Difference between revisions of "Talk:Abnormal Development - Fetal Alcohol Syndrome"

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==2013==
 
==2013==
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===Diagnosis of fetal alcohol syndrome (FAS): German guideline version 2013===
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Eur J Paediatr Neurol. 2013 Apr 22. pii: S1090-3798(13)00051-2. doi: 10.1016/j.ejpn.2013.03.008. [Epub ahead of print]
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Landgraf MN, Nothacker M, Heinen F.
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Source
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Department of Pediatric Neurology and Developmental Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilians, University of Munich, Lindwurmstrasse 4, 80337 Munich, Germany. Electronic address: mirjam.landgraf@med.uni-muenchen.de.
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Abstract
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BACKGROUND:
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Fetal alcohol syndrome (FAS) belongs to the umbrella of fetal alcohol spectrum disorders (FASD) and affects 0.02-0.8% of all annual births with a high number of undetected cases. FAS has severe and life determining consequences for the affected individual and his family.
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AIM:
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The aim of the German guideline version 2013 is to provide objectively evaluated, evidence-based, clinically relevant and easily applicable diagnostic criteria for the full picture FAS.
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METHODS:
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A systematic literature review (2001-2011), analysis of international guidelines and focused hand search were performed. Based on the evidence-assessed literature the multidisciplinary guideline group (14 German Professional Societies, the patient support group "FASD Germany" and 15 additional experts) consented recommendations for the diagnosis of FAS.
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RESULTS:
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The following diagnostic criteria for FAS resulted: at least one deficit of growth, three defined facial characteristics and one functional or structural anomaly of the central nervous system. Confirmation of intrauterine alcohol exposure is not considered as a prerequisite for FAS diagnosis.
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CONCLUSION:
 +
The German guideline presented here constitutes an unbiased evidence-based approach to the diagnosis of patients with fetal alcohol syndrome. It includes a practical pocket guide FAS for a quick overview of the diagnostic workup in everyday clinical work.
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Copyright © 2013 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.
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PMID 23618613
  
 
===Commonality in down and fetal alcohol syndromes===
 
===Commonality in down and fetal alcohol syndromes===

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Cite this page: Hill, M.A. (2020, April 5) Embryology Abnormal Development - Fetal Alcohol Syndrome. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Talk:Abnormal_Development_-_Fetal_Alcohol_Syndrome


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Note - This sub-heading shows an automated computer PubMed search using the listed sub-heading term. References appear in this list based upon the date of the actual page viewing. Therefore the list of references do not reflect any editorial selection of material based on content or relevance. In comparison, references listed on the content page and discussion page (under the publication year sub-headings) do include editorial selection based upon relevance and availability. (More? Pubmed Most Recent)

Fetal Alcohol Syndrome

<pubmed limit=10>Fetal+Alcohol+Syndrome</pubmed>

2013

Diagnosis of fetal alcohol syndrome (FAS): German guideline version 2013

Eur J Paediatr Neurol. 2013 Apr 22. pii: S1090-3798(13)00051-2. doi: 10.1016/j.ejpn.2013.03.008. [Epub ahead of print]

Landgraf MN, Nothacker M, Heinen F. Source Department of Pediatric Neurology and Developmental Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilians, University of Munich, Lindwurmstrasse 4, 80337 Munich, Germany. Electronic address: mirjam.landgraf@med.uni-muenchen.de.

Abstract

BACKGROUND: Fetal alcohol syndrome (FAS) belongs to the umbrella of fetal alcohol spectrum disorders (FASD) and affects 0.02-0.8% of all annual births with a high number of undetected cases. FAS has severe and life determining consequences for the affected individual and his family. AIM: The aim of the German guideline version 2013 is to provide objectively evaluated, evidence-based, clinically relevant and easily applicable diagnostic criteria for the full picture FAS. METHODS: A systematic literature review (2001-2011), analysis of international guidelines and focused hand search were performed. Based on the evidence-assessed literature the multidisciplinary guideline group (14 German Professional Societies, the patient support group "FASD Germany" and 15 additional experts) consented recommendations for the diagnosis of FAS. RESULTS: The following diagnostic criteria for FAS resulted: at least one deficit of growth, three defined facial characteristics and one functional or structural anomaly of the central nervous system. Confirmation of intrauterine alcohol exposure is not considered as a prerequisite for FAS diagnosis. CONCLUSION: The German guideline presented here constitutes an unbiased evidence-based approach to the diagnosis of patients with fetal alcohol syndrome. It includes a practical pocket guide FAS for a quick overview of the diagnostic workup in everyday clinical work. Copyright © 2013 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

PMID 23618613

Commonality in down and fetal alcohol syndromes

Birth Defects Res A Clin Mol Teratol. 2013 Apr 3. doi: 10.1002/bdra.23129. [Epub ahead of print]

Solzak JP, Liang Y, Zhou FC, Roper RJ. Source Department of Biology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana.

Abstract

BACKGROUND: Down syndrome (DS) and Fetal Alcohol Syndrome (FAS) are two leading causes of birth defects with phenotypes ranging from craniofacial abnormalities to cognitive impairment. Despite different origins, we report that in addition to sharing many phenotypes, DS and FAS may have common underlying mechanisms of development. METHODS: Literature was surveyed for DS and FAS as well as mouse models. Gene expression and apoptosis were compared in embryonic mouse models of DS and FAS by qPCR, immunohistochemical and immunoflurorescence analyses. The craniometry was examined using MicroCT at postnatal day 21. RESULTS: A literature survey revealed over 20 comparable craniofacial and structural deficits in both humans with DS and FAS and corresponding mouse models. Similar phenotypes were experimentally found in pre- and postnatal craniofacial and neurological tissues of DS and FAS mice. Dysregulation of two genes, Dyrk1a and Rcan1, key to craniofacial and neurological precursors of DS, was shared in craniofacial precursors of DS and FAS embryos. Increased cleaved caspase 3 expression was also discovered in comparable regions of the craniofacial and brain precursors of DS and FAS embryos. Further mechanistic studies suggested overexpression of trisomic Ttc3 in DS embyros may influence nuclear pAkt localization and cell survival. CONCLUSIONS: This first and initial study indicates that DS and FAS share common dysmorphologies in humans and animal models. This work also suggests common mechanisms at cellular and molecular levels that are disrupted by trisomy or alcohol consumption during pregnancy and lead to craniofacial and neurological phenotypes associated with DS or FAS. Birth Defects Research (Part A), 2013. © 2013 Wiley Periodicals, Inc. Copyright © 2013 Wiley Periodicals, Inc.

PMID 23554291

Alcohol-use disorders during and within one year of pregnancy: a population-based cohort study 1985-2006

BJOG. 2013 May;120(6):744-53. doi: 10.1111/1471-0528.12167. Epub 2013 Feb 19.

O'Leary C, Halliday J, Bartu A, D'Antoine H, Bower C. Source Centre for Population Health Research, Curtin University, Perth, WA, Australia; Division of Population Sciences Telethon Institute for Child Health Research Centre for Child Health Research, University of Western Australia, Perth, WA, Australia.

Abstract

OBJECTIVES: To examine alcohol-use disorders in pregnant women and the extent of under-reporting. DESIGN: Population-based cohort study. SETTING: Western Australia. POPULATION: Women with a birth recorded on the Western Australian Midwives Notification System (1985-2006). METHODS: Mothers with an International Classification of Diseases 9/10 alcohol-related diagnosis, indicating heavy alcohol consumption, recorded on population-based health datasets (non-Aboriginal n = 5839; Aboriginal n = 2583) were identified through the Western Australian data-linkage system. This 'exposed' cohort was frequency matched (on maternal age, year of birth of offspring, Aboriginal status) with comparison mothers without an alcohol-related diagnosis (non-Aboriginal n = 33 979; Aboriginal n = 8005). MAIN OUTCOME MEASURES: Trends in maternal alcohol diagnoses in relation to pregnancy for non-Aboriginal and Aboriginal women. The proportion of children diagnosed with fetal alcohol syndrome (FAS) who had a mother with an alcohol diagnosis recorded during pregnancy. RESULTS: The proportion of Aboriginal mothers in Western Australia with an alcohol diagnosis (23.1%) is ten times greater than for non-Aboriginal mothers (2.3%). There has been a six-fold increase in the percentage of non-Aboriginal births with a maternal alcohol diagnosis recorded during pregnancy and a 100-fold increase for Aboriginal births. Around 70% of the mothers of children diagnosed with FAS did not have an alcohol diagnosis recorded during pregnancy and 18% of the mothers had no record of an alcohol diagnosis. CONCLUSIONS: Maternal alcohol exposure during pregnancy is significantly under-ascertained. Given the severe risks to the fetus from heavy prenatal alcohol exposure, assessment and recording of alcohol use should be routinely undertaken in maternity and other health settings. © 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2013 RCOG.

PMID 23418853

Neuroprotective profile of pyruvate against ethanol-induced neurodegeneration in developing mice brain

Neurol Sci. 2013 Mar 15. [Epub ahead of print]

Ullah N, Naseer MI, Ullah I, Kim TH, Lee HY, Kim MO. Source Division of Life Science, College of Natural Sciences (RINS) and Applied Life Science, Gyeongsang National University, Chinju, 660-701, Republic of Korea.

Abstract

Exposure to ethanol during developmental stages leads to several types of neurological disorders. Apoptotic neurodegeneration due to ethanol exposure is a main feature in alcoholism. Exposure of developing animals to alcohol induces apoptotic neuronal death and causes fetal alcohol syndrome. In the present study, we observed the possible protective effect of pyruvate against ethanol-induced neurodegeneration. Exposure of developing mice to ethanol (2.5 g/kg) induces apoptotic neurodegeneration and widespread neuronal cell death in the cortex and thalamus. Co-treatment of pyruvate (500 mg/kg) protects neuronal cell against ethanol by the reduced expression of caspase-3 in these brain regions. Immunohistochemical analysis and TUNNEL at 24 h showed that apoptotic cell death induced by ethanol in the cortex and thalamus is reduced by pyruvate. Histomorphological analysis at 24 h with cresyl violet staining also proved that pyruvate reduced the number of neuronal cell loss in the cortex and thalamus. The results showed that ethanol increased the expression of caspase-3 and thus induced apoptotic neurodegeneration in the developing mice cortex and thalamus, while co-treatment of pyruvate inhibits the induction of caspase-3 and reduced the cell death in these brain regions. These findings, therefore, showed that treatment of pyruvate inhibits ethanol-induced neuronal cell loss in the postnatal seven (P7) developing mice brain and may appear as a safe neuroprotectant for treating neurodegenerative disorders in newborns and infants.

PMID 23494720


2012

Consensus diagnostic criteria for fetal alcohol spectrum disorders in Australia: a modified Delphi study

BMJ Open. 2012 Oct 25;2(5). pii: e001918. doi: 10.1136/bmjopen-2012-001918. Print 2012.


Watkins RE, Elliott EJ, Mutch RC, Payne JM, Jones HM, Latimer J, Russell E, Fitzpatrick JP, Hayes L, Burns L, Halliday J, D'Antoine HA, Wilkins A, Peadon E, Miers S, Carter M, O'Leary CM, McKenzie A, Bower C. Source Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia.

Abstract

OBJECTIVE: To evaluate health professionals' agreement with components of published diagnostic criteria for fetal alcohol spectrum disorders (FASD) in order to guide the development of standard diagnostic guidelines for Australia.

DESIGN: A modified Delphi process was used to assess agreement among health professionals with expertise or experience in FASD screening or diagnosis. An online survey, which included 36 Likert statements on diagnostic methods, was administered over two survey rounds. For fetal alcohol syndrome (FAS), health professionals were presented with concepts from the Institute of Medicine (IOM), University of Washington (UW), Centers for Disease Control (CDC), revised IOM and Canadian diagnostic criteria. For partial FAS (PFAS), alcohol-related neurodevelopmental disorder (ARND), and alcohol-related birth defects (ARBD), concepts based on the IOM and the Canadian diagnostic criteria were compared.

SETTING/PARTICIPANTS: 130 Australian and 9 international health professionals.

RESULTS: Of 139 health professionals invited to complete the survey, 103 (74.1%) responded, and 74 (53.2%) completed one or more questions on diagnostic criteria. We found consensus agreement among participants on the diagnostic criteria for FAS, with the UW criteria most commonly endorsed when compared with all other published criteria for FAS. When health professionals were presented with concepts based on the Canadian and IOM diagnostic criteria, we found consensus agreement but no clear preference for either the Canadian or IOM criteria for the diagnosis of PFAS, and no consensus agreement on diagnostic criteria for ARND. We also found no consensus on the IOM diagnostic criteria for ARBD.

CONCLUSIONS: Participants indicated clear support for use of the UW diagnostic criteria for FAS in Australia. These findings should be used to develop guidelines to facilitate improved awareness of, and address identified gaps in the infrastructure for, FASD diagnosis in Australia.

PMID 23100447 http://bmjopen.bmj.com/content/2/5/e001918.long

2011

Health initiatives by Indigenous people in Australia

Lancet. 2011 Jun 18;377(9783):2066-7.

Clark S. Source The Lancet, London NW1 7BY, UK. PMID 21684368 http://www.ncbi.nlm.nih.gov/pubmed/21684368 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60884-2/fulltext

Fetal Alcohol Spectrum Disorders: A Population Based Study of Premature Mortality Rates in the Mothers

Matern Child Health J. 2011 Jun 28. [Epub ahead of print]

Li Q, Fisher WW, Peng CZ, Williams AD, Burd L. Source North Dakota Fetal Alcohol Syndrome Center, University of North Dakota School of Medicine and Health Sciences, 501 N Columbia Road Stop 9037, Grand Forks, ND, 58202-9037, USA.

Abstract

Fetal alcohol spectrum disorders (FASD) are associated with an increase in risk for mortality for people with an FASD and their siblings. In this study we examine mortality rates of birth mothers of children with FASD, using a retrospective case control methodology. We utilized the North Dakota FASD Registry to locate birth certificates for children with FASD which we used to identify birth mothers. We then searched for mothers' death certificates. We then compared the mortality rates of the birth mothers with an age matched control group comprised of all North Dakota women who were born and died in the same year as the birth mother. The birth mothers of children with FASD had a mortality rate of 15/304 = 4.93%; (95% CI 2.44-7.43%). The mortality rate for control mothers born in same years as the FASD mothers was 126/114,714 = 0.11% (95% CI 0.09-0.13%). Mothers of children with an FASD had a 44.82 fold increase in mortality risk and 87% of the deaths occurred in women under the age of 50. Three causes of death (cancer, injuries, and alcohol related disease) accounted for 67% of the deaths in the mothers of children with FASD. A diagnosis of FASD is an important risk marker for premature death in the mothers of children diagnosed with an FASD. These women should be encouraged to enter substance abuse treatment.

PMID 21710184

Fetal alcohol syndrome: dashed hopes, damaged lives

Bull World Health Organ. 2011 Jun 1;89(6):398-9. [No authors listed] Abstract Since the term was coined about 40 years ago, fetal alcohol syndrome has slowly become recognized as a public health issue. Alicestine October reports from South Africa's Western Cape province, which has the highest reported rate in the world.

PMID 21673854

Fetal Alcohol Spectrum Disorders: An Overview

Neuropsychol Rev. 2011 Apr 16. [Epub ahead of print]

Riley EP, Infante MA, Warren KR. Source Department of Psychology, Center for Behavioral Teratology, San Diego State University, 6330 Alvarado Court, Suite 100, San Diego, CA, 92120, USA, eriley@mail.sdsu.edu.

Abstract

When fetal alcohol syndrome (FAS) was initially described, diagnosis was based upon physical parameters including facial anomalies and growth retardation, with evidence of developmental delay or mental deficiency. Forty years of research has shown that FAS lies towards the extreme end of what are now termed fetal alcohol spectrum disorders (FASD). The most profound effects of prenatal alcohol exposure are on the developing brain and the cognitive and behavioral effects that ensue. Alcohol exposure affects brain development via numerous pathways at all stages from neurogenesis to myelination. For example, the same processes that give rise to the facial characteristics of FAS also cause abnormal brain development. Behaviors as diverse as executive functioning to motor control are affected. This special issue of Neuropsychology Review addresses these changes in brain and behavior highlighting the relationship between the two. A diagnostic goal is to recognize FAS as a disorder of brain rather than one of physical characteristics.

PMID 21499711

The effects of alcohol on fetal development

Birth Defects Res C Embryo Today. 2011 Mar;93(1):3-11. doi: 10.1002/bdrc.20200.

Jones KL.

Department of Pediatrics, Division of Dysmorphology/Teratology, University of California, San Diego, California. klyons@ucsd.edu.

Abstract

Prenatal exposure to alcohol has profound effects on many aspects of fetal development. Although alterations of somatic growth and specific minor malformations of facial structure are most characteristic, the effects of alcohol on brain development are most significant in that they lead to substantial problems with neurobehavioral development. Since the initial recognition of the fetal alcohol syndrome (FAS), a number of important observations have been made from studies involving both humans and animals. Of particular importance, a number of maternal risk factors have been identified, which may well be of relevance relative to the development of strategies for prevention of the FAS as well as intervention for those who have been affected. These include maternal age >30 years, ethnic group, lower socioeconomic status, having had a previously affected child, maternal under-nutrition, and genetic background. The purpose of this review is to discuss these issues as well as to set forth a number of questions that have not adequately been addressed relative to alcohol's effect on fetal development. Of particular importance is the critical need to identify the full spectrum of structural defects associated with the prenatal effects of alcohol as well as to establish a neurobehavioral phenotype. Appreciation of both of these issues is necessary to understand the full impact of alcohol on fetal development. Birth Defects Research (Part C) 93:3-11, 2011. © 2011 Wiley-Liss, Inc.

Copyright © 2011 Wiley-Liss, Inc.

PMID 21425437

Prevalence, predictors and perinatal outcomes of peri-conceptional alcohol exposure - retrospective cohort study in an urban obstetric population in Ireland

BMC Pregnancy Childbirth. 2011 Apr 11;11(1):27. [Epub ahead of print]

Mullally A, Cleary BJ, Barry J, Fahey TP, Murphy DJ. Abstract ABSTRACT:

BACKGROUND: Evidence-based advice on alcohol consumption is required for pregnant women and women planning a pregnancy. Our aim was to investigate the prevalence, predictors and perinatal outcomes associated with peri-conceptional alcohol consumption.

METHODS: A cohort study of 61,241 women who booked for antenatal care and delivered in a large urban maternity hospital between 2000 and 2007. Self-reported alcohol consumption at the booking visit was categorised as low (0-5 units per week), moderate (6-20 units per week) and high (> 20 units per week).

RESULTS: Of the 81% of women who reported alcohol consumption during the peri-conceptional period, 71% reported low intake, 9.9% moderate intake and 0.2% high intake. Factors associated with moderate alcohol consumption included being in employment OR 4.47 (95% CI 4.17 to 4.80), Irish nationality OR 16.5 (95% CI 14.9 to 18.3), private health care OR 5.83 (95% CI 5.38 to 6.31) and smoking OR 1.86 (95% CI 1.73 to 2.01). Factors associated with high consumption included maternal age less than 25 years OR 2.70 (95% CI 1.86 to 3.91) and illicit drug use OR 6.46 (95% CI 3.32 to 12.60). High consumption was associated with very preterm birth (< 32 weeks gestation) even after controlling for socio-demographic factors adjusted OR 3.15 (95% CI 1.26-7.88). Only three cases of Fetal Alcohol Syndrome were recorded (0.05 per 1000 total births), one each in the low, moderate and high consumption groups.

CONCLUSIONS: Public Health campaigns need to emphasise the importance of peri-conceptional health and pre-pregnancy planning. Fetal Alcohol Syndrome is likely to be under-reported despite the high prevalence of alcohol consumption in this population.

PMID 21481224

2010

Alcohol and other drug treatment services in Australia 2006–07

Around 143,000 alcohol and other drug treatment episodes were provided in Australia in 2008-09'

Australian Institute of Health and Welfare 2008. Alcohol and other drug treatment services in Australia 2006–07: report on the National Minimum Data Set. Drug treatment series no. 8. Cat. no. HSE 59. Canberra: AIHW.

"More episodes of this treatment were for alcohol than any other drug type, and this proportion has now risen four years in a row. ...As seen in previous years, most treatment episodes (66%) were provided to male clients."

Prenatal alcohol exposure triggers ceramide-induced apoptosis in neural crest-derived tissues concurrent with defective cranial development

Cell Death Dis. 2010 May 27;1(5):e46.

Wang G, Bieberich E. Source Institute of Molecular Medicine and Genetics, School of Medicine, Medical College of Georgia, Augusta, GA 30912, USA.

Abstract

Fetal alcohol syndrome (FAS) is caused by maternal alcohol consumption during pregnancy. The reason why specific embryonic tissues are sensitive toward ethanol is not understood. We found that in neural crest-derived cell (NCC) cultures from the first branchial arch of E10 mouse embryos, incubation with ethanol increases the number of apoptotic cells by fivefold. Apoptotic cells stain intensely for ceramide, suggesting that ceramide-induced apoptosis mediates ethanol damage to NCCs. Apoptosis is reduced by incubation with CDP-choline (citicoline), a precursor for the conversion of ceramide to sphingomyelin. Consistent with NCC cultures, ethanol intubation of pregnant mice results in ceramide elevation and increased apoptosis of NCCs in vivo. Ethanol also increases the protein level of prostate apoptosis response 4 (PAR-4), a sensitizer to ceramide-induced apoptosis. Prenatal ethanol exposure is concurrent with malformation of parietal bones in 20% of embryos at day E18. Meninges, a tissue complex derived from NCCs, is disrupted and generates reduced levels of TGF-β1, a growth factor critical for bone and brain development. Ethanol-induced apoptosis of NCCs leading to defects in the meninges may explain the simultaneous presence of cranial bone malformation and cognitive retardation in FAS. In addition, our data suggest that treatment with CDP-choline may alleviate the tissue damage caused by alcohol.

PMID 21364652

2009

Magnetic resonance microscopy defines ethanol-induced brain abnormalities in prenatal mice: effects of acute insult on gestational day 8

Alcohol Clin Exp Res. 2009 Jun;33(6):1001-11. Epub 2009 Mar 19.


Parnell SE, O'Leary-Moore SK, Godin EA, Dehart DB, Johnson BW, Allan Johnson G, Styner MA, Sulik KK.

The Bowles Center for Alcohol Studies, and Neurodevelopmental Disorders Research Center, University of North Carolina, Chapel Hill, NC 27599-7178, USA. sparnell@med.unc.edu

PMID 19302087 http://www3.interscience.wiley.com/journal/122268272/abstract

Integrating case topics in medical school curriculum to enhance multiple skill learning: using fetal alcohol spectrum disorders as an exemplary case

Acad Psychiatry. 2009 Mar-Apr;33(2):143-8.

Paley B, O'Connor MJ, Baillie SJ, Guiton G, Stuber ML. Source Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, CA 90024, USA. bpaley@mednet.ucla.edu

Abstract

OBJECTIVES: This article describes the use of fetal alcohol spectrum disorders (FASDs) as a theme to connect the learning of basic neurosciences with clinical applications across the age span within a systems-based, integrated curricular structure that emphasizes problem-based learning. METHODS: In collaboration with the Centers for Disease Control and Prevention (CDC) and the National Organization on Fetal Alcohol Syndrome, the Western Regional Training Center for Fetal Alcohol Exposure at UCLA developed and integrated educational materials on FASDs into the curriculum for first-year medical students. RESULTS: Quantitative and qualitative evaluations suggested materials were effective in enhancing student knowledge and skills related to FASDs, as well as embryology, brain development, substance abuse, developmental psychopathology, and medical ethics. CONCLUSION: The use of a unifying theme integrating basic science and clinical information and skills is effective for medical student training in the prevention and treatment of common medical problems.


PMID 19398629