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PubMed1998

Prenatal alcohol exposure and communication, behavior, and nonverbal intelligence of 3 school-age children.

Associations of prenatal alcohol exposure in speech, language, behavioral, and intellectual development were investigated in three school-aged children diagnosed with Fetal Alcohol Syndrome, accompanied by Attention Deficit Hyperactivity Disorder. Each child showed similar patterns of moderate-to-severe dysfunctional behavior; however, their scores on speech, language and nonverbal intellectual measures were highly variable.

Attention Deficit Disorder with Hyperactivity↗
PubMed2004

[Alcohol and women: clinical aspects].

Alcohol-related pathologies lead to most serious expressions, both at clinical and social level. The diffused social acceptance of consumption and abuse behavior and the lack of alcohol education for professionals (physicians, psychologists, social workers etc.) make difficult to put in the right frame this issue. Just a multidimensional approach can make the problem understandable. The history of alcohol consumption during the time gives us an exhaustive picture of the negative consequences of alcohol consumption. Alcohol consumption during pregnancy is a problem still underestimated and represents a serious risk for the health of the newborns: children alcohol-exposed in uterus are at risk to develop many pathologies and even the fetal-alcohol syndrome (FAS) that leads to facial anomalies, growth deficiencies and neurological damages. Therefore interventions coping with this kind of issues are needed in order to enhance people's health.

Alcohol Drinking↗
PubMed2006

Characteristics of fathers who have children with fetal alcohol syndrome or incomplete fetal alcohol syndrome.

OBJECTIVES: Determine alcohol use, referrals to treatment, receiving treatment, and medical problems related to alcohol among fathers who have children with FAS or incomplete FAS. METHODS: Fathers who had American Indian children with FAS (Study 1) or incomplete FAS (Study 2) were compared with fathers whose children did not have FAS. RESULTS: About half of case and control fathers had alcohol use and alcohol-related medical problems documented in their medical records. Case fathers were more likely to receive alcohol treatment and have injuries related to alcohol abuse. CONCLUSION: Significantly more fathers of children with FAS were referred for alcohol treatment, received alcohol treatment, experienced injuries, and had delirium tremens than control fathers. Fathers of children with incomplete FAS were significantly more likely to drink alcohol, to have received alcohol treatment, and to have alcohol-related medical problems and injuries than control fathers.

Alcohol-Related Disorders↗
PubMedDate not supplied

Effects of prenatal alcohol on homing behavior, maternal responding and open-field activity in rats.

A radial-maze was used to study homing in offspring and maternal retrieval behaviors after prenatal exposure to alcohol. Pair-fed and untreated (ad lib control diet) groups were included and all offspring were either fostered or cross-fostered at birth. Offspring given ethanol prenatally exhibited a deficit in homing development and were retrieved significantly longer by ad lib control dams over the ten days of testing. The observed retrieval response may represent a compensation for the delayed development of the ethanol-exposed offspring. Consistent with our previous work, ethanol treatment had long-lasting effects on maternal body weight, offspring growth, and juvenile and adult activity as measured in the open-field. The findings suggest that these effects can be attributed to ethanol per se and not undernutrition or postnatal maternal influences. Further work aimed at identifying the stimulus properties underlying the complex maternal-infant interaction is needed in order to explain the observed differences in maternal retrieval response.

Animals↗
PubMed1993

Dual diagnoses. Psychiatric disorders in developmental disabilities.

A high prevalence of psychiatric illness exists in persons with mental retardation. Among children with mild to moderate retardation, psychiatric illnesses resemble those seen in the general population. Major affective disorders, ADHD, and conduct disorder are common and respond to the same interventions used in children without mental retardation. Persons with severe to profound retardation are more likely to engage in stereotypies and self-injurious behaviors. In addition, certain specific syndromes associated with mental retardation present with particular neurocognitive, behavioral, and psychiatric profiles. Common examples are fetal alcohol syndrome, Down syndrome, fragile X syndrome, and Rett syndrome. Specific challenges exist for pediatricians who diagnose and treat patients with mental retardation and psychiatric illness. The child's impaired ability to communicate his or her thoughts and feelings with words makes clinical history taking difficult. The clinician must frequently rely on the observation of family members and teachers. An understanding of developmental profiles and interpersonal, peer, and family dynamics is important. Specific behaviors must be targeted and realistic objectives set in treatment planning, which may include psychotherapy, medication, behavior management techniques, and rehabilitation therapy.

Attention Deficit Disorder with Hyperactivity↗
PubMed1998

Neuropsychological deficits in adolescents with fetal alcohol syndrome: clinical findings.

Understanding the nature of cognitive deficits among adolescent patients with fetal alcohol syndrome (FAS) can direct future research on assessment and intervention. In an exploratory study, nine nonretarded teenagers with FAS were administered tests of IQ and adaptive behavior, and neuropsychological tests presumed sensitive to alcohol effects. Their performance was compared with psychometric norms and to data from a sample of 174 adolescents with minimal or no prenatal alcohol exposure. These nonretarded FAS patients commonly showed behavior problems, decreased social competence, and poor school performance. Neuropsychological testing revealed significant deficits, although no one neuropsychological profile characterized all patients and not all tests revealed problems. Relatively intact performance was observed in procedural memory, some measures of reaction time, and some reading measures. Deficits were seen on attentional and memory tasks tapping visual-spatial skills, short-term auditory attention and memory, declarative learning, and cognitive flexibility and planning. Difficulties in processing speed and accuracy were also seen. Comparison with a subgroup of 52 nonalcohol-exposed or minimally alcohol-exposed adolescents with a similar range of IQ scores demonstrated that deficits among these FAS patients were not fully explained by a general lowering of IQ.

Adolescent↗
PubMed1991

[Disorders of cerebral monoamide oxidase activity in rats after prenatal alcoholization and their correction with reduced glutathione].

Structures of the brain of rats from the offsprings of alcoholized female rats and animals given glutathione postnatally were examined for monoamine oxidase (MAO) activity by histochemistry using discrete cytospectrophotometry. A decrease of the enzyme activity in caudate nucleus neuropile, preserved up to the 60th postnatal day, an increase of the enzyme activity in neuropile of layer III of the visual cortex in 30-day-old rats from the offsprings of the alcoholized females and a lowering in layer V of the visual cortex in 60-day-old offspring were identified. There were no changes in neuropile of the sensorimotor cortex. Postnatal administration of glutathione to the animals alcoholized on an intrauterine basis resulted in complete normalization of MAO activity by the 60th postnatal day.

Alcoholism↗
PubMed2004

Risk for congenital anomalies associated with different sporadic and daily doses of alcohol consumption during pregnancy: a case-control study.

BACKGROUND: The classic clinical criteria for the diagnosis of fetal alcohol syndrome (FAS) include a "characteristic" facial appearance, pre- and postnatal growth deficiency, microcephaly, mental retardation, and occasional major malformations. However, diagnostic constraints, especially in the newborn period, lead to an underestimate of their prevalence. We report an epidemiological study of the potential risk of congenital defects in the offspring of mothers who ingested different sporadic and daily amounts of alcohol during pregnancy. METHODS: The study was based on the data from the ECEMC hospital-based case-control study and surveillance system, with a methodology aimed not only at the surveillance of congenital anomalies, but also at investigating their characteristics, clustering, and causes. For the purposes of this study, we considered as exposed those infants whose mothers reported the ingestion of any amount of alcohol during gestation (4705 mothers of cases and 4329 mothers of controls), and classified them into five groups according to their levels of alcohol consumption. Two groups consisted of mothers who consumed increasing sporadic levels and the other three consisted of mothers who consumed increasing daily levels of alcohol. RESULTS: Our study showed that even low sporadic doses of alcohol consumption during pregnancy may increase the risk of congenital anomalies in the offspring and that this risk increases with increasing levels of alcohol exposure. CONCLUSIONS: The results of our study suggest that it is necessary to generalize the preventive norm and recommend complete abstinence from alcohol during gestation. Birth Defects Research (Part A), 2004.

Abnormalities, Drug-Induced↗
PubMed1984

Cardiac muscle development in mice exposed to ethanol in utero.

The purpose of the present research was to determine the effect of in utero ethanol exposure on cardiac muscle development. Pregnant albino mice (Swiss strain) at 8 days of gestation were divided into three groups: a normal group fed Purina lab chow for rodents and water ad libitum; an ethanol group fed the liquid diet ENSURE with 20% of the calories derived from ethanol (12.6 +/- 1.2 gm/kg body weight per day); and an isocaloric group pairfed ENSURE with 20% of the calories derived from sucrose. These diets were continued until birth, at which time the litter size, crown to rump length, and weight were recorded. Randomly selected neonatal pups from each litter were decapitated and their hearts immediately processed for transmission electron microscopy. Litter size, crown to rump length, and body weight of the ethanol-treated mice at birth were significantly less than normal but not less than pairfed controls. Ultrastructural evaluation of cardiac muscle from mice treated in utero with ethanol in comparison to that from both normal and pair-fed control animals revealed various degrees of morphological alterations. The most pronounced alterations were in mitochondrial structure and included an increase in mitochondrial volume per cytoplasmic volume and a marked decrease in the amount of inner mitochondrial membrane. Myofibrillar abnormalities were also evident in the ethanol group but not in either control group. These abnormalities included a decrease in the myofibril volume per cytoplasmic volume and a disruption in myofibril organization particularly the Z-bands. The ultrastructural alterations in the cardiac muscle from the ethanol treated group were not a result of malnutrition or dehydration as the pairfed group did not exhibit these changes. It is apparent from this study that exposure of mice in utero to ethanol can cause ultrastructural abnormalities in cardiac muscle cells. Whether these changes result in heart pathophysiology and persist to adulthood are not known.

Animals↗
PubMed2002

Corpus callosum shape and neuropsychological deficits in adult males with heavy fetal alcohol exposure.

Persons with brain damage consequent to prenatal alcohol exposure have typically been diagnosed with either fetal alcohol syndrome (FAS) or fetal alcohol effects (FAE), depending on facial features. There is great variability of behavioral deficits within these groups. We sought to combine neuroanatomical measures with neurocognitive and neuromotor measures in criteria of greater sensitivity over the variety of consequences of alcohol exposure. To this end, midline curves of the corpus callosum were carefully digitized in three dimensions from T1-weighted MR scans of 15 adult males diagnosed with FAS, 15 with FAE, and 15 who were unexposed and clinically normal. From 5 h of neuropsychological testing we extracted 260 scores and ratings pertaining to attention, memory, executive function, fine and gross motor performance, and intelligence. Callosal midline shape was analyzed by new morphometric methods, and the relation of shape to behavior by partial least squares. The FAS and FAE subgroups have strikingly more variability of callosal shape than our normal subjects. With the excess shape variation are associated two different profiles of behavioral deficit unrelated to full-scale IQ or to the FAS/FAE distinction within the exposed subgroup. A relatively thick callosum is associated with a pattern of deficit in executive function; one that is relatively thin, with a deficit in motor function. The two combine in a very promising bipolar discrimination of the exposed from the unexposed in this sample. Thus there is considerable information in callosal form for prognosis of neuropsychological deficits in this frequently encountered birth defect.

Adolescent↗
PubMed1991

Prenatal ethanol and the prepubertal sexually dimorphic nucleus of the preoptic area.

The volume of the sexually dimorphic nucleus of the preoptic area of the hypothalamus (SDN-POA) was determined in 14-31-day-old male and female rats whose mothers received a liquid diet containing 5% w/v ethanol from day 8 of gestation to parturition. Pair-fed dams received as a nutritional control an equal volume of an isocaloric liquid diet with maltose-dextrin in place of ethanol. Normal controls had laboratory rat chow and water available ad lib. The SDN-POA volume of ethanol-exposed males was significantly reduced compared to the pair-fed and normal males, and became indistinguishable from the SDN-POA volumes of the pair-fed and normal females. Ethanol-treated females also had a markedly reduced SDN-POA volume compared to the pair-fed and normal females. Our findings indicate that the SDN-POA of prepubertal rats of both sexes is sensitive to the effects of in utero ethanol exposure. While plasma testosterone, progesterone and estradiol titers, which we measured in fetuses on gestation day 22, were differentially affected by maternal ethanol consumption, the alterations by themselves cannot adequately explain the effects of prenatal ethanol exposure on the developing SDN-POA.

Animals↗
PubMed1990

Development of neurotransmitter systems in the mouse embryo following acute ethanol exposure: a histological and immunocytochemical study.

Acute maternal ethanol administration to C57B1/6J mice on gestational day 7 (GD7) results in facial and brain abnormalities similar to those reported in human fetal alcohol syndrome (FAS). Using this model, we assessed the damage to brain structures using histological methods and changes in developing neurotransmitter systems with immunocytochemistry. Cholinergic neurons in the forebrain were stained with a monoclonal antibody to choline acetyltransferase (ChAT). Catecholaminergic neurons in the midbrain and serotoninergic neurons in the hindbrain were stained with polyclonal antisera to tyrosine hydroxylase (TH) and serotonin (5-HT), respectively. Forebrain deficiencies, including loss of midline structures (olfactory bulbs, midline septation, medial septal area) and deficits in lateral and dorsal regions (neostriatum and cerebral cortex) were found in both GD14 embryos and GD18 fetuses. In severely affected offspring, complete loss of the septal region resulted in conjoined lateral ventricles and a reduction in the thickness of the ventricular zone surrounding the single ventricle, as well as a severe loss of ChAT neurons which would normally be located in this territory. However, no consistent changes were seen in the distribution or size of TH or 5-HT neuronal cell groups in the midbrain and hindbrain. These differences in effects on specific neurotransmitter systems reflect the fact that the forebrain is most severely affected by early ethanol administration, whereas the hindbrain is relatively spared. Such differential effects could produce an imbalance in developing neurotransmitter systems in the embryonic and fetal brain, which could explain some of the functional deficits observed in children with FAS.

Abnormalities, Drug-Induced↗
PubMedDate not supplied

Neuropsychological evaluation of preschoolers with fetal alcohol syndrome.

Children with Fetal Alcohol Syndrome (FAS) manifest a variety of central nervous system deficits which may include mental retardation, perceptual, linguistic and fine motor deficits, as well as behaviour problems. The neuropsychological performance of to preschool-aged children with FAS was compared to age, sex, and race-matched controls. Profile analysis revealed significant deficits in the FAS group on measures of intelligence and linguistic abilities. Comparison of group profiles revealed that the FAS group displayed impaired visual-motor integration in the presence of average visual-perceptual matching. The FAS children were also reported to exhibit a greater frequency of behaviour problems compared to controls. Although the FAS group were significantly growth delayed, the often reported association between cognitive abilities and skeletal growth was not evident. These results indicate that preschoolers with FAS display a distinct pattern of impairments, and understanding of this unique ability profile is important for the development of support and intervention programs for these patients and their families.

Body Height↗
PubMed1980

Behavior and learning difficulties in children of normal intelligence born to alcoholic mothers.

Children referred to the Learning Disorders Unit of the Yale-New Haven Hospital were evaluated for indications of prenatal exposure to ethanol. In a total population of 87 children, 15 were found to have a history of maternal heavy drinking during pregnancy. The 11 boys and four girls ranged in age from 6 1/2 to 18 1/2 years. Birth weights ranged from 1,580 to 3,150 gm, median weight 2,213 gm. All growth measurements were affected: head circumference 60% less than tenth percentile, height 60% less than tenth percentile, weight 74% less than twenty-fifth percentile. The children had a continuum of dysmorphic features of FAS, with an inverse relationship noted between age of presentation and intensity of dysmorphic features. All had intelligence in the average range (IQ 82 to 113), yet experienced persistent academic failure. In addition, all shared problems of activity and attention regulation. Our results suggest a continuum of teratogenic effects of ethanol on the CNS. Alcohol exposure in utero may be an important, preventable determinant of attention deficit syndromes in childhood.

Adolescent↗