| Autor: |
Mamluk, Loubaba, Jones, Timothy, Ijaz, Sharea, Edwards, Hannah B, Savović, Jelena, Leach, Verity, Moore, Theresa H M, Hinke, Stephanie von, Lewis, Sarah J, Donovan, Jenny L, Lawlor, Deborah A, Smith, George Davey, Fraser, Abigail, Zuccolo, Luisa, von Hinke, Stephanie, Davey Smith, George |
| Předmět: |
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| Zdroj: |
International Journal of Epidemiology; Dec2020, Vol. 49 Issue 6, p1972-1995, 24p |
| Abstrakt: |
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. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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