Reassessing FASD: Novel Approaches for Evaluating Exposure, Diagnosis and Outcomes in Children Prenatally Exposed to Alcohol

重新评估 FASD：评估产前接触酒精儿童的暴露、诊断和结果的新方法

• 批准号: 10376367
• 负责人: Gretchen E. Bandoli
• 金额: $ 48.81万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10376367
• 关键词: 3-Dimensional; Address; Affect; Alcohol consumption; Alcohols; Behavior; Behavioral; Body Size; Caregivers; Categories; Characteristics; Child; Childhood; Classification; Clinical; Cluster Analysis; Code; Cognition; Cognitive; Collaborations; Communities; Cross-Sectional Studies; Data; Data Analyses; Data Set; Diagnosis; Diagnostic; Digit structure; Dysmorphology; Early Diagnosis; Early identification; Education; Etiology; Face; Fetal Alcohol Exposure; Fetal Alcohol Spectrum Disorder; Foundations; Functional disorder; Funding; Future; General Population; Growth; Health; Household; Image; Income; Individual; Intervention; Interview; Knowledge; Lead; Life; Manuscripts; Measurement; Measures; Mediating; Mediator of activation protein; Mental Health; Methodology; Methods; Minor; Mission; Modeling; Mothers; National Institute of Mental Health; National Institute on Alcohol Abuse and Alcoholism; Neurodevelopmental Deficit; Outcome; Pattern; Performance; Persons; Pharmaceutical Preparations; Population; Poverty; Predictive Value; Pregnancy; Pregnancy Complications; Pregnancy Histories; Preparation; Prevalence; Prevention; Protocols documentation; Publishing; Research; Research Design; Research Personnel; Research Priority; Research Proposals; Risk; Rural; Sampling; School-Age Population; Site; Testing; Time; United States National Institutes of Health; Work; alcohol consumption during pregnancy; alcohol exposure; archive data; archived data; base; cohesion; contextual factors; cost; demographics; developmental disease; diagnostic criteria; disability; disease classification; experience; fetal; fetal diagnosis; first grade; impaired brain development; improved; innovation; insight; malformation; multidisciplinary; neurodevelopment; novel; novel strategies; offspring; population based; postnatal; prenatal exposure; resilience; screening; secondary analysis; sex; teacher; urban residence; urban setting

Project Summary Fetal alcohol spectrum disorders (FASD) are caused by prenatal alcohol exposure (PAE), and occur in 1-5% of the population at a cost that exceeds $4 billion dollars per year. FASD is a continuum of developmental disorders, and can result in life long disabilities. Although beneficial treatments exist, identification of affected individuals has proven difficult, and the majority of individuals with FASD are undiagnosed or misdiagnosed. There are a large number of gaps in knowledge that are critical to improvement in prevention, diagnosis and treatment for FASD. First, although PAE is the cause of FASD, it is not deterministic. A better understanding of the specific alcohol use patterns associated with specific FASD outcomes would inform prevention and intervention efforts, and support earlier diagnoses. Second, classification schema that most effectively utilizes the many physical signs associated with PAE and their contribution as markers of impaired brain development could lead to earlier and better diagnosis. Third, although several co-factors have been established as modifiers of risk for FASD, many more co-factors, mediators and modifiers remain unexplored that could substantially inform the pathophysiology and intervention efforts. Each of these knowledge gaps represent high research priorities for the prevention and treatment of FASD. The purpose of this study is to improve diagnosis of FASD through research that specifically addresses these aforementioned gaps. In a study previously funded by NIH-NIAAA, investigators formed The Collaboration on Fetal Alcohol Spectrum Disorders Prevalence consortium (CoFASP) to determine, for first time, a regionally- based prevalence estimate of FASD in four communities in the U.S. Together, these researchers developed a common protocol for the cross-sectional study design and established agreed upon classification criteria for FASD. Over 6,000 children were screened for FASD, and comprehensive data were collected on over 2,900 children for each of the relevant domains including dysmorphology; growth; cognitive, behavioral and adaptive functioning; maternal characteristics; PAE and for a subset 3D facial images. Using the CoFASP data set, we will 1) employ novel methods to elucidate exposure patterns associated with risk for PAE-related outcomes, 2) test new methodologies and diagnostic criteria as they pertain to FASD diagnosis and neurodevelopmental outcomes, and 3) investigate contextual and health-related covariates that function as mediators and/or modifiers of FASD. The advances proposed in this research allow for insights into the etiology and classification of FASD, and ultimately, factors that affect the prevalence of FASD. The investigators on this proposal are multidisciplinary, and together offer an innovative and cohesive approach to the research proposal. Through these novel approaches, we anticipate providing a foundation for future classification schema, exposure assessment and intervention strategies that are grounded in empirical evidence.

项目概要 胎儿酒精谱系障碍 (FASD) 是由产前酒精暴露 (PAE) 引起的，发生率为 1-5% 每年造成的人口损失超过 40 亿美元。 FASD 是一系列发育障碍， 并可能导致终身残疾。尽管存在有益的治疗方法，但仍需识别受影响的个体 事实证明，诊断 FASD 非常困难，大多数 FASD 患者都未被诊断或误诊。有一个 存在大量知识空白，而这些知识对于改善艾滋病毒的预防、诊断和治疗至关重要 胎儿酒精谱系障碍。首先，虽然 PAE 是 FASD 的原因，但它不是确定性的。对具体情况有更好的了解 与特定 FASD 结果相关的饮酒模式将为预防和干预工作提供信息， 并支持早期诊断。其次，最有效地利用许多物理特征的分类模式 与 PAE 相关的体征及其作为大脑发育受损标记的贡献可能会导致早期 和更好的诊断。第三，虽然一些辅助因素已被确定为 FASD 风险的调节因素， 还有更多的辅助因素、中介因素和调节因素尚未被探索，这些因素可以为 病理生理学和干预措施。这些知识差距中的每一个都代表了高度的研究优先事项 FASD 的预防和治疗。 本研究的目的是通过专门解决这些问题的研究来改善 FASD 的诊断 上述差距。在 NIH-NIAAA 先前资助的一项研究中，研究人员成立了合作组织 胎儿酒精谱系疾病患病率联盟 (CoFASP) 首次确定区域性 基于美国四个社区 FASD 患病率的估计，这些研究人员共同开发了 横断面研究设计的共同方案并建立了商定的分类标准 胎儿酒精谱系障碍。对 6,000 多名儿童进行了 FASD 筛查，并收集了 2,900 多名儿童的综合数据 每个相关领域的儿童，包括畸形学；生长;认知、行为和适应性 发挥作用；母性特征； PAE 和 3D 面部图像子集。使用 CoFASP 数据集，我们 将 1) 采用新颖的方法来阐明与 PAE 相关结果风险相关的暴露模式，2) 测试与 FASD 诊断和神经发育相关的新方法和诊断标准 结果，3) 研究充当中介和/或调节因素的情境和健康相关协变量 胎儿酒精谱系障碍（FASD）。 这项研究提出的进展有助于深入了解 FASD 的病因和分类，以及 最终，影响 FASD 患病率的因素。这项提案的研究人员是多学科的， 并共同为研究提案提供创新且有凝聚力的方法。通过这些小说 方法，我们预计为未来的分类方案、暴露评估和 以经验证据为基础的干预策略。

项目成果

Trajectories of prenatal alcohol exposure and behavioral outcomes: Findings from a community-based sample.

产前酒精暴露和行为结果的轨迹：来自社区样本的发现。

• 发表时间: 2022-04-01
• 影响因子: 4.2
• 作者: Bandoli, G;Kable, J A;Coles, C D;Del Campo, M;Suttie, M;Chambers, C D
• 通讯作者: Chambers, C D

Secondary physical features in children with FASD.

FASD 儿童的次要身体特征。

• 发表时间: 2024-02
• 作者: Del Campo, Miguel;Kable, Julie A;Coles, Claire D;Suttie, Michael;Chambers, Christina D;Bandoli, Gretchen
• 通讯作者: Bandoli, Gretchen