Aperçu: G.M.
L'exposition prénatale à l'alcool peut affecter le développement
neurologique, mais peu d'études ont examiné les associations avec le
trouble du spectre de l'autisme (TSA).
Les chercheurs ont évalué
l'association entre la consommation d'alcool maternelle et les TSA avec
l'Etude pour Explorer le Développement Précoce, une étude cas-contrôle
multi-sites sur les enfants nés entre septembre 2003 et août 2006 aux États-Unis.
Les
mères d'enfants dans la population générale (POP) étaient plus susceptibles de signaler une
consommation d'alcool prénatal que les mères d'enfants avec un diagnostic de TSA
ou de retard de développement (DD). Au
cours du trimestre, 21,2% des mères d'enfants POP ont déclaré une
consommation d'alcool comparativement à 18,1% et 18,2% des mères
d'enfants avec TSA ou DD, respectivement. Au cours de la préconception et du premier mois de grossesse, une à
deux boissons en moyenne par semaine était inversement associée au
risque de TSA.
Ces
résultats ne supportent pas une association négative entre l'exposition
à l'alcool à faible niveau et la TSA, bien que ces résultats soient
basés sur une consommation d'alcool rétrospective autodéclarée. Un
mauvais classement ou une mauvaise classification de l'exposition peut
expliquer les associations inverses avec une ou deux boissons par
semaine.
Les femmes enceintes ou potentiellement enceintes devraient continuer à
suivre les recommandations pour éviter la consommation d'alcool en
raison d'autres effets connus sur la santé du nourrisson et le
développement neurologique.
Paediatr Perinat Epidemiol. 2017 Sep 7. doi: 10.1111/ppe.12404.
Prenatal Alcohol Exposure in Relation to Autism Spectrum Disorder: Findings from the Study to Explore Early Development (SEED)
Singer AB1, Aylsworth AS2, Cordero C1, Croen LA3, DiGuiseppi C4, Fallin MD5,6,7, Herring AH8, Hooper SR9, Pretzel RE10, Schieve LA11, Windham GC12, Daniels JL1.
Author information
- 1
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
- 2
- Departments of Pediatrics and Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC.
- 3
- Division of Research, Kaiser Permanente Northern California, Oakland, CA.
- 4
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO.
- 5
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
- 6
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
- 7
- The Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
- 8
- Department of Biostatistics and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.
- 9
- Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC.
- 10
- Carolina Institute for Developmental Disabilities (CIDD), University of North Carolina at Chapel Hill, Chapel Hill, NC.
- 11
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA.
- 12
- Division of Environmental and Occupational Disease Control, CA Department of Public Health, Oakland, CA.
Abstract
BACKGROUND:
Prenatal alcohol exposure can affect neurodevelopment, but few studies have examined associations with autism spectrum disorder (ASD).METHODS:
We assessed the association between maternal alcohol use and ASD in the Study to Explore Early Development, a multi-site case-control study of children born between September 2003 and August 2006 in the US Regression analyses included 684 children with research clinician-confirmed ASD, 869 children with non-ASD developmental delays or disorders (DDs), and 962 controls ascertained from the general population (POP). Maternal alcohol exposure during each month from 3 months prior to conception until delivery was assessed by self-report.RESULTS:
Mothers of POP children were more likely to report any prenatal alcohol use than mothers of children with ASD or DD. In trimester one, 21.2% of mothers of POP children reported alcohol use compared with 18.1% and 18.2% of mothers of children with ASD or DD, respectively (adjusted OR for ASD vs. POP 0.8, 95% confidence interval 0.6, 1.1). During preconception and the first month of pregnancy, one to two drinks on average per week was inversely associated with ASD risk.CONCLUSIONS:
These results do not support an adverse association between low-level alcohol exposure and ASD, although these findings were based on retrospective self-reported alcohol use. Unmeasured confounding or exposure misclassification may explain inverse associations with one to two drinks per week. Pregnant or potentially pregnant women should continue to follow recommendations to avoid alcohol use because of other known effects on infant health and neurodevelopment.
© 2017 John Wiley & Sons Ltd.
- PMID:28881390
- DOI:10.1111/ppe.12404
