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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

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...

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Autores principales: Mamluk, Loubaba, Jones, Timothy, Ijaz, Sharea, Edwards, Hannah B, Savović, Jelena, Leach, Verity, Moore, Theresa H M, von Hinke, Stephanie, Lewis, Sarah J, Donovan, Jenny L, Lawlor, Deborah A, Davey Smith, George, Fraser, Abigail, Zuccolo, Luisa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7825937/
https://www.ncbi.nlm.nih.gov/pubmed/31993631
http://dx.doi.org/10.1093/ije/dyz272
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author Mamluk, Loubaba
Jones, Timothy
Ijaz, Sharea
Edwards, Hannah B
Savović, Jelena
Leach, Verity
Moore, Theresa H M
von Hinke, Stephanie
Lewis, Sarah J
Donovan, Jenny L
Lawlor, Deborah A
Davey Smith, George
Fraser, Abigail
Zuccolo, Luisa
author_facet Mamluk, Loubaba
Jones, Timothy
Ijaz, Sharea
Edwards, Hannah B
Savović, Jelena
Leach, Verity
Moore, Theresa H M
von Hinke, Stephanie
Lewis, Sarah J
Donovan, Jenny L
Lawlor, Deborah A
Davey Smith, George
Fraser, Abigail
Zuccolo, Luisa
author_sort Mamluk, Loubaba
collection PubMed
description 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
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spelling pubmed-78259372021-01-27 Evidence of detrimental effects of prenatal alcohol exposure on offspring birthweight and neurodevelopment from a systematic review of quasi-experimental studies Mamluk, Loubaba Jones, Timothy Ijaz, Sharea Edwards, Hannah B Savović, Jelena Leach, Verity Moore, Theresa H M von Hinke, Stephanie Lewis, Sarah J Donovan, Jenny L Lawlor, Deborah A Davey Smith, George Fraser, Abigail Zuccolo, Luisa Int J Epidemiol Cognitive Development 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 Oxford University Press 2020-01-29 /pmc/articles/PMC7825937/ /pubmed/31993631 http://dx.doi.org/10.1093/ije/dyz272 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of the International Epidemiological Association. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Cognitive Development
Mamluk, Loubaba
Jones, Timothy
Ijaz, Sharea
Edwards, Hannah B
Savović, Jelena
Leach, Verity
Moore, Theresa H M
von Hinke, Stephanie
Lewis, Sarah J
Donovan, Jenny L
Lawlor, Deborah A
Davey Smith, George
Fraser, Abigail
Zuccolo, Luisa
Evidence of detrimental effects of prenatal alcohol exposure on offspring birthweight and neurodevelopment from a systematic review of quasi-experimental studies
title Evidence of detrimental effects of prenatal alcohol exposure on offspring birthweight and neurodevelopment from a systematic review of quasi-experimental studies
title_full Evidence of detrimental effects of prenatal alcohol exposure on offspring birthweight and neurodevelopment from a systematic review of quasi-experimental studies
title_fullStr Evidence of detrimental effects of prenatal alcohol exposure on offspring birthweight and neurodevelopment from a systematic review of quasi-experimental studies
title_full_unstemmed Evidence of detrimental effects of prenatal alcohol exposure on offspring birthweight and neurodevelopment from a systematic review of quasi-experimental studies
title_short Evidence of detrimental effects of prenatal alcohol exposure on offspring birthweight and neurodevelopment from a systematic review of quasi-experimental studies
title_sort evidence of detrimental effects of prenatal alcohol exposure on offspring birthweight and neurodevelopment from a systematic review of quasi-experimental studies
topic Cognitive Development
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7825937/
https://www.ncbi.nlm.nih.gov/pubmed/31993631
http://dx.doi.org/10.1093/ije/dyz272
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