Results of criterional and descriptive assessing dysmorphological disorders associated with prenatal exposure to ethanol in children 7-10 years of age

Abstract

Diagnosis of disorders that determine the clinical manifestations of fetal alcohol syndrome (FAS) can cause certain difficulties: children with intrauterine alcohol exposure have a fairly wide range of physical, cognitive and behavioral features. The severity of disorders varies, which is determined mainly by the period when mother consumed alcohol (1st, 2nd or 3rd trimester of pregnancy), as well as frequency and amount of alcohol consumed. This article presents results of the second stage of the study among school students 7-10 year of age to identify and assess dysmorphological disorders that have arisen due to prenatal exposure to ethanol. During the first stage of the study, 77 students with delayed physical development (height and weight at the level of the 10th centile and less) were identified with anamnestic data about their mothers’ drinking alcohol during pregnancy. All children were included in the second stage of the study for detailed dysmorphological assessment. Diagnostics was carried out in two directions: criterial, including determining presence or absence of disorders, and if any, determining the severity of facial phenotype of FAS (short palpebral fissure lengths, smooth philtrum, thin upper lip); and descriptive, including determining presence or absence of disorders, and if any, determining severity of other dysmorphological disorders associated with FAS (face shape, features of the eyes, shape of the ears, features of the nostrils and lips, features of the structure of the hands). According to the results of the criteria-based diagnostics, 11 (14.3%) out of 77 children had typical facial anomalies or facial phenotype typical for FAS. 4 children had full correspondence of facial anomalies to severe, and 7 children to moderate. According to results of syndromic diagnosis, all children had from 1 to 6 signs of dysmorphological manifestations of FAS, represented by: upper palmar fold in the form of a «hockey stick» in 42.9%; altered ear configurations in the form of a «railway track» in 42.9%; short palpebral fissure lengths in 41.6%; smooth philtrum in 41.6%; thin upper lip in 41.6%; strabismus in 37.7%; clinodactyly of the 5th finger in 37.7%; small midface in 23.4%.