Use of chaos theory and complex systems modeling to study alcohol effects on fetal condition.
A systems dynamics computer model to predict birth complications for individual pregnant woman was developed from prospectively conducted data on a database of 125 pregnant women. The model is based upon nonlinear mathematics derived from the study of chaos and complex systems. The model was then tested prospectively on 27 additional pregnant women, making predictions on their level of obstetrical risk. The model was refined until it correctly predicted the outcomes of all 125 cases in the development database. Prediction was made with an accuracy of 25/27 cases for the prospective test cases. Predictions were made for fetal condition at birth, presence or absence of operative delivery, and presence or absence of uterine dysfunction. Then the model was used to explore alcohol use during pregnancy. A reasonable spread of alcohol use existed among subjects, allowing consideration of alcohol effects. Alcohol was found to have differential effects on fetal condition at birth depending upon the presence or absence of high levels of psychosocial stress and the use of other substances. In all cases, the effect of alcohol was only evident after the 10 drinks per week level was reached. For the high-stress/one other substance group, there could be an 18-fold effect on fetal condition at birth. For the low-stress/one other substance group, the effect was only 3-fold, and for the alcohol alone group, the effect was negligible.
Mehl
L E
LE
Prevention Research Center, School of Public Health, University of California at Berkeley 94720.
Manchanda
S
S
D000428:Alcohol Drinking / Q000009:adverse effects*; D002110:Caffeine / Q000009:adverse effects; D002188:Cannabis; D003042:Cocaine / Q000009:adverse effects; D003198:Computer Simulation; D005260:Female; D005333:Fetus / Q000187:drug effects*; D003932:Heroin / Q000009:adverse effects; D006801:Humans; D008954:Models, Biological; D017711:Nonlinear Dynamics; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications; D011446:Prospective Studies; D013312:Stress, Physiological / Q000150:complications; D019966:Substance-Related Disorders / Q000150:complications
D002110:Caffeine; D003932:Heroin; D003042:Cocaine