Fetal Alcohol Syndrome: a complex case of teratogenic effects of maternal alcohol consumption and clinical managment
DOI:
https://doi.org/10.12775/QS.2024.15.52107Keywords
fetal alcohol syndrome, FAS, alcohol, teratogenic effect of alcoholAbstract
Introduction and purpose
Maternal alcohol consumption during pregnancy is a well-documented risk factor for adverse fetal outcomes, encompassing a spectrum of disorders known as Fetal Alcohol Spectrum Disorders (FASD). Fetal Alcohol Syndrome (FAS), the most severe form of FASD, manifests with craniofacial anomalies, growth retardation, neurological deficits, and cognitive impairments, imposing lifelong challenges on affected individuals.
This article presents a case report of a 4-week-old female newborn with suspected Fetal Alcohol Syndrome, highlighting the clinical complexities and diagnostic challenges associated with FAS. The infant exhibited characteristic dysmorphic features and cardiac abnormalities, underscoring the diverse spectrum of health issues linked to maternal alcohol consumption.
Conclusion
A presented case report illustrating the clinical complexities of FAS underscores the importance of early recognition and multidisciplinary management. Early identification of FAS is imperative to mitigate long-term outcomes, emphasizing the importance of a multidisciplinary and holistic approach to clinical care. Strategies for addressing maternal alcohol consumption include targeted education, preconception counseling, and innovative therapeutic modalities.
This case report underscores the need for ongoing research and collaborative efforts to reduce the prevalence and impact of FASD on affected individuals and society.
References
Denny L, Coles S, Blitz R. Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorders. Am Fam Physician. 2017 Oct 15;96(8):515-522. PMID: 29094891.
Walker DS, Edwards WE, Herrington C. Fetal alcohol spectrum disorders: Prevention, identification, and intervention. Nurse Pract. 2016 Aug 18;41(8):28-34. doi: 10.1097/01.NPR.0000488709.67444.92. PMID: 27414813.
Lange S, Probst C, Gmel G, Rehm J, Burd L, Popova S. Global Prevalence of Fetal Alcohol Spectrum Disorder Among Children and Youth: A Systematic Review and Meta-analysis. JAMA Pediatr. 2017 Oct 1;171(10):948-956. doi: 10.1001/jamapediatrics.2017.1919. PMID: 28828483; PMCID: PMC5710622.
https://bip.brpo.gov.pl/pl/content/ciaza-alkohol-dzieci-apel-rpo-dwoch-resortow
Popova S, Dozet D, Akhand Laboni S, Brower K, Temple V. Why do women consume alcohol during pregnancy or while breastfeeding? Drug Alcohol Rev. 2022 May;41(4):759-777. doi: 10.1111/dar.13425. Epub 2021 Dec 28. PMID: 34963039; PMCID: PMC9305227.
Evans S. Women with alcohol dependence and FASD prevention. Drug Alcohol Rev. 2023 Jan;42(1):33-35. doi: 10.1111/dar.13516. Epub 2022 Jul 22. PMID: 35866739.
https://podyplomie.pl/medycyna/23788,alkohol-a-ciaza
Addila AE, Azale T, Gete YK, Yitayal M. The effects of maternal alcohol consumption during pregnancy on adverse fetal outcomes among pregnant women attending antenatal care at public health facilities in Gondar town, Northwest Ethiopia: a prospective cohort study. Subst Abuse Treat Prev Policy. 2021 Aug 26;16(1):64. doi: 10.1186/s13011-021-00401-x. PMID: 34446055; PMCID: PMC8390259.
Weile LKK, Hegaard HK, Wu C, Tabor A, Wolf HT, Kesmodel US, Henriksen TB, Nohr EA. Alcohol Intake in Early Pregnancy and Spontaneous Preterm Birth: A Cohort Study. Alcohol Clin Exp Res. 2020 Feb;44(2):511-521. doi: 10.1111/acer.14257. Epub 2019 Dec 26. PMID: 31803953.
Sundermann AC, Zhao S, Young CL, Lam L, Jones SH, Velez Edwards DR, Hartmann KE. Alcohol Use in Pregnancy and Miscarriage: A Systematic Review and Meta-Analysis. Alcohol Clin Exp Res. 2019 Aug;43(8):1606-1616. doi: 10.1111/acer.14124. Epub 2019 Jul 3. PMID: 31194258; PMCID: PMC6677630.
Abel EL. Prenatal effects of alcohol. Drug Alcohol Depend. 1984 Sep;14(1):1-10. doi: 10.1016/0376-8716(84)90012-7. PMID: 6386408.
Popova S, Dozet D, Shield K, Rehm J, Burd L. Alcohol's Impact on the Fetus. Nutrients. 2021 Sep 29;13(10):3452. doi: 10.3390/nu13103452. PMID: 34684453; PMCID: PMC8541151.
Cone-Wesson B. Prenatal alcohol and cocaine exposure: influences on cognition, speech, language, and hearing. J Commun Disord. 2005 Jul-Aug;38(4):279-302. doi: 10.1016/j.jcomdis.2005.02.004. Epub 2005 Apr 8. PMID: 15862811.
McLaughlin SA, Thorne JC, Jirikowic T, Waddington T, Lee AKC, Astley Hemingway SJ. Listening Difficulties in Children With Fetal Alcohol Spectrum Disorders: More Than a Problem of Audibility. J Speech Lang Hear Res. 2019 May 21;62(5):1532-1548. doi: 10.1044/2018_JSLHR-H-18-0359. PMID: 31039324.
Oei JL. Alcohol use in pregnancy and its impact on the mother and child. Addiction. 2020 Nov;115(11):2148-2163. doi: 10.1111/add.15036. Epub 2020 Jun 3. PMID: 32149441.
Momin SZ, Le JT, Miranda RC. Vascular Contributions to the Neurobiological Effects of Prenatal Alcohol Exposure. Adv Drug Alcohol Res. 2023;3:10924. doi: 10.3389/adar.2023.10924. Epub 2023 Apr 12. PMID: 37205306; PMCID: PMC10191416.
Hoyme HE, Kalberg WO, Elliott AJ, Blankenship J, Buckley D, Marais AS, Manning MA, Robinson LK, Adam MP, Abdul-Rahman O, Jewett T, Coles CD, Chambers C, Jones KL, Adnams CM, Shah PE, Riley EP, Charness ME, Warren KR, May PA. Updated Clinical Guidelines for Diagnosing Fetal Alcohol Spectrum Disorders. Pediatrics. 2016 Aug;138(2):e20154256. doi: 10.1542/peds.2015-4256. Epub 2016 Jul 27. PMID: 27464676; PMCID: PMC4960726.
Denny L, Coles S, Blitz R. Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorders. Am Fam Physician. 2017 Oct 15;96(8):515-522. PMID: 29094891.
Lesinskienė S, Žilinskas E, Utkus A, Marčiukaitytė R, Vasiliauskaitė G, Stankevičiūtė R, Kinčinienė O. Fetal Alcohol Spectrum Disorders and Inadequacy of Care: Importance of Raising Awareness in Clinical Practice. Children (Basel). 2023 Dec 20;11(1):5. doi: 10.3390/children11010005. PMID: 38275426; PMCID: PMC10814035.
Mencarelli A, Prontera P, Stangoni G, Troiani S, Becchetti T, Pacitto A, Esposito S. Porencephaly in an Italian neonate with foetal alcohol spectrum disorder: A case report. Medicine (Baltimore). 2020 Jul 31;99(31):e21384. doi: 10.1097/MD.0000000000021384. PMID: 32756128; PMCID: PMC7402805.
Hoyme HE, Kalberg WO, Elliott AJ, Blankenship J, Buckley D, Marais AS, Manning MA, Robinson LK, Adam MP, Abdul-Rahman O, Jewett T, Coles CD, Chambers C, Jones KL, Adnams CM, Shah PE, Riley EP, Charness ME, Warren KR, May PA. Updated Clinical Guidelines for Diagnosing Fetal Alcohol Spectrum Disorders. Pediatrics. 2016 Aug;138(2):e20154256. doi: 10.1542/peds.2015-4256. Epub 2016 Jul 27. PMID: 27464676; PMCID: PMC4960726.
Caputo C, Wood E, Jabbour L. Impact of fetal alcohol exposure on body systems: A systematic review. Birth Defects Res C Embryo Today. 2016 Jun;108(2):174-80. doi: 10.1002/bdrc.21129. Epub 2016 Jun 13. PMID: 27297122.
Onesimo R, De Rose C, Delogu AB, Battista A, Leoni C, Veltri S, De Rosa G, Zampino G. Two case reports of fetal alcohol syndrome: broadening into the spectrum of cardiac disease to personalize and to improve clinical assessment. Ital J Pediatr. 2019 Dec 19;45(1):167. doi: 10.1186/s13052-019-0759-y. PMID: 31856879; PMCID: PMC6923862.
Burd L, Deal E, Rios R, Adickes E, Wynne J, Klug MG. Congenital heart defects and fetal alcohol spectrum disorders. Congenit Heart Dis. 2007 Jul-Aug;2(4):250-5. doi: 10.1111/j.1747-0803.2007.00105.x. PMID: 18377476.
Patel T, Narula S, Naderzad E, Early D, Nandhagopal T. Fetal Alcohol Spectrum Disorder in a Newborn. Cureus. 2022 Sep 6;14(9):e28836. doi: 10.7759/cureus.28836. PMID: 36225508; PMCID: PMC9536239.
Ergun G, Schultz MS, Rettig EK. Fetal Alcohol Spectrum Disorder-Issues of Misdiagnosis and Missed Diagnosis in Black Youth: A Case Report. Innov Clin Neurosci. 2021 Apr-Jun;18(4-6):20-23. PMID: 34980979; PMCID: PMC8667706.
Hur YM, Choi J, Park S, Oh SS, Kim YJ. Prenatal maternal alcohol exposure: diagnosis and prevention of fetal alcohol syndrome. Obstet Gynecol Sci. 2022 Sep;65(5):385-394. doi: 10.5468/ogs.22123. Epub 2022 Jul 29. PMID: 35908651; PMCID: PMC9483667.
Mulat B, Alemnew W, Shitu K. Alcohol use during pregnancy and associated factors among pregnant women in Sub-Saharan Africa: further analysis of the recent demographic and health survey data. BMC Pregnancy Childbirth. 2022 Apr 26;22(1):361. doi: 10.1186/s12884-022-04694-z. PMID: 35473590; PMCID: PMC9044761.
Melder A, Wittmann E, Bulubas L, Dornheim B, Kerber K, Vogelmann U, Campana M, Hubert J, Schmidt V, Heinen F, Padberg F, Landgraf MN. Transcranial magnetic stimulation as a feasible, non-invasive, neuromodulatory intervention in fetal alcohol spectrum disorders. A very first proof of concept. Eur J Paediatr Neurol. 2023 Nov;47:131-142. doi: 10.1016/j.ejpn.2023.10.004. Epub 2023 Oct 24. PMID: 37913649.
Breuer L, Greenmyer JR, Wilson T. Clinical Diagnosis and Management of Fetal Alcohol Spectrum Disorder and Sensory Processing Disorder in Children. Children (Basel). 2024 Jan 16;11(1):108. doi: 10.3390/children11010108. PMID: 38255421; PMCID: PMC10814837.
Terracina S, Tarani L, Ceccanti M, Vitali M, Francati S, Lucarelli M, Venditti S, Verdone L, Ferraguti G, Fiore M. The Impact of Oxidative Stress on the Epigenetics of Fetal Alcohol Spectrum Disorders. Antioxidants (Basel). 2024 Mar 28;13(4):410. doi: 10.3390/antiox13040410. PMID: 38671857; PMCID: PMC11047541.
King JC, Fabro S. Alcohol consumption and cigarette smoking: effect on pregnancy. Clin Obstet Gynecol. 1983 Jun;26(2):437-48. doi: 10.1097/00003081-198306000-00025. PMID: 6851292.
Keen CL, Uriu-Adams JY, Skalny A, Grabeklis A, Grabeklis S, Green K, Yevtushok L, Wertelecki WW, Chambers CD. The plausibility of maternal nutritional status being a contributing factor to the risk for fetal alcohol spectrum disorders: the potential influence of zinc status as an example. Biofactors. 2010 Mar-Apr;36(2):125-35. doi: 10.1002/biof.89. PMID: 20333752; PMCID: PMC2927848.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Sylwia Koziej, Emilia Kowalczyk, Joanna Borkowska, Julia Bajorek
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 118
Number of citations: 0