fetal alcohol syndrome
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Etiology
- exposure to alcohol during pregnancy
- materinal comorbidities[2]
- peripheral nervous system diseases
- conduct disorder
- receptive language disorder
- expressive language disorder
- chronic serous otitis media
Epidemiology
- 1st described in 1973
- leading preventable cause of birth defects & intellectual & neurodevelopmental disabilities in children[1]
- prevalence 1-10% in 4 U.S. communities 2010 to 2016[4]
- prevalence: 11-50 per 1000 children[4]
- 12% of pregnant women reportconsuming alcohol in the past 30 days[5]
- 4% of pregnant women report binge-drinking (consuming >= 4 drinks on one occasion)
- average 4.5 binge-drinking episodes in the past 30 days
- unmarried women more likely than married women to drink (15 vs 9%) & binge-drink (6 vs 2%)
- prevalence of any drinking highest among a group comprising American Indian/ Alaska Native, Asian/Pacific Islander, * multiracial respondents (19%) & lowest among Hispanic women (9%)[5]
Pathology
- prenatal exposure to alcohol can damage the developing fetus
- intellectual & neurodevelopmental disabilities from in utero alcohol exposure are lifelong[1]
Diagnostic criteria
- neurobehavioral plus cognitive or behavioral impairment[3]
- neurodevelopment & neuropsychology assessment >= 1.5 standard deviations below the mean[3]
- cutoffs for height, weight, head circumference, & palpebral fissure length are <= 10th percentile[3]
Complications
- psychological disorder (RR=77)
- chronic serous otitis media (RR=77)
- sensory & conductive hearing loss (RR=126)
- blindness (RR=71)[2]
Management
More general terms
Additional terms
References
- ↑ Jump up to: 1.0 1.1 1.2 1.3 Williams JF, Smith VC for COMMITTEE ON SUBSTANCE ABUSE American Academy of Pediatrics Fetal Alcohol Spectrum Disorders Pediatrics. Oct 19, 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26482673 <Internet> http://pediatrics.aappublications.org/content/early/2015/10/13/peds.2015-3113
- ↑ Jump up to: 2.0 2.1 2.2 Popova S et al. Comorbidity of fetal alcohol spectrum disorder: A systematic review and meta-analysis. Lancet 2016 Jan 5 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26777270 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2901345-8/abstract
Burd L. Fetal alcohol spectrum disorder: Complexity from comorbidity. Lancet 2016 Jan 5 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26777271 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2901346-X/abstract - ↑ Jump up to: 3.0 3.1 3.2 3.3 Adler C, Fairchild DG, Di Francesco L Updated Guidelines Issued for Diagnosing Fetal Alcohol Spectrum Disorders Physician's First Watch, July 27, 2016 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
Hoyme HE, Kalberg WO, Elliott AJ et al Updated Clinical Guidelines for Diagnosing Fetal Alcohol Spectrum Disorders. Pediatrics Jul 2016, e20154256 PMID: https://www.ncbi.nlm.nih.gov/pubmed/27464676 - ↑ Jump up to: 4.0 4.1 4.2 May PA, Chambers CD, Kalberg WO et al Prevalence of Fetal Alcohol Spectrum Disorders in 4 US Communities. JAMA. 2018;319(5):474-482 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29411031 https://jamanetwork.com/journals/jama/article-abstract/2671465
Lange A, Rehm J, Popova S. Implications of Higher Than Expected Prevalence of Fetal Alcohol Spectrum Disorders. JAMA. 2018;319(5):448-449 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29411016 https://jamanetwork.com/journals/jama/article-abstract/2671448 - ↑ Jump up to: 5.0 5.1 5.2 Denny CH, Acero CS, Naimi TS, Kim SY. Consumption of Alcohol Beverages and Binge Drinking Among Pregnant Women Aged 18-44 Years - United States, 2015-2017. MMWR Morb Mortal Wkly Rep 2019;68:365-368 https://www.cdc.gov/mmwr/volumes/68/wr/mm6816a1.htm