They may hyperextend their heads or limbs with hypertonia (too much muscle tone) or hypotonia (too little muscle tone) or both. Some infants may have heart defects or suffer anomalies of the ears, eyes, liver, or joints. They have trouble staying in school, keeping jobs, or sustaining healthy relationships.
Fetal Alcohol Spectrum Disorders – Diagnostic Difficulties in The Neonatal Period and New Diagnostic Approaches
Together FAS and ARND make up the broad category called Fetal Alcohol Spectrum Disorders (FASD). To characterize hearing in children with FASD, diagnosed in the Motherisk Program in Toronto. Previous studies estimated the prevalence of FAS in the general population of the United States at 0.2 – 1.5 per 1000 children, depending on the populations studied and the surveillance methods used 2. Based on past in-school studies of various populations the frequency of FAS was estimated to be 2-7 per 1000 children in South Africa, Italy and USA 8.
Fetal Alcohol Spectrum Disorder (FASD)
- These data are close to the findings from European studies, in which the rate of FASD ranged from 20.3 to 40.5 per 1000 children in a province in Italy and 40.77 per 1000 in Croatia 10, 11.
- Proper and early diagnosis of fetal alcohol effects in infants may be limited by the lack of pathognomonic presentation at birth and in early infancy.
- According to the general definition, Fetal alcohol syndrome (FAS) is the collection of somatic, cognitive and behavioural disorders encountered in children exposed to alcohol during pregnancy.
- However, in the neonatal period, when the potential neurological, cognitive, and behavioural effects are not apparent, significant difficulties in making the diagnosis can occur.
- The estimated percentage of women drinking heavily during pregnancy ranges from 2% to 13%, depending on the population sample studied, the definition “heavy” and the study method used 26, 34.
- Microcephaly is also a significant component of the diagnostic criteria in the newborn period 20, 23, 27.
Children born with maternal PKU syndrome suffer from microcephaly, craniofacial dysmorphism, low birth weight, congenital heart disease, developmental delays, and mental retardation 32. Maternal alcohol consumption in pregnancy is an important public health problem. Unlike other harmful behaviours of pregnant women, such as smoking and taking illegal drugs, drinking alcohol during pregnancy is common across most social groups, irrespectively of age and educational status.
Ear Abnormalities Among Children with Fetal Alcohol Spectrum Disorder: A Systematic Review and Meta-Analysis
Many guidelines have been published 1, 2, 3, 5, 6 since the first description of FAS. The majority of authors agreed that diagnosis would be easier if the symptoms were fully expressed and the prenatal alcohol exposure objectively confirmed 6, 7. Most children with FASD have developmental delays and some have lower than normal intelligence. However, in the neonatal period, when the potential neurological, cognitive, and behavioural effects are not apparent, significant difficulties in making the diagnosis can occur. Therefore, these components should be eliminated from the diagnostic criteria for newborns. Dr. Katbamna is Professor of Audiology in the Department of Speech Pathology and Audiology at Western Michigan University in Kalamazoo, MI.
According to the general definition, Fetal alcohol syndrome (FAS) is the collection of somatic, cognitive and behavioural disorders encountered in children exposed to alcohol during pregnancy. Microcephaly is also a significant component of the diagnostic criteria in the newborn period 20, 23, 27. Consistently with previous studies, May has shown an association between maternal drinking, especially binge episodes and decreased head circumference and facial dysmorphism 28. Fetal alcohol spectrum disorders (FASD) is a group of disorders that can occur in children whose mothers consumed alcohol in pregnancy.
Alcohol intake in pregnant women
- Individuals tend to deny to themselves and to others that they have this problem due to the social stigmatization of drinking in pregnancy, so obtaining an accurate estimate of how many pregnant women drink can be difficult.
- An alcohol-induced neuroectoderm syndrome and alcohol ototoxicity are discussed as possible etiologic factors in the occurrence of sensorineural hearing loss.
- Unlike other harmful behaviours of pregnant women, such as smoking and taking illegal drugs, drinking alcohol during pregnancy is common across most social groups, irrespectively of age and educational status.
- However, because children with FASD are academically and behaviorally challenged, early detection of hearing loss and early intervention is warranted.
- The use of maternal self-reports for collection of alcohol consumption data could result in underreporting or misreporting.
Many genetic and malformation syndromes have some of the clinical characteristics of FAS. These are symptoms of permanent, unchanging damage to the brain and are not within the child’s control. Although psychological factors such as abuse and neglect can add to alcoholism symptoms the intensity of the problems, the behaviors should be viewed first and foremost as a result of brain damage from alcohol. Most infants with FASD are irritable, have trouble eating and sleeping, are sensitive to sensory stimulation, and have a strong startle reflex.
Early diagnosis of prenatal effects is needed because craniofacial dysmorphic features that characterize FASD are found only in a small proportion of children with alcohol-related neurobehavioral impairments and can be difficult to detect in infancy and childhood. Proposed testing of FAEE in meconium samples as a biomarker of prenatal ethanol exposure can facilitate the early diagnosis and intervention in the affected children. Introducing appropriate patient care is crucial to reach the best possible neurological development of the affected individuals, and leads to decreasing the risk for secondary disabilities encountered in FASD patients. For example, the fetal valproate syndrome is characterized, among others, by a long upper lip with relatively shallow philtrum, a relatively small mouth with downturned angles, and a thin upper vermilion border. Pre- and postnatal growth deficiency, short nose, microcephaly, epicantic folds, hypertelorysm, ptosis and developmental delay are often described in fetal hydantoin syndrome. In pregnant women with PKU (phenyloketonuria), noncompliance can result in maternal PKU syndrome, where high phenylalanine (Phe) levels cause severe fetal complications.
- SRT was within the normal range in 40 (98%) of children with FASD and discrimination was normal in all children.
- The prevalence of mild sensorineural hearing loss in children diagnosed with FASD (16dB hearing-level or greater) was not higher than expected in this age group.
- Some infants may have heart defects or suffer anomalies of the ears, eyes, liver, or joints.
- Women who drank higher doses of alcohol during pregnancy, as evidenced by the ethanol metabolites found in the meconium samples of their infants rarely admitted to drinking alcohol during pregnancy.
Links to NCBI Databases
The present study also provided confirmatory evidence of visual, health, and speech and language disorders in children with this syndrome. One of the many problems with the identification of babies at risk is not knowing which infants have been exposed, as many women underreport their use of alcohol during pregnancy. Individuals tend to deny to themselves and to others that they have this problem due to the social stigmatization of drinking in pregnancy, so obtaining an accurate estimate of how many pregnant women drink drunken fetal syndrome can be difficult. The use of maternal self-reports for collection of alcohol consumption data could result in underreporting or misreporting. Women who drank higher doses of alcohol during pregnancy, as evidenced by the ethanol metabolites found in the meconium samples of their infants rarely admitted to drinking alcohol during pregnancy. Self-reporting is likely to miss identifying some individuals at risk of PAE 36, 37.
