Intrauterine Alcohol Exposure Research Articles

Population Baseline of Meconium Ethyl Glucuronide and Ethyl Sulfate Concentrations in Newborns of Nondrinking Women in 2 Mediterranean Cohorts

The detection of ethyl glucuronide (EtG) and ethyl sulfate (EtS) in meconium has been investigated recently as an alternative to meconium fatty acid ethyl esters (FAEEs) measurement as an objective estimate of prenatal alcohol exposure, independent of maternal self-reporting. We report the results of the first study conducted to investigate the concentrations of EtG and EtS in meconium from newborns with and without intrauterine exposure to ethanol, defined by questionnaire and meconium FAEEs concentration. FAEEs, EtG, and EtS were quantified by liquid chromatography tandem mass spectrometry in meconium samples obtained from the Arcispedale Santa Maria Nuova, Reggio Emilia, Italy (n = 80) and from the Hospital del Mar in Barcelona, Spain (n = 105). Median EtG and EtS values in meconium from newborns without intrauterine exposure to ethanol varied between 0.100 and 0.140 nmol/g and 0.010 and 0.020 nmol/g in Reggio Emilia and Barcelona samples, respectively. In meconium from newborns with uncertain prenatal ethanol exposure, the EtG median value was 0.160 nmol/g in the Italian cohort and 0.250 nmol/g in the Spanish one. The median EtS concentration was 0.020 in both cohorts. EtG and EtS median values in 5 meconium samples from newborns of heavily drinking mothers were 7.240 nmol/g and 0.033 nmol/g, respectively. A positive cutoff of 2.0 nmol/g for EtG yielded the best sensitivity and specificity (100%) to discriminate for true prenatal exposure to ethanol. It was not possible to establish a proper cutoff for EtS because of the low number of positive samples. Based on our results, meconium EtG can be proposed as an alternate biomarker for intrauterine alcohol exposure. In contrast to the 7 FAEEs, EtG is just one molecule that could be screened in meconium samples from all newborns by a simple, low-cost, easy-to-perform immunoassay, which can be routinely applied in neonatology wards for the early diagnosis of prenatal exposure to ethanol.

Fetal Alcohol Spectrum Disorders in Young Adulthood

To test the hypothesis that fetal alcohol syndrome (FAS), with the full phenotype, and fetal alcohol effect (FAE), with some but not all of the features, can be combined under the umbrella term fetal alcohol spectrum disorders (FASD). We investigated the long-term sequelae of intrauterine alcohol exposure using physical examination, psychosocial interviews, and a behavioral checklist in a 20-year follow-up study of 37 patients with FASD originally diagnosed as having FAS or FAE in infancy and childhood. Although the characteristic craniofacial malformations of FAS/FAE diminish over time, microcephaly, a poorly developed philtrum and a thin upper lip, and, to a lesser degree, short stature and underweight (in boys) persist. In females, adult body weight increases. Persistent mental handicaps, including intellectual disability, limited occupational options, and dependent living, are the major sequelae, and the scores for various behavioral problems are significantly increased. The devastating effects of intrauterine exposure to alcohol persist into early adulthood and severely limit careers and independent living.

Fetal Alcohol Exposure: Lasting Effects

Intrauterine alcohol exposure during pregnancy results in fetal abnormalities. The full expression of these abnormalities (as craniofacial abnormalities, growth retardation, and impaired intellectual development) is referred to as fetal alcohol syndrome (FAS), and children who display some but not all features are said …

Alcohol use and sudden infant death syndrome

Despite general evidence of fetal toxicities associated with sudden infant death syndrome (SIDS), there has been limited research focusing on the effects of parental alcohol use on SIDS occurrence, either directly or in interaction with other risk conditions. The purpose of this paper is to review the literature on parental, especially maternal, alcohol use and SIDS. We present a model illustrating the possible association of alcohol exposure with SIDS and then use this model to organize study findings. Results show that, despite some ambiguities, intrauterine alcohol exposure is associated with SIDS. Parental postnatal use appears to be linked as well. We conclude that alcohol ingestion is a presumptive risk factor weakening an infant's life-saving responses, and should be more rigorously studied in order to develop and implement appropriate public-health-based interventions.

Twelve‐year follow‐up of children exposed to alcohol in utero

Eighty‐two women who were consuming alcohol while pregnant attended a special clinic at the University Central Hospital, Helsinki with the aim of reducing heavy drinking during pregnancy. The children born to these women were followed up regularly. During their preschool years the children were assessed to have fetal alcohol syndrome, fetal alcohol effects, alcohol‐related neurodevelopmental disorder, pre‐ and/or postnatal growth retardation, or they were assessed to have normal cognitive and somatic growth. Of the original children, 70 of 82 could be traced at the age of 12 years. Through semistructured interview and contact with the health and social care authorities, information was gathered about schooling, family structure, whether help had been sought for behavioural difficulties and major adverse events in the family. The longer the intrauterine alcohol exposure and the more severe the diagnosis related to prenatal alcohol exposure, the more often the children required special education, were temporarily or permanently taken into care, and had behavioural problems. There is a considerable need for prolonged multidisciplinary follow‐up and support of all children whose mothers have not been able to reduce drinking in early pregnancy, whether or not cognitive disturbances are evident in early childhood.

Twelve-year follow-up of children exposed to alcohol in utero.

Eighty-two women who were consuming alcohol while pregnant attended a special clinic at the University Central Hospital, Helsinki with the aim of reducing heavy drinking during pregnancy. The children born to these women were followed up regularly. During their preschool years the children were assessed to have fetal alcohol syndrome, fetal alcohol effects, alcohol-related neurodevelopmental disorder, pre- and/or postnatal growth retardation, or they were assessed to have normal cognitive and somatic growth. Of the original children, 70 of 82 could be traced at the age of 12 years. Through semistructured interview and contact with the health and social care authorities, information was gathered about schooling, family structure, whether help had been sought for behavioural difficulties and major adverse events in the family. The longer the intrauterine alcohol exposure and the more severe the diagnosis related to prenatal alcohol exposure, the more often the children required special education, were temporarily or permanently taken into care, and had behavioural problems. There is a considerable need for prolonged multidisciplinary follow-up and support of all children whose mothers have not been able to reduce drinking in early pregnancy, whether or not cognitive disturbances are evident in early childhood.

The developmental implications of prenatal and/or postnatal crack cocaine exposure in preschool children: a preliminary report.

Previous studies examining the development of prenatally cocaine-exposed children through 3 years of age have found no significant differences between exposed and control groups. This study explored the developmental correlates of prenatal and/or postnatal crack cocaine exposure in children between 4 and 6 years of age. Three groups were studied: Group 1, 18 prenatally-exposed children whose mothers continue to use crack; Group II, 28 children without prenatal exposure whose mothers presently use crack; and Group III, 28 children whose mothers never used crack. Mothers were street-recruited and were comparable in race and socioeconomic status. The three groups of children did not differ on neurological gross motor and expressive language measures. However, prenatally exposed children performed significantly worse than others on receptive language and visual motor drawing tests. Prenatal crack exposure predicted poor visual motor performance even after control for intrauterine alcohol and marijuana exposure, age, birth weight, and duration of maternal crack use.

Prenatal Alcohol Exposure and Long-Term Developmental Consequences

Fetal alcohol syndrome (FAS) is a leading cause of congenital mental retardation but little is known about the long-term development and adolescent outcome of children with FAS. In a 10-year follow-up study of 60 patients diagnosed as having FAS in infancy and childhood, we investigated the long-term sequelae of intrauterine alcohol exposure. We found that the characteristic craniofacial malformations of FAS diminish with time, but microcephaly and, to a lesser degree, short stature and underweight (in boys) persist; in female adolescents body weight normalises. Persistent mental retardation is the major sequela of intrauterine alcohol exposure in many cases, and environmental and educational factors do not have strong compensatory effects on the intellectual development of affected children.

Prenatal alcohol exposure and long-term developmental consequences

Fetal alcohol syndrome (FAS) is a leading cause of congenital mental retardation but little is known about the long-term development and adolescent outcome of children with FAS. In a 10-year follow-up study of 60 patients diagnosed as having FAS in infancy and childhood, we investigated the long-term sequelae of intrauterine alcohol exposure. We found that the characteristic craniofacial malformations of FAS diminish with time, but microcephaly and, to a lesser degree, short stature and underweight (in boys) persist; in female adolescents body weight normalises. Persistent mental retardation is the major sequela of intrauterine alcohol exposure in many cases, and environmental and educational factors do not have strong compensatory effects on the intellectual development of affected children.

Congenital defects of the limbs and alcohol exposure in pregnancy: data from a population based study.

Limb deficiency may occur in offspring prenatally exposed to alcohol. In a study on limb deficiency occurring in 1,213,913 consecutive liveborn infants in British Columbia, born in the years 1952-1984, a total of 659 cases with limb deficiency was identified. Cases with documented maternal alcohol abuse in pregnancy in this group were analyzed separately. We found eight cases with severe prenatal alcohol exposure (6 F, 2 M). In six of the eight cases a terminal transverse defect of the forearm or hand was present. In the remaining two cases ulnar defects were identified. These observations give further support to the hypothesis that intrauterine alcohol exposure may cause limb defects. This has also been demonstrated in experimental animals. Terminal transverse defects made up a larger proportion of cases with known alcohol exposure (6/8) than of cases where alcohol exposure was not noted (217/651) (chi 2 = 6.13; P < 0.025) in this study. The defects primarily involved the right hand and forearm. This suggests a vascular origin of the limb defects after intrauterine alcohol exposure.

The Effect of Intrauterine Alcohol Exposition in Various Durations on Early Cognitive Development

Fifty-three children exposed to alcohol of various duration were examined at 18 to 19 months of age. No significant difference was found in developmental outcome between non-exposed (n = 56) and during the I trimester exposed children (n = 21). Exposure until the III trimester (n = 19) or continuous exposure (n = 13) caused significantly lower scores in language and total mental assessment. The procentual numbers of children with possible developmental risk (failure or pass at acceptance limit) in various developmental fields grew with increasing duration of intrauterine alcohol exposure. Failures in gross or fine motor items differed significantly between the non-exposed and the two long exposed children but in language items only between the non-exposed and the children exposed until the III trimester. A high number of exposed children scored just the limit values indicating a milder form of developmental delay. In comparison with the developmental results of one year of age an increase in delay in cognitive development was seen. The incidences of other teratogenic effects (pre- or postnatal growth retardation, facial dysmorphia) of fetal alcohol exposure were highest in the continuous exposed group. Five (38%) of the continuous exposed children had typical fetal alcohol syndrome and only 1 (5%) of the children exposed until the III trimester.

Intrauterine alcohol and nicotine exposure: Attention and reaction time in 4-year-old children.

Intrauterine alcohol and nicotine exposure: Attention and reaction time in 4-year-old children.

Intrauterine alcohol and nicotine exposure: Attention and reaction time in 4-year-old children.

Intrauterine alcohol and nicotine exposure: Attention and reaction time in 4-year-old children.

Maternal Alcohol Use and Neonatal Habituation Assessed with the Brazelton Scale

Newborn behavioral effects of intrauterine alcohol exposure were examined in 417 infants given the Brazelton Neonatal Assessment Scale. In this longitudinal prospective study, maternal alcohol use was obtained by self-report during the fifth month of pregnancy. Factor analysis of the Brazelton scale yielded 6 factors that were entered into a multiple regression analysis as dependent variables. Maternal alcohol use in mid-pregnancy was significantly related to poorer habituation and increased low arousal in newborn infants, even after adjusting for smoking and caffeine use by mothers, maternal age and nutrition during pregnancy, sex and age of the infant, and obstetric medication. This study lends further support to recognition of maternal alcohol use during pregnancy as a risk factor for alterations in newborn behavior.

Prenatal alcohol exposure in rodents: A review of its effects on offspring activity and learning ability

Abstract The literature relating to the effects of prenatal alcohol exposure on offspring activity is reviewed. It is concluded that if animals are exposed in utero to doses of alcohol greater than 6-7 g/kg per day and are tested prior to 70 days of age, they exhibit an increase in activity in comparison with control offspring. This overactivity appears to result from a lack of response inhibition. It is hypothesized that this is due to a retardation of the development of the cholingeric and/or serotonergic inhibitory systems in the forebrain and suggestions are made as to how this hypothesis could be tested by both behavioural and pharmacological means. Knowledge of the activity changes is then employed to bring order to the literature on the effects of intrauterine alcohol exposure on offspring learning ability. It is concluded that if animals are exposed in utero to doses of alcohol greater than 6-7 g/kg per day and tested prior to 70 days of age their performance on various learning tasks is confounde...