Dysmorphic features in offspring of alcoholic mothers.

Autti‐Rämö, Ilona; Gaily, Eija; Granström, Marja‐Liisa

doi:10.1136/adc.67.6.712

Cited by 39 publications

(17 citation statements)

References 28 publications

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“…Studies with both positive and negative results are reported. 8,12,14 Although among women who drank moderately we found a significant association between binge drinking and their children's risk of renal agenesis or hypoplasia, we cannot interpret this finding with the available data.…”

Section: Discussionmentioning

confidence: 71%

Does Light-to-Moderate Alcohol Consumption During Pregnancy Increase the Risk for Renal Anomalies Among Offspring?

1997

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ABSTRACT. Objective. To determine the association between light-to-moderate prenatal alcohol exposure and congenital renal anomalies.Methods. Data from the population-based Atlanta Birth Defects Case-Control Study were used to examine the association between selected renal anomalies and self-reported maternal alcohol consumption during the period from 1 month before through 3 months after conception. Case infants were ascertained by a populationbased birth defects registry with active case ascertainment; the case group consisted of 158 infants, born during 1968 through 1980 to metropolitan Atlanta residents, in whom these renal anomalies had been diagnosed. Two control groups were used. One had 3029 infants without birth defects, and the other had 4633 infants with birth defects exclusive of the urinary tract who were born during the same period.Results. Overall, there was a moderate association between renal anomalies and moderate prenatal alcohol exposure (odds ratio, 1.5; 95% confidence interval, 1.0 to 2.3). When the renal anomalies were subclassified, moderate prenatal alcohol exposure was significantly associated only with renal agenesis or hypoplasia (odds ratio, 2.5; 95% confidence interval, 1.2 to 5.1), and within this group only infants with bilateral defects and other major anomalies in addition to renal agenesis or hypoplasia had significantly elevated risks. There were no significant associations between reported light consumption and any category of the selected renal anomalies. No conclusions could be reached for reported heavy consumption because of sparse data. Adjustments for potential confounding factors did not alter these results.Conclusion. This study suggests that moderate alcohol consumption during pregnancy may increase a woman's risk of giving birth to a child with renal agenesis or hypoplasia. Pediatrics 1997;99(4). URL: http://www. pediatrics.org/cgi/content/full/99/4/e11; renal anomalies, renal agenesis, prenatal ethanol exposure, multiple congenital anomalies.

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Section: Discussionmentioning

confidence: 71%

Does Light-to-Moderate Alcohol Consumption During Pregnancy Increase the Risk for Renal Anomalies Among Offspring?

1997

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“…One could speculate that the intellectual problems in MPKU offspring could be similar in origin to those seen in the fetal alcohol syndrome since increased blood Phe during pregnancy has resulted in offspring facial dysmorphology [ 19] similar to that observed in fetal alcohol syndrome [2,3] and congenital pyruvate dehydrogenase deficiency [ 18]. Phenylpyruvate (a byproduct of Phe metabolism) and acetaldehyde (a byproduct of alcohol metabolism) are both potent inhibitors of pyruvate dehydrogenase.…”

Section: Discussionmentioning

confidence: 99%

The North American Maternal Phenylketonuria Collaborative Study, developmental assessment of the offspring: preliminary report

et al. 1996

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Preliminary results of 2-year Bayley and 4-year McCarthy test scores are presented. To date numbers are too small to statistically correlate:- offspring from pregnancies in which diet was started prior to conception, offspring from pregnancies with phenylalanine (Phe) levels of 120-360 mumol/l versus 360-600 mumol/l, influence of home environment, influence of maternal nutrition, language development, behaviour/hyperactivity, Revised Wechsler Intelligence Score, school performance and learning disabilities. Two-year Bayley scores (mental and motor) revealed a median developmental quotient of 113 in 58 offspring from control pregnancies, 104 in 19 offspring from untreated "non-phenylketonuria (PKU) mild hyperphenylalaninaemia" (natural Phe levels < 600 mumol/l) pregnancies, 104 in 32 offspring from pregnancies whose Phe levels decreased on treatment to < 600 mumol/l by 10 weeks gestation and remained in that range for the remainder of the pregnancy, 98 in offspring from 32 pregnancies where permanent control was not achieved until 10-20 weeks and 72 in offspring from 51 pregnancies where control was not attained until after 20 weeks gestation. IQ scores determined by the McCarthy test at age 4-5 years revealed a mean of 112 in 43 offspring of control mothers, 99 in 12 offspring of "non PKU mild hyperphenylalaninaemia" women, 93 in 14 offspring whose mother's Phe levels were continuously under 600 mumol/l by 10 weeks gestation, 88 in 24 offspring from pregnancies in metabolic control by 10-20 weeks and 73 in 28 offspring of pregnancies not in metabolic control until after 20 weeks gestation. These preliminary results suggest that early and adequate dietary treatment during pregnancy in maternal PKU may provide some protection to the fetus for later intellectual development but much more data is required before definitive statements about cognition can be made.

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“…The clinical features are identical to those of the foetal alcohol syndrome (Clarren & Smith, 1978;Autti-Ramo et al, 1992) and, in fact, may be due to the same mechanism -interference with the activity of pyruvate dehydrogenase (Robinson, 1987;Hard, 2001). Numerous reviews have been published (Hanley et al, 1987) since the problem of MPKU was initially raised in 1963 by Mabry (Mabry et al, 1963).…”

Section: Maternal Pku (Mpku)mentioning

confidence: 76%