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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| Published in | Lancet neurology Vol. 18; no. 8; pp. 760 - 770 |
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| Main Authors | , , |
| Format | Journal Article |
| Language | English |
| Published |
England
Elsevier Ltd
01.08.2019
Elsevier Limited |
| Subjects | |
| Online Access | Get full text |
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| Abstract | 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. |
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| AbstractList | 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. 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. |
| Author | Charness, Michael E Wozniak, Jeffrey R Riley, Edward P |
| Author_xml | – sequence: 1 givenname: Jeffrey R surname: Wozniak fullname: Wozniak, Jeffrey R email: jwozniak@umn.edu organization: Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA – sequence: 2 givenname: Edward P surname: Riley fullname: Riley, Edward P organization: Center for Behavioral Teratology, San Diego State University, San Diego, CA, USA – sequence: 3 givenname: Michael E surname: Charness fullname: Charness, Michael E organization: Veterans Affairs Boston Healthcare System, Boston, MA, USA |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31160204$$D View this record in MEDLINE/PubMed |
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| SubjectTerms | 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 |
| Title | Clinical presentation, diagnosis, and management of fetal alcohol spectrum disorder |
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