The Hidden Face of Fetal Alcohol Spectrum Disorder

Schwartz, Megan; Hart, Brandon; Weyrauch, Deland; Benson, Perry W.; Klug, Marilyn G.; Burd, Larry

doi:10.2174/1573404813666170418114243

Cited by 10 publications

(9 citation statements)

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“…A frequent clinical concern is how to improve our understanding of how a diagnosis of FASD should change routine clinical care compared to people with other neurodevelopmental disorders or people who do not have FASD. The current study presents a compelling case for early diagnosis and specialized treatment plans for children with FASD [16, 25, 40]. The rates of potentially preventable problems in people with FASD are compelling.…”

Section: Discussionmentioning

confidence: 99%

“…A diagnosis of FASD is also an important risk marker for maternal mortality. The maternal mortality rate in the 10-year period after birthing a child with FASD is about 4.5% and represents a 35-fold increase in mortality risk for birth mothers of a person with FASD [25]. Currently, there is very little information available regarding mortality risk for fathers of children with FASD.…”

Section: Introductionmentioning

confidence: 99%

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Association of adverse childhood experiences and neurodevelopmental disorders in people with fetal alcohol spectrum disorders (FASD) and non-FASD controls

et al. 2019

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BackgroundFetal alcohol spectrum disorder (FASD) is a highly prevalent lifelong disorder with high rates of comorbid neurodevelopmental disorders. Individuals with FASD are often exposed to abuse, neglect and foster home placements which have uncertain effects on the lifelong course of FASD. In this study we compare the prevalence of adverse childhood events (ACEs) and neurodevelopmental disorders in subjects with fetal alcohol spectrum disorders (FASD) and non-FASD controls.MethodsA cross-sectional chart review of patients referred to a regional developmental center was used to identify people with FASD and non-FASD controls. We recorded the number of ACEs and neurodevelopmental disorders in each patient’s chart. The most common diagnoses were attention deficit hyperactivity disorder, comprehension deficits, sleep disorders, and cognitive impairments. T-tests and a regression equation were utilized to determine significant differences between the groups.ResultsThe review identified 203 subjects, 98 with FASD and 105 non-FASD controls. Group mean age was 8.6 years and 64.5% were male. People with FASD were more likely to have any ACEs (mean 5.3) with ACE scores 3.7 points higher than non-FASD controls (mean 1.69) (t = 11.29; p < .001). Increased ACEs were associated with increased rates of neurodevelopmental disorders for people with FASD (R = .179, p = .026) but not for non-FASD controls (R = .130, p = .094).Conclusions: Both FASD and subsequent exposure to ACEs are associated with increased risk for development of comorbid neurodevelopmental disorders. Prevention of ACEs during childhood may decrease risk for development of comorbid neurodevelopmental disorders.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association of adverse childhood experiences and neurodevelopmental disorders in people with fetal alcohol spectrum disorders (FASD) and non-FASD controls

et al. 2019

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“…4 Two studies have reviewed mortality rates for mothers with high levels of alcohol use during pregnancy and women who had a child diagnosed with FASD. 5,6 Both of these meta-analyses found large increases in mortality risk for these mothers. In the most recent review, the mean of the weighted mortality proportion was 11.25%.…”

Section: Introductionmentioning

confidence: 98%

What Do We Know About Prevalence and Management of Intoxicated Women During Labor and Delivery?

Schaff

Moreno

Foster

et al. 2019

Global Pediatric Health

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Objective. To review the published literature on women who were intoxicated at delivery and outcomes for their infants. Methods. A systematic literature review was utilized to identify articles meeting our inclusion criteria. After screening using titles and abstracts, we identified 34 articles requiring full-text review. Each of these were reviewed by at least 2 of the authors. We identified 12 articles that met our inclusion criteria. Results. We identified case reports of 16 mothers who delivered with a blood alcohol concentration (BAC) ranging from 42.1 to 473 mg/dL. Three of the pregnancies (18.8%) ended with a stillbirth, 5 (31.3%) were infant deaths, 6 (37.5%) lived, and 2 (12.5%) had no fetal or infant outcome reported. The BAC for the stillborn infants ranged from 120 to 460 mg/dL. The BAC among the infant deaths ranged from 96 to 715 mg/dL. Among surviving infants, the BAC ranged from 38.4 to 246.5 mg/dL. Conclusion. We identified no deaths with a BAC <96 mg/dL. However, it is not clear if this represents the lower level of BAC where mortality risk increases. In this article, we present 9 suggestions to improve detection and management of these mothers and their infants.

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“…It often reoccurs within sibships and the mortality among birth mothers of children diagnosed with an FASD is increased by nearly 39-fold. 2 , 5 , 6 Recent data demonstrate that 11.9% of non-pregnant women and 5.3% of pregnant women age 15–44 reported illicit drug use in November, 2016. 1 Alcohol use at levels meeting criteria for binge or heavy drinking was reported by 23.7% of non-pregnant women and 2.8% of pregnant women.…”

Section: Introductionmentioning

confidence: 99%

Substance Use in Pregnant Women Using the Emergency Department: Undertested And Overlooked?

Moyer

Johnson

Klug

et al. 2018

WestJEM

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IntroductionThe objective was to determine if pregnant women visiting the emergency department (ED) are tested for substance use as frequently as non-pregnant women.MethodsWe captured all ED visits over a six-year period (2010–2016) from a single community hospital and identified women of childbearing age, defined for our study as 11–50 years old. We collected demographic data including age in years, ethnicity, body mass index, marital status, disposition, last encounter department, method of arrival, and day of week. An independent binary variable was created based on whether the woman was tested for alcohol or drugs (amphetamines, barbiturates, benzodiazepines, cannabis, cocaine, opioids) during her visit. We then compared rates of testing for substance use by pregnancy status.ResultsWe identified 61,222 ED visits by women of childbearing age (range 11–50, mean 30.5, standard deviation 9.6) over a six-year period from 2010–2016. Of the 57,360 non-pregnant women, 4.14% were tested compared to 1.04% of the 3,862 pregnant women tested with a relative risk of 0.25 (p<0.001, 95% confidence interval [CI] [0.183–0.341]). The most highly tested chief complaints for all women – psychiatric or substance use concerns – showed pregnant women were still 37% and 54% less likely to be tested, respectively (risk ratio [RR] 0.46, 95% CI [0.19–1.13]; RR 0.63, 95% CI [0.41–0.96]). Beyond pregnancy status, we found no significant interaction between patient demographics and substance use testing.ConclusionPregnant women presenting to the ED were 75% less likely to be tested for drug or alcohol use than non-pregnant women. Our study showed only pregnancy status as a statistically significant variable in drug- and alcohol-screening rates when pregnant and non-pregnant patient chief complaints and demographics were compared. Increased attention to the screening of pregnant women for substance use may be necessary to provide adequate care and intervention to this population.

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The Hidden Face of Fetal Alcohol Spectrum Disorder

Cited by 10 publications

References 0 publications

Association of adverse childhood experiences and neurodevelopmental disorders in people with fetal alcohol spectrum disorders (FASD) and non-FASD controls

Association of adverse childhood experiences and neurodevelopmental disorders in people with fetal alcohol spectrum disorders (FASD) and non-FASD controls

What Do We Know About Prevalence and Management of Intoxicated Women During Labor and Delivery?

Substance Use in Pregnant Women Using the Emergency Department: Undertested And Overlooked?

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