Clinical presentation, diagnosis, and management of fetal alcohol spectrum disorder

Although prenatal alcohol exposure causes craniofacial anomalies, growth retardation, neurological abnormalities, cognitive impairment, and birth defects, fetal alcohol spectrum disorder is underdiagnosed. Global prevalence of fetal alcohol spectrum disorder is 0·77%, with a higher prevalence of 2–5...

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Bibliographic Details
Published inLancet neurology Vol. 18; no. 8; pp. 760 - 770
Main Authors Wozniak, Jeffrey R, Riley, Edward P, Charness, Michael E
Format Journal Article
LanguageEnglish
Published England Elsevier Ltd 01.08.2019
Elsevier Limited
Subjects
Alcohol use
Alcoholism
Brain research
Cell adhesion & migration
Clinical trials
Cognitive ability
Congenital defects
Cortex
Diagnosis
Drinking behavior
Epidemiology
Executive function
Fetal alcohol syndrome
Growth rate
Health surveillance
Medical diagnosis
Motor skill
Neural networks
Neuroimaging
Neurological complications
Pregnancy
Prenatal experience
Public health
Rehabilitation
School districts
Social behavior
Substantia alba
Womens health
United States > US
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Summary:Although prenatal alcohol exposure causes craniofacial anomalies, growth retardation, neurological abnormalities, cognitive impairment, and birth defects, fetal alcohol spectrum disorder is underdiagnosed. Global prevalence of fetal alcohol spectrum disorder is 0·77%, with a higher prevalence of 2–5% in Europe and North America, highlighting the need for increased diagnosis and treatment. However, diagnosis remains challenging because of the poor reliability of self-reported maternal drinking histories, an absence of sensitive biomarkers, and the infrequency of diagnostic dysmorphic facial features among individuals with fetal alcohol spectrum disorder. Different diagnostic systems and disagreements over criteria have slowed progress in the diagnosis and management of the disorder. Neuroimaging shows abnormalities in brain structure, cortical development, white matter microstructure, and functional connectivity in individuals with fetal alcohol spectrum disorder. These abnormalities modify developmental trajectories and are associated with deficits in cognition, executive function, memory, vision, hearing, motor skills, behaviour, and social adaptation. Promising trials of nutritional interventions and cognitive rehabilitation therapies are underway, with the aim of treating cognitive deficits in fetal alcohol spectrum disorders.
ISSN:1474-4422
1474-4465
DOI:10.1016/S1474-4422(19)30150-4