The fetal alcohol spectrum of disorders (FASD) combines a number of congenital developmental disorders in children who were exposed to intrauterine alcohol, and is represented by mental, behavioral, intellectual, physical and other disabling disorders that persist throughout life. The aim of the study is to test methodology of actively identifying cases of morpho-anatomical and cognitive impairment that arose as the result of fetal effects of alcohol, and to assess prevalence of such disorders in children of primary school age in one of the administrative centers of the Russian Federation. The study was divided into three phases. The article describes the results of the first stage — screening of primary schoolchildren to identify and assess severity of their lag in physical development arising due to prenatal exposure to ethanol. Physical indicators based on the results of accurate measurement of height, weight and calculation of the body mass index of the child were compared to standard indicators taking into account the age and gender of the children. During screening of 2,763 school students, 77 (2.8%) with physical development retardation were found. Among those: 9 (11.7%) had severe physical development retardation — height and weight were below the 3rd centile of age norm indicators; 16 (20.8%) had moderate physical development retardation — both or one indicators (height and/ or weight) were below the 3rd centile of age norm indicators; 52 (67.5%) had minor violations / physical development retardation — one or both indicators (height and/or weight) were at the 10th centile of age norm indicators. All children who had physical development retardation were referred for further diagnostics, in order to identify dysmorphological and cognitive impairments typical for FASD.

Diagnosis of disorders that determine the clinical manifestations of fetal alcohol syndrome (FAS) can cause certain difficulties: children with intrauterine alcohol exposure have a fairly wide range of physical, cognitive and behavioral features. The severity of disorders varies, which is determined mainly by the period when mother consumed alcohol (1st, 2nd or 3rd trimester of pregnancy), as well as frequency and amount of alcohol consumed. This article presents results of the second stage of the study among school students 7-10 year of age to identify and assess dysmorphological disorders that have arisen due to prenatal exposure to ethanol. During the first stage of the study, 77 students with delayed physical development (height and weight at the level of the 10th centile and less) were identified with anamnestic data about their mothers’ drinking alcohol during pregnancy. All children were included in the second stage of the study for detailed dysmorphological assessment. Diagnostics was carried out in two directions: criterial, including determining presence or absence of disorders, and if any, determining the severity of facial phenotype of FAS (short palpebral fissure lengths, smooth philtrum, thin upper lip); and descriptive, including determining presence or absence of disorders, and if any, determining severity of other dysmorphological disorders associated with FAS (face shape, features of the eyes, shape of the ears, features of the nostrils and lips, features of the structure of the hands). According to the results of the criteria-based diagnostics, 11 (14.3%) out of 77 children had typical facial anomalies or facial phenotype typical for FAS. 4 children had full correspondence of facial anomalies to severe, and 7 children to moderate. According to results of syndromic diagnosis, all children had from 1 to 6 signs of dysmorphological manifestations of FAS, represented by: upper palmar fold in the form of a «hockey stick» in 42.9%; altered ear configurations in the form of a «railway track» in 42.9%; short palpebral fissure lengths in 41.6%; smooth philtrum in 41.6%; thin upper lip in 41.6%; strabismus in 37.7%; clinodactyly of the 5th finger in 37.7%; small midface in 23.4%.

Introduction FAS and FASD are completely preventable conditions which can be reduced by methods of prevention aimed at alcohol eliminating by women during pregnancy. Objectives The aim of the study was to assess level of intellectual impairment in children with FAS and FASD. Methods All children who participated in the study had physical development retardation and various dysmorphological features of FAS or FASD. The sample included 77 children, 8.6±1.03 years of age. FAS was diagnosed in 8 children, FASD in 69 children. Assessments were carried out by pediatrician, psychiatrist and psychologist; level of intelligence was assessed using WISC test. Results Among children with FAS average IQ was 65.9 points (extremely low level), which corresponds to «mild mental retardation» diagnosis (F70, ICD-10). Four children with FAS had intelligence corresponding to «very low» level (IQ=70-79), three had «mild mental retardation» (IQ=50-69), and one had «moderate mental retardation» (F71, ICD-10) (IQ=35-49). Among children with FASD average IQ was higher and reached 79.5 points, corresponding to «very low» intelligence level. «Moderate mental retardation» was identified in 7.8% children with FASD; 22.1% children had «mild mental retardation», and 27.3% had «very low». In 37.7% children IQ level was within normal range: «low average» in 19.5% (IQ=80-89) and «average» in 18.2% (IQ=90-109). «Very high intelligence» (IQ=120-129) was detected in 2.6% children, «extremely high intelligence» (IQ=130 points and above) in 2.6%. Conclusions All children with FAS had impaired mental development. Children with FASD showed a wide range of total IQ values, from moderate degree of mental retardation to very high intelligence. Disclosure No significant relationships.