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Behavioral Problems and Fetal Alcohol Exposure

Behavioral Problems Associated with Fetal Alcohol Exposure Laura Arensmeyer April 2004   Introduction Ethanol crosses the placenta and causes CNS cell death by apoptosis, and reduces neural cell genesis. Fetal Alcohol Syndrome (FAS) Prenatal or postnatal growth retardation. CNS dysfunction. Syndrome-specific craniofacial abnormalities. Fetal Alcohol Effects (FAE) Fulfilling only two of the above three criteria. Alcohol-Related Neurodevelopmental Disorder (ARND) Signs of persistent cognitive difficulties and subsequent learning problems. Growth retardation and typical facies are usually absent. Cost to society. Prevalence of FAS is estimated at 1 to 1.5 cases per 1000 live births. Annual cost estimates for FAS range from $74.6 million to $9.7 billion per year. Lifetime cost of care per case in excess of $1.4 million. Association of Prenatal Alcohol Exposure with Behavioral and Learning Problems in Early Adolescence. Recruitment 1529 women interviewed during 5th month. 250 infants of social drinkers vs. 250 infants of infrequent drinkers/abstainers selected at birth. At 14 years, neuropsychological and psychosocial testing by single examiner with no knowledge of history. Assessment of Alcohol exposure By maternal report, average social drinker has 2-2.5 drinks per occasion before pregnancy, about 2 drinks per occasion by mid pregnancy. Assessment of Adolescent Learning and Behavior Adolescent self-report. Parental Interview. Examiner report. Conclusions Increasing levels of alcohol intake correspond to subtle impairment in learning and behavior in adolescence. a) Impairment occurs even when alcohol consumption is mild. b) Highest risk is early in pregnancy and binge drinking.   No alcohol related growth deficiencies or facial dysmorphology were seen, but disturbances in function were present in adolescence. Common behavior problems included: Antisocial behavior, substance use, school difficulties, and...