Congenital Malformations in Offspring of a Chronic Alcoholic Mother

Abstract

Three cases in one family—a girl and monozygotic girl twins, the offspring of a chronic alcoholic mother —are presented. They show a pattern of prenatal onset of growth deficiency and developmental delay, with microcephaly, small palpebral fissures, and multiple minor anomalies, recently described in a series of 11 unrelated cases by Jones et al. and named by them the "fetal alcohol syndrome." After considering alternative theories, we conclude, with them, that the cases demonstrate an association between the maternal alcohol intake and the abnormalities found in the offspring. We report these three cases in confirmation of their findings.

Fetal alcohol syndrome: Behavioral teratology.

“…General scientific attention was drawn to the potentially deleterious effects of prenatal exposure to alcohol in 1972 when Ulleland rereported that a group of children born to alcoholic women were typicall)' underweight at birth, had small head circumference, and exhibited delayed growth and development. The following year, [ones and his co-workers Jones, Smith, Ulleland, & Streissguth, 1973) Warner, & Leichtman, 1974;Tenbrink & Buchin, 1975).…”

“…In each case, only one of the twins exhibited teratogenicity. Palmer et al (1974) reported a case of monozygotic twins born with the FAS. Al-though they shared the same placenta and exhibited many similar characteristics of the FAS, they differed on some physical features associated with the FAS.…”

“…Although diagnosis of the FAS is based on recognition of growth deficiency and distinctive facial features (e.g., short palpebral fissures of the eye, a short upturned nose, diminished to absent groove from the nose to the upper lip, and thin upturned upper lip, , mental retardation has been observed in nearly all reports of the FAS (e.g., Dehaene et al, 1977;Fryns et al, 1977;Hall & Orenstein, 1974;Ijaiya, Schwenk, & Gladtke, 1976;Jones & Smith, 1975;Lemoine et al, 1968;Palmer et al, 1974;Root, Reiter, Andriola, & Duckett, 1975;Streissguth, 1976b), with intelligence scores ranging from borderline to severe mental retardation (Streissguth, 1976b). About 85% of all the children who were identified as having the FAS scored two or more standard deviations below the mean on standardized cognitive tests .…”