胎儿酒精。发育障碍的致畸原因。

A P Streissguth, R A LaDue
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引用次数: 0

摘要

胎儿酒精综合症(FAS)和胎儿酒精效应(FAE)是可预防的智力迟钝和发育障碍形式,由大量产前酒精暴露引起。FAS总体患病率的最佳证据约为750例活产中有1例,但这一数字会根据社区的饮酒习惯、当地医生的诊断技能和兴趣而有所不同。很可能许多婴儿出生时患有FAS或FAE,但从未被识别出来,也从未得到适当的诊断或评估。有时与FAS混淆的其他诊断包括努南综合征和威廉综合征。更常见的是,患有轻度FAS或FAE的儿童没有被识别出来。仔细评估怀孕期间可能的母亲酒精滥用是鉴别诊断和适当病例管理的一个重要因素。酒精是一种致畸药物,产前接触酒精会产生各种各样的缺陷,这取决于剂量、时间和接触条件,以及母亲和孩子在敏感性方面的个体差异。并非所有接触过的儿童都会受到影响。可能30-40%的长期酗酒母亲在怀孕期间饮酒的孩子会患上FAS。这些儿童患智力迟钝或发育障碍的风险很高。然而,即使在这个群体中,最终的结果也可能存在很大的个体差异。预后涉及损害程度与环境的稳定性和结构之间的相互作用。母亲在怀孕期间滥用酒精的孩子即使没有FAS,也可能面临各种学习和注意力问题的风险,但在没有形态学影响的情况下,诊断和预后情况不太清楚。针对预防和干预的系统努力可以确保每个儿童发展到他或她自己的最大潜力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Fetal alcohol. Teratogenic causes of developmental disabilities.

Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE) are preventable forms of mental retardation and developmental disability caused by heavy prenatal alcohol exposure. Our best evidence of the overall prevalence of FAS is around 1 in 750 live births, but this figure will vary according to the drinking habits of the community and the diagnostic skills and interests of local physicians. It is likely that many infants are born with FAS or FAE, are never recognized as such, and are never properly diagnosed or evaluated. Other diagnoses that are sometimes confused with FAS include Noonan syndrome and William syndrome. More often, children with milder FAS or FAE go unrecognized. Careful evaluation of possible maternal alcohol abuse during pregnancy can be an important factor in differential diagnosis and proper case management. Alcohol is a teratogenic drug that can produce a wide variety of deficits from prenatal exposure, depending on the dose, timing, and conditions of exposure, as well as on individual differences in sensitivity on the part of the mother and the child. Not all children who are exposed are affected. Perhaps 30-40% of the children of chronic alcoholic mothers who were drinking during pregnancy will have FAS. These children are at high risk for mental retardation or developmental disability. Even within this group, however, there can be large individual differences in eventual outcome. Prognosis involves an interaction between the extent of the damage and the stability and structure of the environment. Children whose mothers were abusing alcohol during pregnancy can be at risk for various learning and attentional problems even without FAS, but in the absence of morphologic effects, the diagnostic and prognostic picture is less clear. Systematic efforts toward both prevention and intervention can assure that each child develops to his or her own best potential.

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