• Media type: E-Article
  • Title: Development and validation of a postnatal risk score that identifies children with prenatal alcohol exposure
  • Contributor: Bernes, Gemma A.; Courchesne‐Krak, Natasia S.; Hyland, Matthew T.; Villodas, Miguel T.; Coles, Claire D.; Kable, Julie A.; May, Philip A.; Kalberg, Wendy O.; Sowell, Elizabeth R.; Wozniak, Jeffrey R.; Jones, Kenneth L.; Riley, Edward P.; Mattson, Sarah N.
  • Published: Wiley, 2022
  • Published in: Alcoholism: Clinical and Experimental Research
  • Extent: 52-65
  • Language: English
  • DOI: 10.1111/acer.14749
  • ISSN: 0145-6008; 1530-0277
  • Keywords: Psychiatry and Mental health ; Toxicology ; Medicine (miscellaneous)
  • Abstract: <jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>This study aimed to develop an efficient and easily calculable risk score that can be used to identify an individual's risk of having been exposed to alcohol prenatally.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Data for this study were collected as part of the Collaborative Initiative on Fetal Alcohol Spectrum Disorders, Phases 2 and 3. Two cohorts (ages 5 to 17 years) completed a comprehensive neurobehavioral battery and a standard dysmorphology exam: a development cohort (DC; <jats:italic>n</jats:italic> = 325) and a comparative cohort (CC; <jats:italic>n</jats:italic> = 523). Both cohorts included two groups: those with histories of heavy prenatal alcohol exposure (AE‐DC, <jats:italic>n</jats:italic> = 121; AE‐CC, <jats:italic>n</jats:italic> = 177) and a control group that included subjects with minimal or no prenatal alcohol exposure (CON‐DC, <jats:italic>n</jats:italic> = 204; CON‐CC, <jats:italic>n</jats:italic> = 346). Behavioral assessments and physical exam data were combined using regression techniques to derive a risk score indicating the likelihood of prenatal alcohol exposure. Subjects were then divided into two subgroups: (1) low risk and (2) high risk. Chi‐square (<jats:italic>χ</jats:italic><jats:sup>2</jats:sup>) determined classification accuracy and ROC curves were produced to assess the predictive accuracy. Correlations between risk scores and intelligence quotient and executive function scores were calculated.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Subjects were accurately classified in the DC (<jats:italic>χ</jats:italic><jats:sup>2</jats:sup> = 78.61, <jats:italic>p</jats:italic> &lt; 0.001) and CC (<jats:italic>χ</jats:italic><jats:sup>2</jats:sup> = 86.63, <jats:italic>p</jats:italic> &lt; 0.001). The classification model also performed well in the DC (ROC = 0.835 [SE = 0.024, <jats:italic>p</jats:italic> &lt; 0.001]) and CC (ROC = 0.786 [SE = 0.021, <jats:italic>p</jats:italic> &lt; 0.001]). In the AE‐CC and CON‐CC, there were modest but significant associations between the risk score and executive function (AE‐CC: <jats:italic>r</jats:italic> = −0.20, <jats:italic>p</jats:italic> = 0.034; CON‐CC: <jats:italic>r</jats:italic> = −0.28, <jats:italic>p</jats:italic> &lt; 0.001) and intelligence quotient (AE‐CC: <jats:italic>r</jats:italic> = −0.20, <jats:italic>p</jats:italic> = 0.034; CON‐CC: <jats:italic>r</jats:italic> = −0.28, <jats:italic>p</jats:italic> &lt; 0.001).</jats:p></jats:sec><jats:sec><jats:title>Conclusion(s)</jats:title><jats:p>The risk score significantly distinguished alcohol‐exposed from control subjects and correlated with important cognitive outcomes. It has significant clinical potential and could be easily deployed in clinical settings.</jats:p></jats:sec>
  • Description: <jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>This study aimed to develop an efficient and easily calculable risk score that can be used to identify an individual's risk of having been exposed to alcohol prenatally.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Data for this study were collected as part of the Collaborative Initiative on Fetal Alcohol Spectrum Disorders, Phases 2 and 3. Two cohorts (ages 5 to 17 years) completed a comprehensive neurobehavioral battery and a standard dysmorphology exam: a development cohort (DC; <jats:italic>n</jats:italic> = 325) and a comparative cohort (CC; <jats:italic>n</jats:italic> = 523). Both cohorts included two groups: those with histories of heavy prenatal alcohol exposure (AE‐DC, <jats:italic>n</jats:italic> = 121; AE‐CC, <jats:italic>n</jats:italic> = 177) and a control group that included subjects with minimal or no prenatal alcohol exposure (CON‐DC, <jats:italic>n</jats:italic> = 204; CON‐CC, <jats:italic>n</jats:italic> = 346). Behavioral assessments and physical exam data were combined using regression techniques to derive a risk score indicating the likelihood of prenatal alcohol exposure. Subjects were then divided into two subgroups: (1) low risk and (2) high risk. Chi‐square (<jats:italic>χ</jats:italic><jats:sup>2</jats:sup>) determined classification accuracy and ROC curves were produced to assess the predictive accuracy. Correlations between risk scores and intelligence quotient and executive function scores were calculated.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Subjects were accurately classified in the DC (<jats:italic>χ</jats:italic><jats:sup>2</jats:sup> = 78.61, <jats:italic>p</jats:italic> &lt; 0.001) and CC (<jats:italic>χ</jats:italic><jats:sup>2</jats:sup> = 86.63, <jats:italic>p</jats:italic> &lt; 0.001). The classification model also performed well in the DC (ROC = 0.835 [SE = 0.024, <jats:italic>p</jats:italic> &lt; 0.001]) and CC (ROC = 0.786 [SE = 0.021, <jats:italic>p</jats:italic> &lt; 0.001]). In the AE‐CC and CON‐CC, there were modest but significant associations between the risk score and executive function (AE‐CC: <jats:italic>r</jats:italic> = −0.20, <jats:italic>p</jats:italic> = 0.034; CON‐CC: <jats:italic>r</jats:italic> = −0.28, <jats:italic>p</jats:italic> &lt; 0.001) and intelligence quotient (AE‐CC: <jats:italic>r</jats:italic> = −0.20, <jats:italic>p</jats:italic> = 0.034; CON‐CC: <jats:italic>r</jats:italic> = −0.28, <jats:italic>p</jats:italic> &lt; 0.001).</jats:p></jats:sec><jats:sec><jats:title>Conclusion(s)</jats:title><jats:p>The risk score significantly distinguished alcohol‐exposed from control subjects and correlated with important cognitive outcomes. It has significant clinical potential and could be easily deployed in clinical settings.</jats:p></jats:sec>
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