PATTERN OF MALFORMATION IN OFFSPRING OF CHRONIC ALCOHOLIC MOTHERS
Abstract
Eight unrelated children of three different ethnic groups, all born to mothers who were chronic alcoholics, have a similar pattern of craniofacial, limb, and cardiovascular defects associated with prenatal-onset growth deficiency and developmental delay. This seems to be the first reported association between maternal alcoholism and aberrant morphogenesis in the offspring.
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Normative Magnetic Resonance Imaging Data Increase the Sensitivity to Brain Volume Abnormalities in the Classification of Fetal Alcohol Spectrum Disorder
2024, Journal of PediatricsTo evaluate the use of a large magnetic resonance imaging (MRI) normative dataset to quantify structural brain anomalies that may improve diagnostic sensitivity for atypical brain volume in youth with fetal alcohol spectrum disorder (FASD).
Participants included 48 children with prenatal alcohol exposure (PAE) and 43 controls, ages 8-17 years, from the longitudinal Collaborative Initiative on FASD s. Recently published lifespan brain charts were used to quantify participants’ (per)centile for brain volumes (cortical and subcortical gray matter and cortical white matter), providing an index of (dis)similarity to typically developing individuals of the same age and sex.
Participants with PAE demonstrated lower mean centile scores compared with controls. Participants with PAE and scores ≤ 10th centile on at least 1 brain volume metric demonstrated significantly lower performance on measures of intellectual function and aspects of executive functioning compared with participants with PAE and “typical” volumes (>10th centile). Brain volume centiles explained a greater amount of variance in IQ and improved sensitivity to brain volume anomalies in FASD compared with the most commonly used diagnostic criterion of occipitofrontal circumference (OFC) ≤ 10th.
Age- and sex-adjusted brain volumes based on a large normative dataset may be useful predictors of functional outcomes and may identify a greater number of individuals with FASD than the currently used criterion of OFC.
Alcohol and pregnant women or women who want to become pregnant
2023, Sages-FemmesL’alcool est la première substance psychoactive expérimentée par les jeunes et, surtout, celle qui est le plus largement consommée au sein de la population. Ses répercussions et sa dangerosité, pour soi et pour les autres, ont été largement documentées ces dernières décennies. Les conséquences de cette consommation ainsi que les possibles actions préventives pour ce qui touche aux femmes enceintes ou en désir de grossesse doivent être connues par les soignants qui les accompagnent.
Alcohol is the first psychoactive substance experienced by young people and, above all, the one most widely consumed in the population. Its repercussions and its dangerousness, for oneself and for others, have been widely documented in the last decades. The consequences of this consumption as well as the possible preventive actions for pregnant women or women who want to become pregnant must be known by the caregivers who accompany them.
Treating Neonatal Abstinence Syndrome in the Newborn
2023, Principles of NeonatologyNearly 32,000 newborn infants are noted to show symptoms related to prenatal opioid exposure, the neonatal opioid withdrawal syndrome (NOWS), in the United States. The correlation between maternal methadone intake and the incidence/severity of NOWS is poor and needs investigation; there may be an impact of maternal intake of other stimulants or prescription medications, or there may be genetic variables, many of which are still being identified. The best treatment of NOWS also continues to be a matter of debate. Nonpharmacologic treatment and environmental modifications are important. In infants with severe symptoms, the management rests on opiate supplementation with careful weaning approaches. Several new pharmacologic approaches are also being evaluated. In this chapter, we present a review of the information available so far on the pathogenesis, clinical identification, and management of these infants.
Early life exposure and developmental consequences
2023, Personal Care Products and Human HealthThis chapter reviews evidence that exposures to chemical components in personal care products during prenatal and early postnatal life may be impacting on human health both in childhood and in later adult life. Evidence is outlined for placental transfer of chemicals in products used by mothers during pregnancy and for the presence of chemicals in breast milk which are transferred to the baby during breast feeding. Consequences of early life exposures to endocrine-disrupting chemicals are discussed in the context of adverse effects on male and female reproductive health, neurodevelopmental disorders, and development of obesity. Evidence is outlined that early life exposures may have consequences for the prevalence of childhood atopic dermatitis, for adverse respiratory outcomes such as asthma, and for the development of cancer. Given the range of adverse consequences, efforts to reduce exposure among pregnant women and in young children are a justifiable precaution.
Intrauterine Drug Exposure: Fetal and Postnatal Effects
2023, Avery's Diseases of the NewbornSubstance use disorders affect people of childbearing age, with the highest prevalence in people 18 to 25 years of age. Intrauterine exposure to drugs, both licit and illicit, is therefore common, and substance use disorders are associated with increased risks of stillbirth and fetal growth restriction. Fetal alcohol exposure is associated with a spectrum of conditions which may be underrecognized. Use of tobacco and e-cigarettes during pregnancy is associated with low birth weight and preterm birth as well as sudden infant death syndrome (SIDS). Cannabis use has risen markedly since it has been legalized in numerous US states, increasing concerns about its impact on the developing brain. Chronic fetal opioid exposure may be associated with neonatal abstinence syndrome, which requires monitoring in the neonatal period to guide treatment. Pharmacologic and behavioral treatment of opioid use disorder during pregnancy is associated with improved maternal and neonatal outcomes. Stimulant use during pregnancy is associated with cardiovascular abnormalities and adverse pregnancy outcomes. Short-term sequelae of other intrauterine psychotropic drug exposures have been increasingly recognized and characterized in the medical literature. Screening for substance use during pregnancy and referral for sensitive, informed, and comprehensive prenatal care benefit the mother-infant dyad. Neonatal and childhood outcome assessments can be confounded by polypharmacy, concurrent maternal psychiatric and/or medical conditions, disparities in health care delivery, and socioeconomic disadvantages. Well-designed, supportive postnatal follow-up care can improve outcomes for the infant and family.
Environmental toxins and neurodevelopment
2023, Encyclopedia of Mental Health, Third Edition: Volume 1-3The prenatal period in human development reflects a time when the embryo or fetus is particularly sensitive to environmental insult from maternal experiences. Therefore, pregnant women should have a clear understanding of what toxins, or teratogens may be present in their environment and how unhealthy exposures can be avoided. Unfortunately, many teratogens go unnoticed in food and water supplies, which increases risk to fetal health and offspring outcome. Teratogens like Methylmercury (MeHg), Polychlorinated Biphenyls (PCBs), and Bisphenol-A (BPA) are hidden, or disguised, in seemingly healthy foods like fish or canned peaches; as well as polybrominated diphenyl ethers (PBDEs) found in seafood, soil, and flame retardants used in household items such as furniture and electronics. Other teratogens—such as nicotine, caffeine, cannabis, and alcohol—are not hidden, but their safety is disputed among physicians and in the media. This article highlights several disguised and disputed teratogens and describes how they may impact brain development, behavior, and mental health.