Background Prenatal alcohol exposure can result in physical and neurocognitive deficits that are collectively termed ‘Fetal Alcohol Spectrum Disorders’ (FASD). Though FASD is associated with life-long intellectual disability, the mechanisms mediating the emergence of secondary mental-health and physical disabilities are poorly understood. Based on our previous data showing that maternal ethanol exposure in mice resulted in an immediate reduction in cranially directed fetal blood flow, we hypothesized that such exposure would also result in persistent alterations in cranially directed blood flow in the prenatally alcohol exposed (PAE) adult. We also hypothesized that PAE adults exposed to an acute cerebrovascular insult would exhibit more brain damage and neurobehavioral impairment compared to non-PAE adult controls. Methods Pregnant C57Bl/6 mice were exposed to ethanol, 3g/kg, or water by intra-gastric gavage. Blood flow in carotid, renal and femoral arteries was assessed by ultrasound imaging in PAE and control adults, at 3, 6, and 12 months of age. To mimic ischemic stroke in young adult populations, 3-month-old PAE and control animals were subject to transient middle cerebral artery occlusion (MCAo) and subsequently assessed for behavioral recovery, stroke infarct volume and brain cytokine profiles. Results PAE resulted in a significant age-related decrease in blood acceleration in adult mice, specifically in the carotid artery. A unilateral transient MCAo resulted in equivalent cortico-striatal damage in both PAE and control adults. However, PAE adult mice exhibited significantly decreased post-stroke behavioral recovery compared to controls. Conclusions Our data collectively show that PAE adult mice exhibit a persistent, long-term loss of cranially directed blood flow, and decreased capacity to compensate for brain trauma due to acute onset adult diseases like ischemic stroke.

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Background: There is limited literature written on the course and outcomes for pregnant mothers with Shone complex. Methods: We describe a case series of five pregnancies in four women with Shone complex within a multidisciplinary cardio-obstetrics clinic from 2016-2018. Results: Maternal age ranged from 21-39 years. Three patients had preserved left ventricular function while one had moderately decreased function. Gestational age at presentation ranged from 6-15 weeks. There were three successful pregnancies (mean gestational age = 37 weeks, range 35-39 weeks) with one patient accounting for two unsuccessful pregnancies. All infants were delivered via Cesarean section. One infant required a NICU stay, but all other infants delivered were healthy. Conclusion: Patients with Shone complex can have successful pregnancies although complications can occur for both the mother and the baby. Comprehensive prenatal care, coordinated and consistent management during pregnancy, and tertiary care support can promote positive maternal and fetal outcomes.