Effect on the child of alcohol abuse during pregnancy. Retrospective and prospective studies. Acta Paediatr Scand, Suppl. 275: 112, 1979.-Retrospective and prospective investigations of children to alcoholic women gave an incidence of fetal alcohol lesion of one per 300 deliveries of whom half had the complete fetal alcohol syndrome. Perinatal and infant mortalities were increased seven to tenfold and low birth weight (~2 5 0 0 g), preterm deliveries (<37 weeks) and smallness for gestational age (<-2 S.D.) were increased eightfold, threefold and twelvefold, respectively. Small size at birth correlated with reduced mental performance later in life, 58% had IQ below 85 and 19% below 70. 8 % had cerebral palsy. The incidence of cerebral palsy associated with maternal inebriety was 1/5000 deliveries, i.e. every sixth case of cerebral palsy. Tracing of alcoholic women during pregnancy and treatment gave favourahle effect on intrauterine growth when sobriety could be induced early in pregnancy but could not protect from functional brain disturbance measured by neurological performance and by evoked response electroencephalography. Damage to the fetus by alcohol is now the largest known health hazard by a noxious agent that is preventable.
From a retrospective material including all the 103 children of 30 alcoholic women, the 21 youngest born 1970-76, were paired to controls matched for sex, age, birth weight, gestational age and living area. IQ scores were measured with Griffiths and WISC scales. Controls tested within the normal range for Swedish children, while the study group scored 15-19 IQ points below controls (p less than 0.01), the means of the study group corresponding to -1.6 SD below means of the controls. Significant differences between the groups were found in all subscales. Visual perception was measured with Frostig's test. Perceptual age was generally equal to mental age except in the most severely affected cases where perceptional age was lower than mental age. A marked perceptual delay exceeding 1 year was found in 8/17 tested cases in the study group, while all controls were normal. Developmental levels evaluated from Human Figure Drawings according to Koppitz was in accordance with IQ test results. Indicators of emotional instability were found significantly more often in the study group than in controls. Hyperactivity, distractability and short attention span were found in 12/21 cases and perseveration in 6/21 cases but not among controls. Members of the study group with traits of the fetal alcohol syndrome (10/21) had significantly lower IQ and perceptual delay was more pronounced than in members without such signs. No significant IQ difference was found between subjects reared in foster homes and in biological homes.
Twenty-one children born 1970-76, selected from 103 children of 30 alcoholic women, were paired to controls matched for sex, age, birth weight and gestational age. The sample (10 girls, 11 boys) was representative of the whole group with regard to weight, length and head circumference at birth. At follow-up (mean age 70 months) the study group was significantly leaner, shorter and had smaller mean head circumference than the control group. The controls had significant catch-up growth from birth to follow-up of weight, height and head circumference to the mean for Swedish children. The study group had no catch-up growth. Compared to controls the study group had significantly lower fine and gross motor age test scores and inferior coordination. One child had cerebral palsy (spastic hemiplegia) and in 6 other children slight tremor and ataxia were observed. Malformations and/or other signs of the fetal alcohol syndrome (FAS) were found in 10 cases. Study group children with FAS had significantly slower growth of head circumference than others without FAS. Children placed in foster home care (n = 11) were found to have significantly (p less than 0.05) lower birth weight, birth length and head circumference than children raised at home (n = 10). There were no significant differences at follow up between study group children raised in foster homes or in homes of their biological mother.
SUMMARY Methods have been adapted and their reproducibility tested for the determination of blood lipids and the fatty acid composition of the phosphoglycerides. The main lipid classes in 20 women from the south‐western part of Sweden at term pregnancy and of umbilical cord plasma of their newborn infants were studied. Determinations were made of the fatty acid pattern of plasma phosphoglycerides and of cephalins and lecithin of red cells. The concentration of the major lipid classes in maternal and umbilical cord plasma agreed well with previously reported figures from other countries. The maternal plasma fatty acid pattern of phosphoglycerides was similar to that of adult males. The mothers and their infants had identical concentrations of the total sum of all polyunsaturated fatty acids in plasma phosphoglycerides, in red cell lecithin and in red cell cephalins. The infants' pattern differed from the mothers' by much lower concentrations of the parent fatty acids, linoleic and linolenic acids, and correspondingly increased concentrations of the more polyunsaturated fatty acids of the two series. The fatty acid composition in the red cell lecithin of mother and infant reflected that in the corresponding plasma. The cephalins contained more polyunsaturated fatty acids than the lecithin in both mothers' and infants' red cells. The study produced no biochemical evidence of an essential fatty acid deficiency in these newborns. The identical concentration of total polyunsaturated fatty acids in blood phosphoglycerides of mothers and infants in combination with the pronounced change in the ratio between the parent fatty acids and the highly polyunsaturated derivates, suggest a homeo‐static regulation of the fatty acid composition of the blood phosphoglycerides.
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