confidence intervals (CIs). Analyses were repeated after matching on enrollment length, and age and year at the start of enrollment. In the Medicaid sample, we also stratified by demographic characteristics and analyzed severe and non-severe CHD diagnoses separately. Multidimensional bias analysis considered the influence of unmeasured prenatal tobacco exposure.

Results

Among 8732,345 children in the Medicaid sample, 5.2 % with FASDs and 1.0 % without FASDs had CHDs (matched cohort PR = 3.4 [CI: 2.8, 4.1]). PRs were similar when stratified by sex and race and ethnicity, and when looking at exclusively severe or non-severe CHDs. Among 10,567,765 children in the commercial claims sample, 3.0 % with FASDs and 0.6 % without FASDs had CHDs (matched cohort PR= 4.6 [CI: 3.3, 6.4]).

Conclusion

CHDs were more common among children with FASDs compared to those without FASDs in two administrative database samples. Increased provider awareness about CHDs as a potential FASD comorbidity may improve timely CHD care.

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来源期刊

Drug and alcohol dependence 医学-精神病学

CiteScore

7.40

自引率

7.10%

发文量

409

审稿时长

41 days

期刊介绍： Drug and Alcohol Dependence is an international journal devoted to publishing original research, scholarly reviews, commentaries, and policy analyses in the area of drug, alcohol and tobacco use and dependence. Articles range from studies of the chemistry of substances of abuse, their actions at molecular and cellular sites, in vitro and in vivo investigations of their biochemical, pharmacological and behavioural actions, laboratory-based and clinical research in humans, substance abuse treatment and prevention research, and studies employing methods from epidemiology, sociology, and economics.