PEDIATRICS Vol. 95 No. 1 January 1995, pp. 66-73
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Perinatal Brain Injury in Premature Infants Born to Mothers Using Alcohol in Pregnancy

Claudia Holzman DVM, MPH1, Nigel Paneth MD, MPH1, Ruth Little ScD2, Jennifer Pinto-Martin PhD3, and Neonatal Brain Hemorrhage Study Team

1 Program in Epidemiology, Michigan State University, East Lansing, Michigan
2 National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
3 Department of Pediatrics and Clinical Epidemiology Unit, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

Objective. Alcohol has been shown to have teratogenic effects on the fetal central nervous system. However, little research has been done to assess the impact of prenatal alcohol exposure on premature infants, a group particularly vulnerable to perinatal brain injury.

Methods. We examined the relation between maternal alcohol use and the most common forms of brain injury in premature infants—germinal matrix/intraventricular hemorrhage (GM/IVH) and white-matter damage—in a large population-based cohort of infants weighing 2000 g or less. The analyses included 349 infants younger than 31 weeks' gestation who received at least one cranial ultrasound scan and whose mothers were queried about prenatal alcohol use in a postpartum interview.

Results. Infants of mothers who reported "moderate" alcohol use (fewer than seven drinks per week and fewer than three drinks per occasion) to "high" use (seven or more drinks per week and/or three or more drinks per occasion) before recognized pregnancy, and moderate alcohol use during pregnancy, were not at increased risk for brain injury. However, after controlling for potentially confounding factors, infants of women reporting high alcohol use during pregnancy were at increased risk of developing isolated brain hemorrhage (odds ratio [OR] = 5.5, 95% confidence interval [CI] = 1.2, 24.7), any brain hemorrhage (OR = 6.7, 95% CI = 1.8, 26.4), and white-matter damage (OR = 9.5, 95% CI = 1.9, 46.4).

Conclusion. Premature infants of women who report consuming seven or more drinks per week and/or three or more drinks per occasion during pregnancy have substantially elevated risks of both of the most common forms of brain injury in premature infants.

Submitted on October 8, 1993
Accepted on May 13, 1994




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