Altered bone and body composition in children and adolescents with confirmed prenatal alcohol exposure

Young, Sophia; Gallo, Linda A.; Brookes, Denise S.K.; Hayes, Nicole; Maloney, Maree; Liddle, Karen; James, Amanda; Moritz, Karen M.; Reid, Natasha

doi:10.1016/j.bone.2022.116510

Cited by 8 publications

(10 citation statements)

References 40 publications

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“…PAE was associated with CNS damage (Avaria et al, 2004; Popova et al, 2016) and altered insulin sensitivity dependent on the body mass index (BMI) of the individual (Kable et al, 2021). Delayed skeletal maturation (Habbick et al, 1998), reduced bone mineral density (Young et al, 2022), and sex‐specific dentofacial anomalies and tooth disturbances (Naidoo et al, 2005, 2006) were also reported.…”

Section: Resultsmentioning

confidence: 99%

Factors to be considered as part of a holistic assessment for fetal alcohol spectrum disorder: A scoping review

Reid,

Kent,

Hewlett

et al. 2023

Alcohol: Clinical and Experimental Research

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BackgroundA scoping review was undertaken to identify factors outside of current fetal alcohol spectrum disorder (FASD) diagnostic criteria that could be considered as part of a holistic assessment process to enable targeted recommendations and supports to improve outcomes. Evidence will be used to inform the revision of the Australian Guide to the Diagnosis of FASD.MethodsSix electronic databases were searched. Studies were eligible if they included factors outside of the diagnostic criteria that clinicians might need to consider as part of a holistic (i.e., physical, social, mental health and wellbeing) assessment process. Data charting and content analysis was performed for synthesis of results.Results121 studies were included that spanned 12 key areas. This included physical health, sleep, adverse postnatal experiences, substance use/other risk‐taking behaviors, contact with the criminal justice system, mental health, First Nations cultural considerations, transition to adult roles, involvement with the out‐of‐home care system, feeding and eating, strengths/interests/external resources and incontinence.ConclusionsAreas to be considered as part of a holistic assessment and diagnostic process spanned individual, family, and system level factors. The results of the current review provide guidance for clinicians regarding the wide range of factors that may influence long‐term health, development, and wellbeing for individuals with prenatal alcohol exposure and FASD. In practice this guidance can be used to inform an individualized assessment process to facilitate tailored recommendations and supports to best meet the complex needs of those living with FASD and their families.

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Section: Resultsmentioning

confidence: 99%

Factors to be considered as part of a holistic assessment for fetal alcohol spectrum disorder: A scoping review

Reid,

Kent,

Hewlett

et al. 2023

Alcohol: Clinical and Experimental Research

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“…Given the trend towards increased growth plate bridging, suggestive of an accelerated fusion mechanism [48], this could explain the reasons for these results. Evidence of this from human populations is limited as FASD children aged < 9 years are similar in height to age-matched controls; by adolescence, individuals with FASD are shorter [23], yet longer term studies in skeletally mature FASD adults have not been performed. In addition, previous reports identified that adult female rats, and both juvenile and adult male rats exposed to alcohol in utero were more susceptible to developing an osteoarthritis-like phenotype and display cartilage degradation [69, 75].…”

Section: Discussionmentioning

confidence: 99%

“…Whilst these data suggest a detrimental effect of PAE on bone development, the long-term effects on the adult skeleton have not been fully investigated. Similarly, whilst sex differences in human FASD populations have been observed across various systems and clinical outcomes, including neurodevelopment, cognitive performance, endocrine disorders, facial dysmorphology, pre-and postpartum mortality, body composition and metabolic abnormalities [35][36][37], any potential sexual dimorphism associated with bone architecture and composition is unclear [23]. As evidence suggests that diagnosis and disease presentation of these patients can alter between males and females, establishing these sex differences will support future policies and clinical management [35].…”

Section: Introductionmentioning

confidence: 99%

Sexually dimorphic effects of prenatal alcohol exposure on the murine skeleton

Bourne,

Jayash,

Michels

et al. 2024

Preprint

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Background: Prenatal alcohol exposure (PAE) can result in lifelong disabilities known as foetal alcohol spectrum disorder (FASD) and is associated with childhood growth deficiencies and increased bone fracture risk. However, the effects of PAE on the adult skeleton remain unclear and any potential sexual dimorphism is undetermined. Therefore, we utilised a murine model to examine sex differences with PAE on in vitro bone formation, and in the juvenile and adult skeleton. Methods: Pregnant C57BL/6J female mice received 5% ethanol in their drinking water during gestation. Primary calvarial osteoblasts were isolated from neonatal offspring and mineralised bone nodule formation and gene expression assessed. Skeletal phenotyping of 4- and 12-week-old male and female offspring was conducted by micro-computed tomography (uCT), 3-point bending, growth plate analyses, and histology. Results: Osteoblasts from male and female PAE mice displayed reduced bone formation, compared to control (less than or equal to 30%). Bglap and Ahsg were upregulated with PAE in both sexes compared to control, whereas Vegfa, Bmp6, Tgfbr1 and Flt1 were downregulated in PAE male osteoblasts only. In 12-week-old mice, uCT analysis revealed a sex and exposure interaction across several trabecular bone parameters. PAE was detrimental to the trabecular compartment in male mice compared to control, yet PAE females were unaffected. Both male and female mice had significant reductions in cortical parameters with PAE. Whilst male mice were negatively affected along the tibia length, females were only distally affected. Posterior cortical porosity was increased in PAE females only. Mechanical testing revealed PAE males had significantly reduced bone stiffness compared to controls; maximum load and yield was reduced in both sexes. PAE had no effect on total body weight or tibial bone length in either sex. However, total growth plate width in male PAE mice compared to control was reduced, whilst female PAE mice were unaffected. 4-week-old mice did not display the altered skeletal phenotype with PAE observed in 12-week-old animals. Conclusions: Evidence herein suggests for the first time that PAE exerts divergent sex effects on the skeleton, possibly influenced by underlying sex specific transcriptional mechanisms of osteoblasts. Establishing these sex differences will support future policies and clinical management of FASD.

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“…Alcohol exposure during foetal life appears to have a detrimental effect on bone development. Children with foetal alcohol spectrum disorders (FASD) have lower WBLH BMD in adolescence than controls [45]. This might reflect their shorter stature given the effect of bone size on BMD measurement by DXA, and greater exposure to other drugs of abuse is seen in children with FASD and might also affect bone health [45].…”

Section: Maternal Lifestyle In Pregnancy and Offspring Bone Healthmentioning

confidence: 99%

“…Children with foetal alcohol spectrum disorders (FASD) have lower WBLH BMD in adolescence than controls [45]. This might reflect their shorter stature given the effect of bone size on BMD measurement by DXA, and greater exposure to other drugs of abuse is seen in children with FASD and might also affect bone health [45]. However, animal studies have suggested that even low levels of alcohol exposure are deleterious to bone development independent of the effect on foetal growth [46].…”

Section: Maternal Lifestyle In Pregnancy and Offspring Bone Healthmentioning

confidence: 99%

Early Life Programming of Skeletal Health

Moon,

Citeroni,

Aihie

et al. 2023

Curr Osteoporos Rep

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Purpose of Review Increasing bone mineral accrual during childhood might delay the onset of osteoporosis. We discuss the scientific evidence for early life approaches to optimising skeletal health. Recent Findings There is an ever-growing body of evidence from observational studies suggesting associations between early life exposures, particularly during foetal development, and bone mineral density (BMD). The findings of such studies are often heterogeneous, and for some exposures, for example, maternal smoking and alcohol intake in pregnancy or age at conception, intervention studies are not feasible. The most frequently studied exposures in intervention studies are calcium or vitamin D supplementation in pregnancy, which overall suggest positive effects on offspring childhood BMD. Summary Maternal calcium and/or vitamin D supplementation during pregnancy appear to have positive effects on offspring BMD during early childhood, but further long-term follow-up is required to demonstrate persistence of the effect into later life.

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Altered bone and body composition in children and adolescents with confirmed prenatal alcohol exposure

Cited by 8 publications

References 40 publications

Factors to be considered as part of a holistic assessment for fetal alcohol spectrum disorder: A scoping review

Factors to be considered as part of a holistic assessment for fetal alcohol spectrum disorder: A scoping review

Sexually dimorphic effects of prenatal alcohol exposure on the murine skeleton

Early Life Programming of Skeletal Health

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