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

2018 ◽  
Vol 96 (2) ◽  
pp. 204-212 ◽  
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.

scholarly journals Understanding and Supporting Adults with Fetal Alcohol Spectrum Disorder - Strategies for Health Professionals: an Opinion Piece

2018 ◽  
Author(s):  
Amy Martyniuk ◽  
Sherri Melrose
Keyword(s):  
Health Professionals ◽  
Fetal Alcohol Spectrum Disorder ◽  
Alcohol Exposure ◽  
Community Services ◽  
Spectrum Disorder ◽  
Fetal Alcohol ◽  
Behavioral Challenges ◽  
Executive Functioning Deficits ◽  
Fetal Alcohol Spectrum ◽  
Prompt Diagnosis

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.

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

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.

Making Research More Ethical for Adults with Fetal Alcohol Spectrum Disorder

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.

Understanding and managing sleep disruption in children with fetal alcohol spectrum disorder

2018 ◽  
Vol 96 (2) ◽  
pp. 267-274 ◽  
Author(s):  
Ana Hanlon-Dearman ◽  
Maida Lynn Chen ◽  
Heather Carmichael Olson
Keyword(s):  
Fetal Alcohol Spectrum Disorder ◽  
Sleep Problems ◽  
Prenatal Alcohol Exposure ◽  
Alcohol Exposure ◽  
Evidence Base ◽  
Spectrum Disorder ◽  
Rational Approach ◽  
Sleep Disruption ◽  
Fetal Alcohol ◽  
Fetal Alcohol Spectrum

Accumulating evidence has revealed high rates of sleep disruption among children with fetal alcohol spectrum disorder (FASD). Multiple animal and clinical studies have found a clear association between sleep problems and prenatal alcohol exposure, and recent research is beginning to characterize the types and extent of sleep disruption in FASD. Nevertheless, sleep disruption in children with FASD often goes unrecognized or is treated without referring to an evidence base. Children’s disrupted sleep interferes with parental sleep and increases caregiver burden, which is of particular importance for families raising children with FASD, a group with very high levels of caregiving stress. The literature supporting an association between sleep problems and deficits in emotional, behavioral, and cognitive function in children is compelling, but needs further investigation in children with FASD. This paper will review the current state of knowledge on sleep in FASD and recommend a rational approach to sleep interventions for affected children and their families.

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