Implications of Higher Than Expected Prevalence of Fetal Alcohol Spectrum Disorders

Lange, Shannon; Rehm, Jürgen; Popova, Svetlana

doi:10.1001/jama.2017.21895

Cited by 15 publications

(12 citation statements)

References 17 publications

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“…The complete phenotype also includes characteristic craniofacial dysmorphology, growth retardation, and behavioral deficits in children diagnosed with fetal alcohol syndrome (FAS; Chudley et al, ; Jones, ; Mattson, Crocker, & Nguyen, ; Tables ). Recent, rigorously controlled studies report that FASD occurs at an incidence of at least 1–1.5% and potentially as high as 3.1–9.8% (Lange, Rehm, & Popova, ; May et al, ), and is postulated to be one of the leading preventable causes of neurodevelopmental disorders in the Western world (Mattson et al, ). The lifetime economic burden of FASD is estimated to be $1.1 million per individual in Canada based on medical, special education, productivity, and incarceration costs (Thanh & Jonsson, ).…”

Section: Fetal Alcohol Spectrum Disorders: Background Prevalence Anmentioning

confidence: 99%

Oxidative stress and DNA damage in the mechanism of fetal alcohol spectrum disorders

Bhatia

Drake

Miller

et al. 2019

Birth Defects Research

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This review covers molecular mechanisms involving oxidative stress and DNA damage that may contribute to morphological and functional developmental disorders in animal models resulting from exposure to alcohol (ethanol, EtOH) in utero or in embryo culture. Components covered include: (a) a brief overview of EtOH metabolism and embryopathic mechanisms other than oxidative stress; (b) mechanisms within the embryo and fetal brain by which EtOH increases the formation of reactive oxygen species (ROS); (c) critical embryonic/fetal antioxidative enzymes and substrates that detoxify ROS; (d) mechanisms by which ROS can alter development, including ROS-mediated signal transduction and oxidative DNA damage, the latter of which leads to pathogenic genetic (mutations) and epigenetic changes; (e) pathways of DNA repair that mitigate the pathogenic effects of DNA damage; (f) related indirect mechanisms by which EtOH enhances risk, for example by enhancing the degradation of some DNA repair proteins; and, (g) embryonic/fetal pathways like NRF2 that regulate the levels of many of the above components. Particular attention is paid to studies in which chemical and/or genetic manipulation of the above mechanisms has been shown to alter the ability of EtOH to adversely affect development. Alterations in the above components are also discussed in terms of: (a) individual embryonic and fetal determinants of risk and (b) potential risk biomarkers and mitigating strategies. FASD risk is likely increased in progeny which/who are biochemically predisposed via genetic and/or environmental mechanisms, including enhanced pathways for ROS formation and/or deficient pathways for ROS detoxification or DNA repair.

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Section: Fetal Alcohol Spectrum Disorders: Background Prevalence Anmentioning

confidence: 99%

Oxidative stress and DNA damage in the mechanism of fetal alcohol spectrum disorders

Bhatia

Drake

Miller

et al. 2019

Birth Defects Research

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“…In a study of youth in child welfare care in Manitoba, Canada, Fuchs et al (2005, 2007) estimated that 17 percent had a diagnosis or were suspected to have FASD. This means that FASD is not a rare disorder (Lange et al , 2018) but rather one that occurs in the population with some frequency, which suggests the need for greater public education on alcohol use and pregnancy as well as on FASD.…”

Section: Introductionmentioning

confidence: 99%

Stigma as a dominant discourse in fetal alcohol spectrum disorder

Choate

Badry

2019

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Purpose The purpose of this paper is to conduct a scoping review of the literature to explore the many ways stigma affects people with FASD and to highlight the disciplines and places where discourse on FASD and stigma is taking place. Design/methodology/approach Searches were conducted in PubMed, ERIC, Family & Society Studies Worldwide, Families Studies Abstracts and Google Scholar between 2008 and 2018. Search terms focused on stigma, shame and the connection to FASD with a view to looking across social and medical science literature. Findings Searches identified 39 full text manuscripts, 13 of which were included in the scoping review. Stigma toward people with FASD exists in multiple professional forums across disciplines. The relationship between mother’s use of alcohol and the lasting impact on the child is a focus in the articles identified from a public health perspective. The review showed there was limited cross-disciplinary discussion evident. In total 13 articles were selected for inclusion in this review. Research limitations/implications Negative discourses predominate with little attention being paid to possible areas of success as well as cases of lower FASD impacts. There is a significant void in work focusing on positive outcomes for people with FASD. Such discourse would support a better understanding of pathways to more positive outcomes. Originality/value This paper highlights the issue of FASD and stigma through identification of relevant literature and expands the conversation to offer insights into the challenging terrain that individuals with FASD must navigate. The issue of stigma is not linked only to individuals with FASD but also their support systems. It is critical to recognize the multiple attributions of stigma to FASD in order to effectively take up conversations across and between disciplines to promote new discourses focused on de-stigmatization.

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“…More recently, a series of studies involving a large sample size examining the prevalence of FASD among school-age children in 4 regions of the Unites States (Rocky Mountain, Midwestern, Southeastern, and Pacific Southwestern) has confirmed that at least 2% of children in first grade had FASD (Chambers et al, 2019;May et al, 2018May et al, , 2020aMay et al, , 2020bMay et al, , 2020cPopova et al, 2020). The burden of FASD on society is a severe global medical issue (Lange et al, 2018). However, the precise mechanism underlying the development of FASD remains unclear.…”

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confidence: 99%

Epigenetic Clock Analysis in Children With Fetal Alcohol Spectrum Disorder

Okazaki

Otsuka

Shinko

et al. 2021

Alcoholism Clin & Exp Res

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Background Fetal alcohol spectrum disorder (FASD) is characterized by severe clinical impairment, considerable social burden, and high mortality and morbidity, which are due to various malformations, sepsis, and cancer. As >50% of deaths from FASD occur during the first year of life, we hypothesized that there is the acceleration of biological aging in FASD. Several recent studies have established genome‐wide DNA methylation (DNAm) profiles as “epigenetic clocks” that can estimate biological aging, and FASD has been associated with differential DNAm patterns. Therefore, we tested this hypothesis using epigenetic clocks. Methods We investigated 5 DNAm‐based measures of epigenetic age (HorvathAge, HannumAge, SkinBloodAge, PhenoAge, and GrimAge) and telomere length (DNAmTL) using 4 independent publicly available DNAm datasets; 2 datasets were derived from buccal epithelium, and the other 2 datasets were derived from peripheral blood. Results Compared with controls, children with FASD exhibited an acceleration of GrimAge in 1 buccal and 2 blood datasets. No significant difference was found in other DNAm ages and DNAmTL. Meta‐analyses showed a significant acceleration of GrimAge in the blood samples but not in the buccal samples. Conclusions This study provides novel evidence regarding accelerated epigenetic aging in children with FASD.

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Implications of Higher Than Expected Prevalence of Fetal Alcohol Spectrum Disorders

Cited by 15 publications

References 17 publications

Oxidative stress and DNA damage in the mechanism of fetal alcohol spectrum disorders

Oxidative stress and DNA damage in the mechanism of fetal alcohol spectrum disorders

Stigma as a dominant discourse in fetal alcohol spectrum disorder

Epigenetic Clock Analysis in Children With Fetal Alcohol Spectrum Disorder

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