Can Fetal Alcohol Exposure Increase the Risk of Hypertension? A New Study in Children and Adolescents Diagnosed With Fetal Alcohol Spectrum Disorder Suggests It Can

Fetal Alcohol Spectrum Disorder (FASD) is a non-diagnostic umbrella term used to describe the spectrum of lifelong physical, mental and intellectual disabilities that can result from prenatal exposure to alcohol. Fetal Alcohol Spectrum Disorder is preventable when pregnant women abstain from drinking any type or amount of alcohol at any time during pregnancy. One in 100 children worldwide are affected. Prompt diagnosis and treatment referrals for infants and children improve functionality. Yet, conditions related to fetal alcohol exposure frequently remain unrecognized and untreated. Adults with both diagnosed and hidden Fetal Alcohol Spectrum Disorder experience significant cognitive, behavioral and executive functioning deficits. Co-morbid physical and psychiatric disorders are common. This editorial provides health professionals with information to understand and support adults with Fetal Alcohol Spectrum Disorder. Specific strategies related to initiating referrals to community services, communicating intentionally and responding positively to behavioral challenges are discussed.

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Suicidality and Associated Factors Among Individuals Assessed for Fetal Alcohol Spectrum Disorder Across the Lifespan in Canada

The Canadian Journal of Psychiatry ◽

10.1177/07067437211053288 ◽

2021 ◽

pp. 070674372110532

Author(s):

Katherine Flannigan ◽

Carly McMorris ◽

Amanda Ewasiuk ◽

Dorothy Badry ◽

Mansfield Mela ◽

...

Keyword(s):

Suicidal Ideation ◽

Affect Regulation ◽

Fetal Alcohol Spectrum Disorder ◽

Prenatal Alcohol Exposure ◽

Secondary Analysis ◽

Clinical Information ◽

Alcohol Exposure ◽

Spectrum Disorder ◽

Fetal Alcohol ◽

Fetal Alcohol Spectrum

Objective Individuals with fetal alcohol spectrum disorder (FASD) experience a range of complex neurodevelopmental, psychological, and socioenvironmental vulnerabilities. There is growing evidence that suicidal ideation, attempts, and death by suicide are significant concerns within this population. In this study, we (1) determined the rate of suicidal ideation/attempts in a large group of individuals with prenatal alcohol exposure (PAE) who were assessed for FASD in Canada and (2) investigated the associations between suicidal ideation/attempts and select demographic and biopsychosocial factors in this group. Method A secondary analysis of data from Canada's National FASD Database, a national repository of clinical information gathered through FASD assessment and diagnostic clinics across the country, was conducted. Descriptive analyses, chi-square/Fisher's exact tests, and binary logistic regression were used to examine demographic and biopsychosocial variables and their associations with suicidality. Results In our sample of 796 participants ( Mage = 17.7 years, range = 6–59; 57.6% male) assessed for FASD, 25.9% were reported to experience suicidal ideation/attempts. Numerous demographic and biopsychosocial factors were found to be significantly associated with suicidal ideation/attempts. The strongest associations with suicidal ideation/attempts were substance use, history of trauma/abuse, and impaired affect regulation. Conclusions With this study, we contribute to the emerging evidence of elevated risk of suicidality among individuals with PAE/FASD and improve our understanding of factors that may exacerbate this risk. Findings have relevance for improving screening, prevention, and proactive treatment approaches for individuals with PAE and FASD, their families, and wider support systems.

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Maternal iron nutriture as a critical modulator of fetal alcohol spectrum disorder risk in alcohol-exposed pregnancies

Biochemistry and Cell Biology ◽

10.1139/bcb-2017-0206 ◽

2018 ◽

Vol 96 (2) ◽

pp. 204-212 ◽

Cited By ~ 4

Author(s):

Kaylee K. Helfrich ◽

Nipun Saini ◽

Pamela J. Kling ◽

Susan M. Smith

Keyword(s):

Alcohol Consumption ◽

Fetal Alcohol Spectrum Disorder ◽

Iron Homeostasis ◽

Maternal Nutrition ◽

Premenopausal Women ◽

Alcohol Exposure ◽

Spectrum Disorder ◽

Fetal Alcohol ◽

Liver Iron ◽

Fetal Alcohol Spectrum

Alcohol consumption during pregnancy places the fetus at risk for permanent physical, cognitive, and behavioral impairments, collectively termed fetal alcohol spectrum disorder (FASD). However, prenatal alcohol exposure (PAE) outcomes vary widely, and growing evidence suggests that maternal nutrition is a modifying factor. Certain nutrients, such as iron, may modulate FASD outcomes. Untreated gestational iron deficiency (ID) causes persistent neurodevelopmental deficits in the offspring that affect many of the same domains damaged by PAE. Although chronic alcohol consumption enhances iron uptake and elevates liver iron stores in adult alcoholics, alcohol-abusing premenopausal women often have low iron reserves due to menstruation, childbirth, and poor diet. Recent investigations show that low iron reserves during pregnancy are strongly associated with a worsening of several hallmark features in FASD including reduced growth and impaired associative learning. This review discusses recent clinical and animal model findings that maternal ID worsens fetal outcomes in response to PAE. It also discusses underlying mechanisms by which PAE disrupts maternal and fetal iron homeostasis. We suggest that alcohol-exposed ID pregnancies contribute to the severe end of the FASD spectrum.

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Fine motor skills in a population of children in remote Australia with high levels of prenatal alcohol exposure and Fetal Alcohol Spectrum Disorder

BMC Pediatrics ◽

10.1186/s12887-017-0945-2 ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 3

Author(s):

Robyn Doney ◽

Barbara R. Lucas ◽

Rochelle E. Watkins ◽

Tracey W. Tsang ◽

Kay Sauer ◽

...

Keyword(s):

Motor Skills ◽

Fetal Alcohol Spectrum Disorder ◽

Prenatal Alcohol Exposure ◽

Alcohol Exposure ◽

Spectrum Disorder ◽

Fine Motor ◽

Fine Motor Skills ◽

Fetal Alcohol ◽

Prenatal Alcohol ◽

Fetal Alcohol Spectrum

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59 Fetal Alcohol Spectrum Disorder in Canada’s Children: Pediatric Advocacy for Optimal Physical and Mental Health

Paediatrics & Child Health ◽

10.1093/pch/pxaa068.058 ◽

2020 ◽

Vol 25 (Supplement_2) ◽

pp. e24-e25

Author(s):

Jocelynn Cook ◽

Ana Hanlon-Dearman ◽

Kathy Unsworth

Keyword(s):

Public Health ◽

Mental Health ◽

At Risk ◽

Children And Adolescents ◽

Fetal Alcohol Spectrum Disorder ◽

Spectrum Disorder ◽

Physical And Mental Health ◽

Fetal Alcohol ◽

Canadian Population ◽

Fetal Alcohol Spectrum

Abstract Introduction/Background Fetal Alcohol Spectrum Disorder (FASD) is a diagnostic term used to describe the range of physical and neurobehavioural effects that may result from prenatal exposure to alcohol. With school prevalence figures of approximately 4%, this may represent as many as 224,000 children across Canada. The pediatrician is key to identifying children who may be at risk based on exposure and in providing regular health and developmental surveillance to families caring for these children. To date, information about the range of specific co-morbidities in the paediatric population has not been clearly established for the Canadian population. The Canadian National FASD Dataform has been collecting diagnostic and assessment data from specialty FASD clinics across Canada for the last 6 years. Objectives The purpose of this abstract is to describe the physical and mental health conditions seen in children and adolescents with FASD in Canada. Design/Methods The Canadian National Dataform collects information from 29 Canadian FASD diagnostic clinics. Dataform started in 2011 as a project funded by the Public Health Agency of Canada to provide national clinical information on FASD in Canada. The database is hosted on the RedCap platform. De-identified clinical data collected includes information on FASD diagnoses, other prenatal exposures, brain domains of impairment and physical/mental health co-morbidities. Descriptive and quantitative analyses were used to compare individuals with and without FASD in the sample. Results Of the 1,684 records in the database, 58% had FASD, 11% were designated as At Risk for FASD and 31% did not receive an FASD-related diagnosis. Nine percent (N=152) were between the ages of 0-5 years, 46% (N=780) were 6-12 years and 24% (N=402) were 13-17 years of age. Of all individuals with FASD, 53% were also exposed prenatally to other substances including nicotine (43%), cannabis (29%) and cocaine/crack (18%), which did not significantly differ from the exposures of those who do not have FASD in the sample. Eighty-eight percent of the sample had confirmed prenatal alcohol exposure (PAE). Data show that children and adolescents across all age groups who meet criteria for FASD had significantly more impairment across each of the 10 brain domains measured when compared to those who have PAE but do not meet criteria for an-FASD diagnosis (Figure 1). The children and adolescents with FASD had significantly higher physical and mental health co-morbidities across all age cohorts (Tables 1 and 2). It is important to note that, in most cases, the rates of co-morbidities are higher than in the general Canadian population. Conclusion Children with FASD/PAE are at risk for physical and mental health co-morbidity and on-going risk for developing new and significant health challenges. They should be followed by a community pediatrician. Appropriate anticipatory guidance should be provided to families at check-ups, including referrals for early intervention. A community team to support families caring for complex children optimizes developmental outcomes, reducing the burden of care. Understanding complexities of PAE changes how we consider public health policy/service delivery.

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RE-AIM Evaluation of the Alcohol and Pregnancy Project: Educational Resources to Inform Health Professionals About Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorder

Evaluation & the Health Professions ◽

10.1177/0163278710381261 ◽

2011 ◽

Vol 34 (1) ◽

pp. 57-80 ◽

Cited By ~ 15

Author(s):

Janet M. Payne ◽

Kathryn E. France ◽

Nadine Henley ◽

Heather A. D'Antoine ◽

Anne E. Bartu ◽

...

Keyword(s):

Health Professionals ◽

Fetal Alcohol Spectrum Disorder ◽

Prenatal Alcohol Exposure ◽

Alcohol Exposure ◽

Spectrum Disorder ◽

Educational Resources ◽

Fetal Alcohol ◽

Prenatal Alcohol ◽

Fetal Alcohol Spectrum

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Making Research More Ethical for Adults with Fetal Alcohol Spectrum Disorder

Research Involving Participants with Cognitive Disability and Difference ◽

10.1093/oso/9780198824343.003.0015 ◽

2019 ◽

pp. 173-184

Author(s):

John Aspler

Keyword(s):

Focus Group ◽

Fetal Alcohol Spectrum Disorder ◽

Alcohol Exposure ◽

In Utero ◽

Spectrum Disorder ◽

Fetal Alcohol ◽

Focus Group Interviews ◽

Focus Group Study ◽

Group Interviews ◽

Fetal Alcohol Spectrum

In this chapter, the author reflects on challenges associated with conducting focus group interviews with adults with fetal alcohol spectrum disorder (FASD)—a complex neurodevelopmental disability caused by alcohol exposure in utero. Given the heterogeneity of this diagnosis, people with FASD have different strengths and weaknesses. Therefore, for effective and ethical research inclusion, each person with FASD may need unique accommodations, which can help to both minimize concerns about unjust research exclusion and mitigate sources of vulnerability. To explore these issues, the author describes the focus group study, presents anticipated risks and challenges, explores critical stakeholder feedback, and addresses ethical tensions arising from the resulting protocol adjustments. This chapter demonstrates the importance of researchers remaining open to criticism and being willing to work through their moral discomfort.

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