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Evidence of detrimental effects of prenatal alcohol exposure on offspring birthweight and neurodevelopment from a systematic review of quasi-experimental studies
International Journal of Epidemiology ( IF 7.7 ) Pub Date : 2020-01-29 , DOI: 10.1093/ije/dyz272 Loubaba Mamluk 1, 2, 3 , Timothy Jones 2, 3 , Sharea Ijaz 2, 3 , Hannah B Edwards 2, 3 , Jelena Savović 2, 3 , Verity Leach 2, 3 , Theresa H M Moore 2, 3 , Stephanie von Hinke 4 , Sarah J Lewis 2 , Jenny L Donovan 2, 3 , Deborah A Lawlor 1, 2, 3, 5 , George Davey Smith 1, 2, 5 , Abigail Fraser 1, 2, 5 , Luisa Zuccolo 1, 2
中文翻译:
通过对准实验研究的系统回顾,证明产前酒精暴露对后代出生体重和神经发育的有害影响
更新日期:2020-01-29
International Journal of Epidemiology ( IF 7.7 ) Pub Date : 2020-01-29 , DOI: 10.1093/ije/dyz272 Loubaba Mamluk 1, 2, 3 , Timothy Jones 2, 3 , Sharea Ijaz 2, 3 , Hannah B Edwards 2, 3 , Jelena Savović 2, 3 , Verity Leach 2, 3 , Theresa H M Moore 2, 3 , Stephanie von Hinke 4 , Sarah J Lewis 2 , Jenny L Donovan 2, 3 , Deborah A Lawlor 1, 2, 3, 5 , George Davey Smith 1, 2, 5 , Abigail Fraser 1, 2, 5 , Luisa Zuccolo 1, 2
Affiliation
Abstract
Background
Systematic reviews of prenatal alcohol exposure effects generally only include conventional observational studies. However, estimates from such studies are prone to confounding and other biases.Objectives
To systematically review the evidence on the effects of prenatal alcohol exposure from randomized controlled trials (RCTs) and observational designs using alternative analytical approaches to improve causal inference.Search strategy
Medline, Embase, Web of Science, PsychINFO from inception to 21 June 2018. Manual searches of reference lists of retrieved papers.Selection criteria
RCTs of interventions to stop/reduce drinking in pregnancy and observational studies using alternative analytical methods (quasi-experimental studies e.g. Mendelian randomization and natural experiments, negative control comparisons) to determine the causal effects of prenatal alcohol exposure on pregnancy and longer-term offspring outcomes in human studies.Data collection and analysis
One reviewer extracted data and another checked extracted data. Risk of bias was assessed using customized risk of bias tools. A narrative synthesis of findings was carried out and a meta-analysis for one outcome.Main results
Twenty-three studies were included, representing five types of study design, including 1 RCT, 9 Mendelian randomization and 7 natural experiment studies, and reporting on over 30 outcomes. One study design–outcome combination included enough independent results to meta-analyse. Based on evidence from several studies, we found a likely causal detrimental role of prenatal alcohol exposure on cognitive outcomes, and weaker evidence for a role in low birthweight.Conclusion
None of the included studies was judged to be at low risk of bias in all domains, results should therefore be interpreted with caution.Systematic review registration
This study is registered with PROSPERO, registration number CRD42015015941
中文翻译:
通过对准实验研究的系统回顾,证明产前酒精暴露对后代出生体重和神经发育的有害影响
摘要
背景
对产前酒精暴露影响的系统评价通常只包括传统的观察性研究。然而,此类研究的估计很容易出现混淆和其他偏差。目标
系统地回顾来自随机对照试验 (RCT) 和观察性设计的产前酒精暴露影响的证据,使用替代分析方法来改善因果推断。搜索策略
Medline、Embase、Web of Science、PsychINFO 从开始到 2018 年 6 月 21 日。手动检索检索到的论文的参考文献列表。选择标准
妊娠期停止/减少饮酒干预措施的随机对照试验,以及使用替代分析方法(准实验研究,例如孟德尔随机化和自然实验、阴性对照比较)的观察性研究,以确定产前酒精暴露对妊娠和长期后代结局的因果影响在人类研究中。数据收集与分析
一位审阅者提取数据,另一位审阅者检查提取的数据。使用定制的偏倚风险工具评估偏倚风险。对研究结果进行了叙述性综合,并对一项结果进行了荟萃分析。主要结果
纳入了 23 项研究,代表 5 种类型的研究设计,包括 1 项随机对照试验、9 项孟德尔随机研究和 7 项自然实验研究,并报告了 30 多项结果。一项研究设计-结果组合包括足够的独立结果来进行荟萃分析。根据多项研究的证据,我们发现产前饮酒可能对认知结果产生有害的因果作用,而与低出生体重有关的证据则较弱。结论
纳入的研究均被认为在所有领域均具有低偏倚风险,因此应谨慎解释结果。系统审核注册
本研究已在 PROSPERO 注册,注册号 CRD42015015941