Fetal alcohol syndrome from infancy through childhood: A review of the literature

Wekselman, Kathryn; Spiering, Kathy; Hetteberg, Carol; Kenner, Carole; Flandermeyer, Ann

doi:10.1016/s0882-5963(05)80047-8

Cited by 10 publications

(11 citation statements)

References 21 publications

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“…A number of studies have found poor pregnancy and neonatal outcomes among women who used alcohol or illegal drugs during pregnancy, [1][2][3][4] and the long-term impact of prenatal alcohol or illicit drug exposure on the development and behavior of the exposed child [5][6][7][8] is now being documented. However, despite the concern over the consequences of prenatal exposure to alcohol and other drugs, substance use by the pregnant woman remains a frequently missed diagnosis.…”

Section: Introductionmentioning

confidence: 99%

The 4P's Plus© Screen for Substance Use in Pregnancy: Clinical Application and Outcomes

et al. 2005

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Determine the prevalence of substance use among pregnant women in five diverse communities utilizing the 4P's Plus r screen for alcohol, tobacco, and other drug use. STUDY DESIGN:Pregnant women enrolled in prenatal care clinics in five communities were screened for substance use with the 4P's Plus r . Those women with a positive screen underwent an assessment for substance use through a follow-up structured clinical interview conducted at the same prenatal visit. RESULTS:Among 7818 women in five communities, 2555 (32.7%) had a positive screen for substance use in pregnancy. Four of the communities conducted a follow-up assessment on all women with a positive screen (n ¼ 1548). Among these women, 717 (15% of the total population) had continued use after learning of the pregnancy. Overall, 21% of the pregnant women used alcohol prior to recognition of the pregnancy, and 11% continued use after knowledge of the pregnancy. Among the 512 women who continued to use alcohol, 2% were drinking daily, 7% were drinking 3 to 6 days per week, 27% were drinking 1 to 2 days per week, and 63% were drinking less than 1 day per week. The rates of marijuana use and other illicit drug use among the women were 7 and 2%, respectively, prior to knowledge of pregnancy and dropped to 3 and 1% after learning of the pregnancy. CONCLUSION:The 4P's Plus r identifies not only those pregnant women whose drinking or drug use is at a high enough level to impair daily functioning, but provides an opportunity for early intervention for the much larger group of women whose pregnancies are at risk from relatively small amounts of substance use.

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Section: Introductionmentioning

confidence: 99%

The 4P's Plus© Screen for Substance Use in Pregnancy: Clinical Application and Outcomes

et al. 2005

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“…Prenatal alcohol exposure has been studied for some 25 years, and Jones and Smith described FAS in 1973 (Wekselman, 1995). However, general interest was stimulated by the work of Michael Dorris, who wrote the book 'The Broken Cord' (1989).…”

Section: Diagnosing Fasmentioning

confidence: 99%

Review : FAS/FAE: impact on children

Cramer

Davidhizar²

1999

J Child Health Care

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Alcohol is a teratogen and it can cause lasting birth defects called Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE). FAS is one of the leading causes of mental retardation. FAS/FAE can result in a myriad of behavioral, learning and developmental problems. There are estimates of 12,000 new cases of FAS yearly. The school nurse plays an important advocacy and educational role in helping the child with FAS. Family involvement is important for the child with FAS.

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“…Fetal alcohol syndrome (FAS) has been recognized for more than 2 decades. It is a compilation of dysmorphic features: facial features, including short palpebral fissures, epicanthal folds, broad nasal bridge, flattened midfacies, short upturned or beak-like nose, thin upper lip or vermilion border, smooth philtrum, micrognathia, and hypoplastic maxilla; microcephaly; abnormal palmar creases; growth retardation, both intrauterine and failure to catch up after birth; and central nervous system involvement exhibited as cognitive impairment, learning disabilities, and impulsivity (Streissguth, Clarren, & Jones, 1985;Wekselman, Spiering, Hetteberg, Kenner, & Flandermeyer, 1995) (see Figure 1). Fetal alcohol syndrome is diagnosed if three classic criteria are found: positive facial dysmorphic characteristics, neurodevelopmental dysfunction, and prenatal and postnatal growth retardation.…”

Section: Fetal Alcohol Syndromementioning

confidence: 99%

“…Accurately predicting the children who will be born with full-blown FAS and those who will have absolutely no effects is difficult. One woman may drink throughout a pregnancy and have a health infant, whereas another woman may drink 1 or 2 drinks and have no other risk factors yet have an infant with fullblown FAS (Flandermeyer, 1993;Wekselman et al, 1995). So when there has been in utero exposure, what are the long-term effects?…”

Section: Fetal Alcohol Syndromementioning

confidence: 99%