Behavioral Teratogenic Effects of Alcohol: Focus on Neurobehavioral Disorder Associated With Prenatal Alcohol Exposure

2018 ◽  
Author(s):  
Lauren R. Doyle ◽  
Sarah N. Mattson
Keyword(s):  
Adaptive Functioning ◽  
Fetal Alcohol Spectrum Disorders ◽  
Prenatal Alcohol Exposure ◽  
Self Regulation ◽  
Alcohol Exposure ◽  
Later Life ◽  
Preliminary Evidence ◽  
Functional Impairments ◽  
Effective Interventions ◽  
Prenatal Alcohol

Prenatal exposure to teratogens may alter fetal development and significantly impact later life. Perhaps the best known teratogen is alcohol; prenatal alcohol exposure causes a broad range of effects that can cause lifelong impairment. Of greatest significance are the functional impairments in behavior and cognition. Recognition of these impairments led to the inclusion of the neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders under “conditions for further study.” This proposed diagnosis captures the significant neurodevelopmental and mental health impacts associated with prenatal alcohol exposure and requires impairment in neurocognitive functioning, self-regulation, and adaptive functioning. This chapter reviews clinical impacts of prenatal alcohol exposure, with particular focus on ND-PAE. Methods for comprehensively assessing fetal alcohol spectrum disorders, specifically ND-PAE, are discussed as well as preliminary evidence for implementing effective interventions with these individuals.

scholarly journals Association between fetal sex and maternal plasma microRNA responses to prenatal alcohol exposure: evidence from a birth outcome-stratified cohort

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Nihal A. Salem ◽  
◽  
Amanda H. Mahnke ◽  
Alan B. Wells ◽  
Alexander M. Tseng ◽  
...  
Keyword(s):  
Statistical Power ◽  
Fetal Alcohol Spectrum Disorders ◽  
Birth Outcome ◽  
Prenatal Alcohol Exposure ◽  
Statistical Parameter ◽  
Alcohol Exposure ◽  
Later Life ◽  
Parameter Estimates ◽  
Fetal Sex ◽  
Prenatal Alcohol

Abstract Most persons with fetal alcohol spectrum disorders (FASDs) remain undiagnosed or are diagnosed in later life. To address the need for earlier diagnosis, we previously assessed miRNAs in the blood plasma of pregnant women who were classified as unexposed to alcohol (UE), heavily exposed with affected infants (HEa), or heavily exposed with apparently unaffected infants (HEua). We reported that maternal miRNAs predicted FASD-related growth and psychomotor deficits in infants. Here, we assessed whether fetal sex influenced alterations in maternal circulating miRNAs following prenatal alcohol exposure (PAE). To overcome the loss of statistical power due to disaggregating maternal samples by fetal sex, we adapted a strategy of iterative bootstrap resampling with replacement to assess the stability of statistical parameter estimates. Bootstrap estimates of parametric and effect size tests identified male and female fetal sex-associated maternal miRNA responses to PAE that were not observed in the aggregated sample. Additionally, we observed, in HEa mothers of female, but not male fetuses, a network of co-secreted miRNAs whose expression was linked to miRNAs encoded on the X-chromosome. Interestingly, the number of significant miRNA correlations for the HEua group mothers with female fetuses was intermediate between HEa and UE mothers at mid-pregnancy, but more similar to UE mothers by the end of pregnancy. Collectively, these data show that fetal sex predicts maternal circulating miRNA adaptations, a critical consideration when adopting maternal miRNAs as diagnostic biomarkers. Moreover, a maternal co-secretion network, predominantly in pregnancies with female fetuses, emerged as an index of risk for adverse birth outcomes due to PAE.

scholarly journals Screening in treatment programs for Fetal Alcohol Spectrum Disorders that could affect therapeutic progress

2013 ◽  
Vol 2 (3) ◽  
pp. 37-49 ◽  
Author(s):  
Therese M Grant ◽  
Natalie Novick Brown ◽  
J. Christopher Graham ◽  
Nancy Whitney ◽  
Dan Dubovsky ◽  
...  
Keyword(s):  
Life History ◽  
Fetal Alcohol Spectrum Disorders ◽  
Prenatal Alcohol Exposure ◽  
Cognitive Impairments ◽  
Alcohol Exposure ◽  
Treatment Programs ◽  
Fetal Alcohol ◽  
Prenatal Alcohol ◽  
Spectrum Disorders ◽  
Fetal Alcohol Spectrum

Grant, T., Novick Brown, N., Graham, J., Whitney, N., Dubovsky, D. , & Nelson, L. (2013). Screening in treatment programs for Fetal Alcohol Spectrum Disorders that could affect therapeutic progress. The International Journal Of Alcohol And Drug Research, 2(3), 37-49. doi:10.7895/ijadr.v2i3.116 (http://dx.doi.org/10.7895/ijadr.v2i3.116)Aims: While structured intake interviews are the standard of care in substance abuse treatment programs, these interviews often do not screen for cognitive impairments, such as those found in fetal alcohol spectrum disorders (FASD) and other brain-based developmental disorders. The research reported here supports a brief interview protocol, the Life History Screen (LHS), that screens clients unobtrusively for adverse life-course outcomes typically found in FASD, so as to guide follow-up assessments and treatment planning.Design: Two-group observational study.Setting: A three-year case management intervention program in Washington State for high-risk women who abuse alcohol and/or drugs during pregnancy.Participants: Group 1: No prenatal alcohol exposure (N = 463); Group 2: Diagnosed with FASD (Fetal Alcohol Syndrome, Alcohol Related Neurodevelopmental Disorder, fetal alcohol effects, or static encephalopathy) by a qualified physician (N = 25), or suspected of having FASD (reported prenatal alcohol exposure and displayed behaviors consistent with a clinical diagnosis of FASD) (N = 61).Measures: The Addiction Severity Index (ASI) was administered to participants at intake. We analyzed eleven ASI items that corresponded to questions on the LHS in order to assess the potential of the LHS for identifying adults with possible FASD. The Life History Screen itself was not administered.Findings: Analysis of group differences between the diagnosed FASD and suspected FASD groups supported our decision to collapse the two groups for the main analysis. The Life History Screen shows promise as an efficient pre-treatment screen, in that core items are significantly associated with FASD group membership on factors involving childhood history, maternal drinking, education, substance use, employment, and psychiatric symptomatology.Conclusions: The Life History Screen may have utility as a self-report measure that can be used at the outset of treatment to identify clients with cognitive impairments and learning disabilities due to prenatal alcohol exposure.

scholarly journals Executive Functioning Correlates With Communication Ability in Youth With Histories of Heavy Prenatal Alcohol Exposure

2018 ◽  
Vol 24 (10) ◽  
pp. 1026-1037 ◽  
Author(s):  
Lauren R. Doyle ◽  
Eileen M. Moore ◽  
Claire D. Coles ◽  
Julie A. Kable ◽  
Elizabeth R. Sowell ◽  
...  
Keyword(s):  
Working Memory ◽  
Executive Function ◽  
Fetal Alcohol Spectrum Disorders ◽  
Spatial Working Memory ◽  
Prenatal Alcohol Exposure ◽  
Alcohol Exposure ◽  
Global Model ◽  
Vineland Adaptive Behavior Scales ◽  
Communication Ability ◽  
Prenatal Alcohol

AbstractObjectives: Caregivers of youth with heavy prenatal alcohol exposure report impaired communication, which can significantly impact quality of life. Using data collected as part of the Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CIFASD), we examined whether cognitive variables predict communication ability of youth with histories of heavy prenatal alcohol exposure. Methods: Subjects (ages 10–16 years) comprised two groups: adolescents with heavy prenatal alcohol exposure (AE) and non-exposed controls (CON). Selected measures of executive function (NEPSY, Delis-Kaplan Executive Function System), working memory (CANTAB), and language were tested in the child, while parents completed communication ratings (Vineland Adaptive Behavior Scales – Second Edition). Separate multiple regression analyses determined which cognitive domains predicted communication ability. A final, global model of communication comprised the three cognitive models. Results: Spatial Working Memory and Inhibition significantly contributed to communication ability across groups. Twenty Questions performance related to communication ability in the CON group only while Word Generation performance related to communication ability in the AE group only. Effects remained significant in the global model, with the exception of Spatial Working Memory. Conclusions: Both groups displayed a relation between communication and Spatial Working Memory and Inhibition. Stronger communication ability related to stronger verbal fluency in the AE group and Twenty Questions performance in the CON group. These findings suggest that alcohol-exposed adolescents may rely more heavily on learned verbal storage or fluency for daily communication while non-exposed adolescents may rely more heavily on abstract thinking and verbal efficiency. Interventions aimed at aspects of executive function may be most effective at improving communication ability of these individuals. (JINS, 2018, 24, 1026–1037)

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