Perspective Chapter: Autism Spectrum Disorder Neurophenotype with Preconceptional and Prenatal Alcohol Exposure – A Call for Industry Responsibility in Prevention

Abstract

Preconceptional and prenatal alcohol exposure is a widespread, costly, and preventable influence on neurodevelopment contributing to Autism Spectrum Disorder. Neurodevelopmental Disorder associated with Prenatal Alcohol Exposure is a heterogeneous neurophenotype that underscores the importance of etiology in diagnosis, treatment, and prevention. Expanding upon previously published clinical implications, this perspective elucidates a phenomenology describing neurophenotypic heterogeneity leading to a range of clinical neurophenotypes including Autism Spectrum Disorder as well as neurodevelopmental issues and neuropsychiatric problems. Given that ND-PAE affects up to 1 in 20 people, a pandemic-level public health response is warranted to prevent and treat preconceptional and prenatal alcohol exposure. Given the widespread use of alcohol during reproductive years, governmental enforcement of industry responsibility in consumer protection should include point of sales labeling and risk reduction advertising about the reproductive effects of alcohol products. Widespread dissemination of public health information by physicians and allied health professionals would help improve awareness that use of the solvent (alcohol) can cause reproductive health effects to gametes, zygotes, embryos, and fetuses. Improvements in screening for ND-PAE, nonjudgmental discussions with biological parents about preconceptional alcohol use, pregnancy planning through contraceptive access, and marketing mandates may reduce unintentional exposures prior to pregnancy recognition.

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“…Approximately 1 in 58 Americans are estimated to have Autistic Disorder (ICD-10 F84.0). Individuals with ND-PAE/FASD can have comorbid autism, which has a higher neurophenotypic expression with prenatal alcohol exposure [5]. Severe and persistent mental illness (SMI) is more prevalent in individuals with FASD/ND-PAE [6] and autism [7], worsened by a history of adverse childhood experiences (ACEs).…”