Fetal alcohol spectrum disorders

Svetlana Popova¹, Michael E Charness^{2

3

4

5}, Larry Burd⁶, Andi Crawford⁷, H Eugene Hoyme⁸, Raja A S Mukherjee⁹, Edward P Riley¹⁰, Elizabeth J Elliott^{11

12}

Affiliations

¹ Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada. lana.popova@camh.ca.
² VA Boston Healthcare System, West Roxbury, MA, USA.
³ Department of Neurology, Harvard Medical School, Boston, MA, USA.
⁴ Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
⁵ Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.
⁶ North Dakota Fetal Alcohol Syndrome Center, Department of Pediatrics, University of North Dakota School of Medicine and Health Sciences, Pediatric Therapy Services, Altru Health System, Grand Forks, ND, USA.
⁷ Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
⁸ Sanford Children's Genomic Medicine Consortium, Sanford Health, and University of South Dakota Sanford School of Medicine, Sioux Falls, SD, USA.
⁹ National UK FASD Clinic, Surrey and Borders Partnership NHS Foundation Trust, Redhill, Surrey, UK.
¹⁰ Center for Behavioral Teratology, San Diego State University, San Diego, CA, USA.
¹¹ Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
¹² New South Wales FASD Assessment Service, CICADA Centre for Care and Intervention for Children and Adolescents affected by Drugs and Alcohol, Sydney Children's Hospitals Network, Westmead, Sydney, New South Wales, Australia.

PMID: 36823161
DOI: 10.1038/s41572-023-00420-x

Review

Fetal alcohol spectrum disorders

Svetlana Popova et al. Nat Rev Dis Primers. 2023.

. 2023 Feb 23;9(1):11.

doi: 10.1038/s41572-023-00420-x.

Authors

Svetlana Popova¹, Michael E Charness^{2

3

4

5}, Larry Burd⁶, Andi Crawford⁷, H Eugene Hoyme⁸, Raja A S Mukherjee⁹, Edward P Riley¹⁰, Elizabeth J Elliott^{11

12}

Affiliations

¹ Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada. lana.popova@camh.ca.
² VA Boston Healthcare System, West Roxbury, MA, USA.
³ Department of Neurology, Harvard Medical School, Boston, MA, USA.
⁴ Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
⁵ Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.
⁶ North Dakota Fetal Alcohol Syndrome Center, Department of Pediatrics, University of North Dakota School of Medicine and Health Sciences, Pediatric Therapy Services, Altru Health System, Grand Forks, ND, USA.
⁷ Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
⁸ Sanford Children's Genomic Medicine Consortium, Sanford Health, and University of South Dakota Sanford School of Medicine, Sioux Falls, SD, USA.
⁹ National UK FASD Clinic, Surrey and Borders Partnership NHS Foundation Trust, Redhill, Surrey, UK.
¹⁰ Center for Behavioral Teratology, San Diego State University, San Diego, CA, USA.
¹¹ Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
¹² New South Wales FASD Assessment Service, CICADA Centre for Care and Intervention for Children and Adolescents affected by Drugs and Alcohol, Sydney Children's Hospitals Network, Westmead, Sydney, New South Wales, Australia.

PMID: 36823161
DOI: 10.1038/s41572-023-00420-x

Abstract

Alcohol readily crosses the placenta and may disrupt fetal development. Harm from prenatal alcohol exposure (PAE) is determined by the dose, pattern, timing and duration of exposure, fetal and maternal genetics, maternal nutrition, concurrent substance use, and epigenetic responses. A safe dose of alcohol use during pregnancy has not been established. PAE can cause fetal alcohol spectrum disorders (FASD), which are characterized by neurodevelopmental impairment with or without facial dysmorphology, congenital anomalies and poor growth. FASD are a leading preventable cause of birth defects and developmental disability. The prevalence of FASD in 76 countries is >1% and is high in individuals living in out-of-home care or engaged in justice and mental health systems. The social and economic effects of FASD are profound, but the diagnosis is often missed or delayed and receives little public recognition. Future research should be informed by people living with FASD and be guided by cultural context, seek consensus on diagnostic criteria and evidence-based treatments, and describe the pathophysiology and lifelong effects of FASD. Imperatives include reducing stigma, equitable access to services, improved quality of life for people with FASD and FASD prevention in future generations.

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References

1. Gellius, A. & Beloe, W. The Attic Nights of Aulus Gellius (Johnson, J., 1795).
1. Goodwin, W. W. (ed.) Plutarch’s Morals (Little & Brown, 1871).
1. Lemoine, P., Harousseau, H., Borteyru, J. P. & Menuet, J. C. Children of alcoholic parents: observed anomalies: discussion of 127 cases. Ouest Med. 8, 476–482 (1968). This article describes FAS, beginning the modern era of understanding of the impact of PAE on development.
1. Jones, K., Smith, D., Ulleland, C. & Streissguth, A. Pattern of malformation in offspring of chronic alcoholic mothers. Lancet 301, 1267–1271 (1973). This article describes FAS, beginning the modern era of understanding of the impact of PAE on development. - DOI
1. Jones, K. & Smith, D. Recognition of the fetal alcohol syndrome in early infancy. Lancet 302, 999–1001 (1973). This article describes FAS, beginning the modern era of understanding of the impact of PAE on development. - PubMed - DOI

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Fetal alcohol spectrum disorders

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Fetal alcohol spectrum disorders

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