Impaired Eyeblink Conditioning in Children With Fetal Alcohol Syndrome

Jacobson, Sandra W.; Stanton, Mark E.; Molteno, Christopher D.; Burden, Matthew J.; Fuller, Douglas S.; Hoyme, H. Eugene; Robinson, Luther K.; Khaole, Nathaniel; Jacobson, Joseph L.

doi:10.1111/j.1530-0277.2007.00585.x

Cited by 167 publications

(289 citation statements)

References 34 publications

(37 reference statements)

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“…Drinking levels among HE groups did not differ statistically. Alcoholconsuming mothers reported an average of 2.8 standard drinks per day 31,32 As expected, WISC-IV IQ scores of exposed children were lower than those of controls. The children categorized as FAS or PFAS were substantially more likely to meet clinical dysmorphology criteria than were those of the HE or control groups.…”

Section: Sample Characteristicsmentioning

confidence: 80%

“…The 192 participants were from 2 longitudinal University of Cape Town (UCT) cohorts recruited from the local Cape coloured(mixedancestry)community, 31,32 where the incidence of heavy alcohol use during pregnancy and FAS are among the highest in the world. In one cohort (N = 137), 31 drinking histories of mothers were obtained prospectively by using a timeline follow-back interview 33 administered at recruitment in antenatal clinics, during pregnancy, and at 6 weeks postpartum, to ascertain third trimester drinking.…”

Section: Participantsmentioning

confidence: 99%

“…In one cohort (N = 137), 31 drinking histories of mothers were obtained prospectively by using a timeline follow-back interview 33 administered at recruitment in antenatal clinics, during pregnancy, and at 6 weeks postpartum, to ascertain third trimester drinking. Heavy drinkers consumed $14 standard drinks per week or participated in binges of $5 drinks per occasion.…”

Section: Participantsmentioning

confidence: 99%

“…31,32 blinded to prenatal alcohol exposure history, using a standard protocol 2 and the Astley Lip-Philtrum Guide14. There was substantial agreement between them on assessment of dysmorphism, including published philtrum and vermilion rating scales 35 and palpebral fissure length (r = 0.80, 0.84, and 0.77, respectively), and between them and another dysmorphologist (N.K.)…”

Section: Clinical and Neurobehavioral Assessmentsmentioning

confidence: 99%

“…Individuals with genetic disorders were excluded. As part of the UCT longitudinal FASD studies, neurobehavioral assessment was undertaken at 9-year follow-up 31,32,36 and included fourth edition of Wechsler Intelligence Scale for Children (WISC IV), 37 to measure IQ, verbal comprehension and perceptual reasoning, and California Verbal Learning Test-Children' s Version (CVLT-C), [38][39][40] to measure recall of words learned over consecutive trials and recognition memory after a 20-minute delay. Testing was conducted by Master' s level neuropsychologists in the primary language (Afrikaans or English) used in a child' s home and school.…”

Section: Clinical and Neurobehavioral Assessmentsmentioning

confidence: 99%

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Facial Dysmorphism Across the Fetal Alcohol Spectrum

2013

PEDIATRICS

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WHAT IS KNOWN ON THIS SUBJECT: Prenatal alcohol exposure causes a continuum of effects. The most severe phenotype, fetal alcohol syndrome, involves facial dysmorphism, growth deficits, and neurocognitive problems. The classic facial characteristics include short palpebral fissures, smooth philtrum, and thin upper vermillion. WHAT THIS STUDY ADDS:This study develops novel strategies to help detect facial dysmorphism across the fetal alcohol spectrum, especially in children with heavy alcohol exposure but without classic facial characteristics. The methods show potential for identifying which of these children are cognitively affected. abstract OBJECTIVE: Classic facial characteristics of fetal alcohol syndrome (FAS) are shortened palpebral fissures, smooth philtrum, and thin upper vermillion. We aim to help pediatricians detect facial dysmorphism across the fetal alcohol spectrum, especially among nonsyndromal heavily exposed (HE) individuals without classic facial characteristics. METHODS:Of 192 Cape Coloured children recruited, 69 were born to women who reported abstaining from alcohol during pregnancy. According to multifaceted criteria, the remainder were allocated clinically to the FAS (n = 22), partial FAS (n = 26) or nonsyndromal HE (n = 75) categories. We used dense surface modeling and signature analyses of 3-dimensional facial photographs to determine agreement between clinical categorization and classifications induced from face shape alone, to visualize facial differences, and to consider predictive links between face shape and neurobehavior.RESULTS: Face classification achieved significant agreement with clinical categories for discrimination of nonexposed from FAS alone (face: 0.97-1.00; profile: 0.92) or with the addition of partial FAS (face: 0.90; profile: 0.92). Visualizations of face signatures delineated dysmorphism across the fetal alcohol spectrum and in half of the nonsyndromal HE category face signature graphs detected facial characteristics consistent with prenatal alcohol exposure. This subgroup performed less well on IQ and learning tests than did nonsyndromal subjects without classic facial characteristics.CONCLUSIONS: Heat maps and morphing visualizations of face signatures may help clinicians detect facial dysmorphism across the fetal alcohol spectrum. Face signature graphs show potential for identifying nonsyndromal heavily exposed children who lack the classic facial phenotype but have cognitive impairment. Pediatrics 2013;131:e779-e788 AUTHORS:

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Section: Sample Characteristicsmentioning

confidence: 80%

Section: Participantsmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

Section: Clinical and Neurobehavioral Assessmentsmentioning

confidence: 99%

Section: Clinical and Neurobehavioral Assessmentsmentioning

confidence: 99%

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Facial Dysmorphism Across the Fetal Alcohol Spectrum

2013

PEDIATRICS

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Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorder

Chudley¹,

Longstaffe²

2010

Management of Genetic Syndromes

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Assessment of benefits of a universal screen for maternal alcohol use during pregnancy

Gifford¹,

Farkas²,

Jackson³

et al. 2010

Birth Defects Research

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INTRODUCTION The objective of this report is to estimate the benefits of universal meconium screening for maternal drinking during pregnancy. Fetal alcohol spectrum disorder (FASD), including its most severe manifestation fetal alcohol syndrome (FAS), is preventable and remains a public health tragedy. The incidences of FAS and FASD have been conservatively estimated to be 0.97 and 10 per 1000 births, respectively. Meconium testing has been demonstrated to be a promising at-birth method for detection of drinking during pregnancy. METHODS The current costs of FAS and FASD, alcohol treatment programs, and meconium screening were estimated by literature review. Monetary values were converted roughly to equal dollars in 2006. RESULTS Costs of adding meconium analysis to the current newborn screening program and of treatment for the identified mothers were estimated and compared to potential averted costs that may result from identification and intervention for mothers and affected infants. Three potential maternal treatment strategies are analyzed. Depending on the treatment type, the savings may range from $6 to $97 for every $1 spent on screening and treatment. DISCUSSION It needs to be emphasized, however, that such screening is premature and that to be effective this screening can be implemented only if there is a societal willingness to institute prevention and intervention programs to improve both women’s and children’s health. Future research should be directed at improving detection and developing in-depth prevention and remedial intervention programs. A thorough consideration of the ethical issues involved in such a screening program is also needed.

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Impaired Eyeblink Conditioning in Children With Fetal Alcohol Syndrome

Cited by 167 publications

References 34 publications

Facial Dysmorphism Across the Fetal Alcohol Spectrum

Facial Dysmorphism Across the Fetal Alcohol Spectrum

Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorder

Assessment of benefits of a universal screen for maternal alcohol use during pregnancy

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