May et al. have recently evaluated the prevalence estimates for the entire continuum of FASD range to be per 1000 individuals (2.4% – 4.8%) among first grade children in a representative Midwestern US city 9. 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. The authors affirm that human research participants provided informed consent, for publication of the images in Figure 4. While the classic “presentation” of FAS usually raises no diagnostic doubts, even the specialist may have difficulties when the phenotype is not complete or atypical 1. The differential diagnosis of FAS/FASD in the dysmorphological and neurobehavioral aspects of FASD is broad.
Alcohol intake in pregnant women
- Her applied research focus includes assessment of the effects of environmental and therapeutic ototoxic agents in children, whereas her basic research assesses the influence of these agents on the development of the auditory system in the frog model.
- The differential diagnosis of FAS/FASD in the dysmorphological and neurobehavioral aspects of FASD is broad.
- The latest reports offer the chance of diagnosing children in the neonatal period.
The patients’ facial features can change when they get older, therefore the diagnosis should be based on the point in time when these features were most severely expressed 5. A total of 5 (11.2%) of children had hearing loss of at least 16dB hearing–level, mostly unilateral. SRT was within the normal range in 40 (98%) of children with FASD and discrimination was normal in all children.
Fetal Alcohol Spectrum Disorder (FASD)
- Maternal alcohol consumption in pregnancy is an important public health problem.
- Although psychological factors such as abuse and neglect can add to the intensity of the problems, the behaviors should be viewed first and foremost as a result of brain damage from alcohol.
- May et al. have recently evaluated the prevalence estimates for the entire continuum of FASD range to be per 1000 individuals (2.4% – 4.8%) among first grade children in a representative Midwestern US city 9.
They require long-term support what is alcoholism and some degree of supervision in order to succeed. Submit your articles to the African Journal of Biomedical Research, active in Scopus Q3 and Clarivate Web of Science Zoological Records. All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Fetal alcohol syndrome. Hearing, speech, language, and vestibular disorders
Many more children with prenatal exposure to alcohol are affected neurobehaviorally than the number who exhibit the structural features of FAS 4, 12. The new approach to finding objective data of prenatal alcohol exposure focuses on analyzing ethanol metabolites in the biological tissues of either the pregnant woman or the neonate 38. The presence of the main facial features and growth retardation is thought to be most significant for drunken fetal syndrome FAS/ FASD recognition in the neonatal period 22, 23. Alcohol-exposed neonates can be small for gestational age and remain below average throughout their lives with respect to head circumference, weight and height. Animal and human studies have found an association between high alcohol consumption during the first trimester of pregnancy and the facial features and presence of intrauterine growth retardation (IUGR) in the affected children 24. Identification of alcohol-affected children continues to be challenging, especially during infancy, the optimal time to initiate remedial interventions.
May et al. (2013) found a high frequency of alcohol consumption during pregnancy, even regarding binge drinking (40% of the women surveyed). However, they admitted that the sample mothers were extraordinarily forthcoming and reliable in reporting alcohol use 28. These studies have shown that the number of binge episodes and the number of average alcoholic beverages per day during the first trimester were the highest risk-exposure pattern for alcohol-related facial features and growth deficiencies. 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.
- If there is no alcohol exposure in the third trimester, the growth parameters can be normal.
- May et al. (2013) found a high frequency of alcohol consumption during pregnancy, even regarding binge drinking (40% of the women surveyed).
- Such hearing disorders may contribute to the speech and language and learning difficulties seen in children with fetal alcohol syndrome.
- The presentation of individual features may be variably expressed with age and tends to improve with the advancement in age of the affected individuals.
- They may hyperextend their heads or limbs with hypertonia (too much muscle tone) or hypotonia (too little muscle tone) or both.
- These criteria are appropriate for the evaluation of older children, when it is possible to assess the neurodevelopmental pattern 3, 5, 6.
FASD characteristics in the neonatal period
These criteria are appropriate for the evaluation of older children, when it is possible to assess the neurodevelopmental pattern 3, 5, 6. 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. However, because children with FASD are academically and behaviorally challenged, early detection of hearing loss and early intervention is warranted. Abusing illegal drugs by pregnant women (e.g. cocaine and others) may cause characteristics similar to those observed in infants exposed to alcohol, such as intrauterine growth retardation, smaller head circumference and behavioural and cognitive deficits 26.
An overview of current advances in perinatal alcohol exposure and pathogenesis of fetal alcohol spectrum disorders
Fourteen children with the fetal alcohol syndrome were evaluated by standard audiologic procedures. All 13 of these children (93%) had clinically significant histories of bilateral recurrent serous otitis media (ie, they were otitis prone), and at least four children (29%) had bilateral sensorineural hearing losses in addition to being otitis prone. Many of the children with recurrent serous otitis media required repeated myringotomies with placement of ventilation tubes, and those with sensorineural hearing losses required sound amplification during childhood. An alcohol-induced neuroectoderm syndrome and alcohol ototoxicity are discussed as possible etiologic factors in the occurrence of sensorineural hearing loss. The findings suggest that hearing disorders are a heretofore unrecognized characteristic of the fetal alcohol syndrome. Such hearing disorders may contribute to the speech and language and learning difficulties seen in children with fetal alcohol syndrome.
If there is no alcohol exposure in the third trimester, the growth parameters can be normal. Some maternal pregnancy complications, such as gestational diabetes, can lead to increased fetal size and can mask the effects of growth retardation caused by prenatal alcohol exposure. Early diagnosis of fetal alcohol syndrome – after birth or in infancy – is very often impossible or very difficult due to the incomplete manifestation of the key dysmorphic features. The latest reports offer the chance of diagnosing children in the neonatal period. The presentation of individual features may be variably expressed with age and tends to improve with the advancement in age of the affected individuals. Only 7% of the children are diagnosed in the first days of life, the average age of diagnosis is about 3.3 years 4, 20, 21.
Abnormal outcomes of pregnancy
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. Data from the latest research estimating the proportion of women drinking alcohol during pregnancy in Europe showed that on average 15.8% of pregnant women reported alcohol consumption. The highest proportion of alcohol consumption during pregnancy was found in the UK (28.5%), Russia (26.5%), and Switzerland (20.9%) and the lowest in Norway (4.1%), Sweden (7.2%) and Poland (9.7%) 35. Alcohol is the most prevalent human teratogen affected by early exposure of the fetus. Although not listed as a major part of the fetal alcohol spectrum disorder (FASD), different texts list hearing loss as a characteristic of the FASD, based on several small studies. FASD and other fetal alcohol effects, including alcohol-related neurodevelopmental disorder (ARND) are diagnosed with the presence of some CNS (Central Nervous System) anomalies and behavioural or cognitive abnormalities.