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CC BY 4.0 · Rev Bras Ginecol Obstet 2019; 41(05): 333-347
DOI: 10.1055/s-0039-1688905
Review Article
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Maternal Exposure to Alcohol and Low Birthweight: A Systematic Review and Meta-Analysis

Exposição maternal ao álcool e baixo peso ao nascer: revisão sistemática e metanálise
Priscilla Perez da Silva Pereira 
1   Department of Nursing, Universidade Federal de Rondônia, Porto Velho, RO, Brazil
,
Fabiana Araújo Figueiredo Da Mata
2   Department of Medicine, Universidade Brasilia, Brasília, DF, Brazil
,
Ana Claudia Morais Godoy Figueiredo
2   Department of Medicine, Universidade Brasilia, Brasília, DF, Brazil
,
Roberta Borges Silva
2   Department of Medicine, Universidade Brasilia, Brasília, DF, Brazil
,
Maurício Gomes Pereira
2   Department of Medicine, Universidade Brasilia, Brasília, DF, Brazil
› Author Affiliations
Further Information

Publication History

10 January 2019

21 March 2019

Publication Date:
10 June 2019 (online)

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Abstract

Objective To investigate the relationship between maternal exposure to alcohol and low birthweight (LBW).

Methods The literature search was performed in January 2017 using the following electronic databases: Medline, Embase, LILACS, SciELO, Web of Science, Scopus, CINHAL, Proquest, and PsychInfo. The search strategy used the following terms: alcohol drinking, binge drinking, alcohol-related disorders, alcoholism, alcohol addiction/use/abuse/consumption, light/moderate/social/low drinking, low birthweight, case-control studies, retrospective studies, and cohort studies. No restrictions regarding language or publication date were considered. The literature search yielded 2,383 articles, and after screening and eligibility assessment, 39 articles were included in the systematic review, and 38 studies were included in the meta-analysis.

Results Maternal alcohol consumption was associated with LBW among retrospective cohort studies (relative risk [RR] = 1.37; 95%CI [confidence interval]:1.10–1.77; I2 = 98.4%; p < 0.01). Prospective cohort studies (RR = 1.11; 95%CI: 0.98–1.25; I2 = 81.5%; p < 0.01), and case-control studies (odds ration [OR] = 1.16; 95%CI: 0.68–1.97; I2 = 61.2%; p = 0.05) showed no association between alcohol and LBW. No publication bias was identified, and the meta-regression showed that the sample size influenced the high heterogeneity among retrospective cohort studies. The subgroup analysis showed differences in association between groups when compared by sample size, type of adjustment, or crude measures and publication year.

Conclusions We have not found an association between alcohol consumption during gestation and LBW in the analysis in all of the subgroups. In addition, we have found a high heterogeneity between the primary studies, which is related to methodological differences in the conduction of these studies.

Resumo

Objetivo Investigar a associação entre a exposição maternal ao álcool e o baixo peso ao nascer.

Método A busca na literatura ocorreu em janeiro de 2017 nas seguintes bases de dados eletrônicas: Medline, Embase, LILACS, SciELO, Web of Science, Scopus, CINHAL, Proquest, e PsychInfo. A estratégia de busca utilizou os seguintes termos: alcohol drinking, binge drinking, alcohol-related disorders, alcoholism, alcohol addiction/use/abuse/consumption, light/moderate/social/low drinking, low birthweight, case-control studies, retrospective studies, e cohort studies. Não houve restrição de idioma e ano de publicação. A busca na literatura identificou 2.383 artigos, e depois de analisados conforme os critério de elegibilidade, foram incluídos na revisão sistemática 39 estudos, e 38 estudos foram incluídos na metanálise.

Resultados A amostra foi composta por 497.023 gestantes. O consumo materno de álcool foi associado ao baixo peso ao nascer entre os estudos de coorte retrospectiva (risco relativo [RR] = 1,37; IC [intervalo de confiança] 95%: 1,10–1,77; I2 = 98,4%; p < 0,01). Os estudos de coorte prospectiva (RR = 1,11; IC95%: 0,98–1,25; I2 = 81,5%; p < 0,01) e caso-controle (razão de chances [OR, na sigla em inglês] = 1,16; IC95%: 0,68–1,97; I2 = 61,2%; p = 0,05) não apresentaram associação entre o consumo e o desfecho. Não foi identificado viés de publicação, e a metarregressão mostrou que o tamanho da amostra influenciou a heterogeneidade entre os estudos de coorte prospectiva. Na análise por subgrupo, houve diferenças entre os grupos por tamanho de amostra, por tipo de ajuste e por ano de publicação.

Conclusão Não encontramos associação entre o consumo e o baixo peso ao nascer em todas as análises por subgrupo. Além disso, encontramos alta heterogeneidade entre os estudos primários, e isto se deve possivelmente às diferenças metodológicas na condução destes estudos.

Keywords

pregnant women - low birthweight - alcoholic beverages - systematic review - meta-analysis

Palavras-chave

gestante - baixo peso ao nascer - consumo de álcool - revisão sistemática - metanálise

Supplementary Material

 

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