背景:考虑性别和性别相关因素对于理解和支持健康和福祉至关重要。尽管性别和性别都会影响发育障碍的人,在胎儿酒精谱系障碍(FASD)患者中,关于这些因素及其影响的研究相对较少,复杂的神经发育障碍影响了约4%-5%的人口。需要了解FASD中与性别和性别相关的差异,以促进循证评估,治疗计划,和宣传。要开始解开这些因素,我们调查了FASD评估患者在整个生命周期中临床表现和体验方面的性别差异.
方法:我们分析了来自加拿大29个FASD诊断中心的2574份临床记录。参与者的年龄范围为1至61岁(平均15.2岁),一半以上(58.3%)是出生时的男性。研究变量包括参与者人口统计学,产前酒精暴露(PAE)的物理指标,神经发育障碍,FASD诊断,同时发生的身体和心理健康诊断,和环境逆境。
结果:在FASD诊断结果或PAE的物理指标方面,男性和女性之间没有显着差异。然而,男性经历了明显更多的神经发育障碍。女性的内分泌问题发生率更高,焦虑,和抑郁/情绪障碍,而男性的注意力缺陷多动障碍发生率较高,行为障碍,和对立的反抗障碍。逆境也因性别而异,女性在受害/监护方面遭受创伤和法律问题的比率更高,和男性在学校和冒犯/监禁方面有更多困难。基于性别的差异在青少年(13-17岁)和成年人(≥25岁)中最为明显。
结论:患有PAE/FASD的个体在整个生命周期的临床表现和经历中经历了显著的性别相关差异。这项研究的结果应该有助于指导研究人员,服务提供商,和政策制定者改善FASD筛查,诊断,和干预,更好地解决所有性别的PAE/FASD患者的需求。
Consideration of sex- and gender-related factors is critical for understanding and supporting health and wellbeing. Although both sex and gender influence people with developmental disabilities, there is relatively little research on these factors and their influences among individuals with fetal alcohol spectrum disorder (FASD), a complex neurodevelopmental disability impacting an estimated 4%-5% of the population. Understanding sex- and gender-related differences in FASD is needed to facilitate evidence-informed assessment, treatment planning, and advocacy. To begin unpacking these factors, we investigated sex-based differences in clinical presentation and experiences among individuals assessed for FASD across the lifespan.
We analyzed 2574 clinical records from 29 FASD diagnostic centers in Canada. Participants ranged in age from 1 to 61 years (mean 15.2 years), and more than half (58.3%) were male at birth. Study variables included participant demographics, physical indicators of prenatal alcohol exposure (PAE), neurodevelopmental impairment, FASD diagnosis, co-occurring physical and mental health diagnoses, and environmental adversity.
There were no significant differences between males and females with respect to FASD diagnostic outcome or physical indicators of PAE. However, males experienced significantly more neurodevelopmental impairment. Females experienced higher rates of endocrine problems, anxiety, and depressive/mood disorders, whereas males had higher rates of attention deficit-hyperactivity disorder, conduct disorder, and oppositional defiant disorder. Adversity also differed by sex, with females experiencing higher rates of trauma and legal problems with victimization/custody, and males having more difficulties with school and offending/incarceration. Sex-based differences were most apparent in adolescents (13-17 years) and adults (≥25 years).
Individuals with PAE/FASD experience notable sex-related differences in clinical presentation and experiences across the lifespan. Findings from this study should help to guide researchers, service providers, and policy makers to improve FASD screening, diagnosis, and intervention and better address the needs of individuals with PAE/FASD of all genders.