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Confidence Intervals
Published in Marcello Pagano, Kimberlee Gauvreau, Heather Mattie, Principles of Biostatistics, 2022
Marcello Pagano, Kimberlee Gauvreau, Heather Mattie
Consider the distribution of heights for the population of individuals between the ages of 12 and 40 who suffer from fetal alcohol syndrome. Fetal alcohol syndrome refers to the severe end of the spectrum of disabilities caused by maternal alcohol use during pregnancy. The distribution of heights is approximately normal with unknown mean μ. We wish to find both a point estimate and a confidence interval for μ. The confidence interval provides a range of reasonable values for the parameter of interest.
Fetal Development and Maternal Diet
Published in Praveen S. Goday, Cassandra L. S. Walia, Pediatric Nutrition for Dietitians, 2022
Avoiding tobacco and alcohol are key components of a healthy pregnancy. Cigarettes (including e-cigarettes) contain thousands of chemicals including nicotine that can pass from the mother to the fetus. Nicotine causes vasoconstriction which in turn compromises oxygen and nutrient delivery to the fetus. In addition to nicotine, alcohol consumption can impact normal fetal growth and development. Lifelong complications may occur, with the most severe being fetal alcohol syndrome leading to growth problems, mental disability, behavioral problems, and abnormal facial features.
Substance Abuse and Addiction
Published in James M. Rippe, Manual of Lifestyle Medicine, 2021
Excessive alcohol consumption carries a wide variety of comorbidities. These include a variety of neurological sequelae, including an increased risk of ischemic stroke. Cardiovascular complications may include cardiomyopathy, atrial fibrillation, ventricular tachycardia, and hypertension. The best well-known physical consequence of alcohol is liver damage which proceeds along the spectrum from ketosis and hepatitis to fibrosis and then cirrhosis. There is also a strong association between alcohol use and cancer risk. Cancers of the following organs have been associated with alcohol use: mouth, esophagus, pharynx, larynx, liver, colon, rectum, and breast. In the urinary system in men, complications may include testicular atrophy and a decrease in erectile capacity. In women amenorrhea, decreased ovarian size and infertility have been noted as well as increased risk of spontaneous abortion. It should be noted that alcohol use during pregnancy can result in fetal alcohol syndrome.
Depression, Anxiety, and Substance Use Disorders and Treatment Receipt Among Pregnant Women in the United States: A Systematic Review of Trend and Population-Based Studies
Published in Issues in Mental Health Nursing, 2020
Taghreed N. Salameh, Lynne A. Hall
Alcohol consumed during pregnancy is associated with fetal alcohol syndrome (Lehikoinen, Orden, Heinonen, & Voutilainen, 2016) and low birth weight (Irner, Teasdale, Nielsen, Vedal, & Olofsson, 2012). Prenatal illicit drug use is associated with medical and obstetric complications (Lambert & Bauer, 2012; Metz & Stickrath, 2015) and impaired neurodevelopment in prenatally exposed infants (Jaques et al., 2014). Neonatal Abstinence Syndrome (NAS) is a serious consequence of prenatal exposure to opioids (Narkowicz, Płotka, Polkowska, Biziuk, & Namieśnik, 2013). In the United States, the incidence of infants with NAS reached 3.39 per 1,000 live births in 2009 (Patrick et al., 2012), then increased substantially to 5.8 per 1000 hospital births in 2012 (Patrick, Davis, Lehmann, & Cooper, 2015). NAS places an economic burden on society because of costs related to prolonged hospitalization of infants with NAS (Patrick et al., 2015) (Patrick et al., 2015) and child protective services (Ondersma, Simpson, Brestan, & Ward, 2000).
Everyday memory difficulties in children and adolescents with Fetal Alcohol Spectrum Disorder
Published in Developmental Neurorehabilitation, 2019
Sabrina Agnihotri, Sivaniya Subramaniapillai, Michelle Keightley, Carmen Rasmussen, Debra Cameron, Jennifer Ryan, Joanne Rovet
All diagnoses in the current study were made at the Hospital for Sick Children using the 2005 Canadian guidelines,52,53,54 which were the available diagnostic criteria at the time of study completion. These criteria identify three distinct FASD diagnoses: Fetal Alcohol Syndrome (FAS), Partial Fetal Alcohol Syndrome (pFAS), and Alcohol-Related Neurodevelopmental Disorder (ARND). Four key signs and symptoms, referred to as the 4-Digit Diagnostic Code, was used to rank from one to four according to increasing severity: (i) evidence of prenatal or postnatal growth impairments; (ii) characteristic facial anomalies, including short palpebral fissure lengths, smooth philtrum, and thin or flat upper lip; (iii) central nervous system (CNS) impairment (e.g. neurologic signs, brain structure abnormalities); and (iv) history of maternal alcohol exposure. A diagnosis of FAS is made when all criteria are present, however, maternal alcohol exposure can be unconfirmed. By contrast, a diagnosis of pFAS must include confirmed maternal alcohol exposure, but all three characteristic facial features of FAS do not need to be present. ARND is diagnosed in the absence of facial and growth anomalies, when individuals have confirmed prenatal alcohol exposure and: (i) evidence of CNS abnormalities and/or (ii) behavioral or cognitive conditions that are inconsistent with their developmental level (i.e. issues within the areas of cognition, communication, academic achievement, executive functioning, attention, adaptive behavior, social skills, and communication).
Adolescent Substance Use and Effects on the Birth Experience
Published in Issues in Mental Health Nursing, 2018
While use during pregnancy may decrease, some adolescents continue usage. Depression and dating violence during the perinatal period have been identified as risk factors for continued substance use, including binge drinking (Siegel & Brandon, 2014; Riaz, Lewis, Naughton, & Ussher, 2017). Continued alcohol use has been linked with subsequent adolescent pregnancies (Bottoroff et al., 2014). The effect of alcohol on the fetus is a significant health care concern and has been documented for many decades. A wide spectrum of infant morphological and behavioral outcomes, referred to as the fetal alcohol spectrum disorder, has been defined, with fetal alcohol syndrome, the most extreme fetal alcohol pathology (Coriale et al., 2013). The spectrum of defects is large and includes cognitive problems, executive functions regulations, memory impairment, learning problems, language disorders, visual-spatial deficits, motor impairments, attention deficits problems, psychopathology, and secondary disabilities (Coriale et al., 2013).