Upper Airway Obstruction in Infants With Fetal Alcohol Syndrome

Usowicz, Anna G.; Golabi, Mahin; Curry, Cynthia J.

doi:10.1001/archpedi.1986.02140240085031

Cited by 6 publications

(4 citation statements)

References 6 publications

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“…All five children in this sample also had mild sleep disordered breathing; the median apnea hypopnea index (AHI), used to indicate severity of sleep apnea, was more than two standard deviations above the reported mean AHI in community sample data. Importantly, craniofacial abnormalities observed in some individuals with FASD can include narrowed upper airways, which may contribute to increased likelihood of disordered breathing during sleep (Usowicz et al, 1986). Additionally, animals with PAE demonstrate a blunted respiratory response to low oxygen (Dubois et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

Sleep in Infants and Children with Prenatal Alcohol Exposure

Inkelis

Thomas

2018

Alcoholism Clin & Exp Res

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Prenatal exposure to alcohol can result in a range of neurobehavioral impairments and physical abnormalities. The term "fetal alcohol spectrum disorders (FASD)" encompasses the outcomes of prenatal alcohol exposure (PAE), the most severe of which is fetal alcohol syndrome. These effects have lifelong consequences, placing a significant burden on affected individuals, caregivers, and communities. Caregivers of affected children often report that their child has sleep problems, and many symptoms of sleep deprivation overlap with the cognitive and behavioral deficits characteristic of FASD. Alcohol-exposed infants and children demonstrate poor sleep quality based on measures of electroencephalography, actigraphy, and questionnaires. These sleep studies indicate a common theme of disrupted sleep pattern, more frequent awakenings, and reduced total sleep time. However, relatively little is known about circadian rhythm disruption and the neurobehavioral correlates of sleep disturbance in individuals with PAE. Furthermore, there is limited information available to healthcare providers about identification and treatment of sleep disorders in patients with FASD. This review consolidates the findings from studies of infant and pediatric sleep in this population, providing an overview of typical sleep characteristics, neurobehavioral correlates of sleep disruption, and potential avenues for intervention in the context of PAE.

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Section: Discussionmentioning

confidence: 99%

Sleep in Infants and Children with Prenatal Alcohol Exposure

Inkelis

Thomas

2018

Alcoholism Clin & Exp Res

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“…It has been proposed that AE might interfere with XIIn development and might be of prognostic relevance for the predisposition to upper airway obstructions in infants with FASD (Usowicz et al, 1986) and contribute to an increased risk of SIDS (Iyasu et al, 2002; Burd et al, 2004; Duncan et al, 2008; Kinney, 2009). However, the consequences of AE for the development of the XIIn and other brainstem structures have, so far, attracted only limited attention.…”

Section: Discussionmentioning

confidence: 99%

“…Prenatal AE predisposes to respiratory disorders, including problems with the neural control of the upper airway that may result in upper airway obstructions (Usowicz et al, 1986). FASD-associated craniofacial dysmorphisms, including midface hypoplasia and microretrognathia that are typically caused by AE during first trimester of pregnancy (Sant'Anna and Tosello, 2006), may exacerbate these problems.…”

Section: Introductionmentioning

confidence: 99%

Loss of motoneurons in the ventral compartment of the rat hypoglossal nucleus following early postnatal exposure to alcohol

Stettner

Kubin

Volgin

2013

Journal of Chemical Neuroanatomy

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Perinatal Alcohol exposure (AE) has multiple detrimental effects on cognitive and various behavioral outcomes, but little is known about its impact on the autonomic functions. In a rat model of fetal alcohol spectrum disorders (FASD), we investigated neurochemical and neuroanatomical alterations in two brainstem nuclei, the hypoglossal nucleus (XIIn) and the dorsal nucleus of the vagus nerve (Xdn). One group of male Sprague-Dawley rats (n=6) received 2.625 g/kg ethanol intragastrically twice daily on postnatal days (PD)4–9, a period equivalent to the third trimester of human pregnancy, and another group (n=6) was sham-intubated. On PD18–19, the rats were perfused and medullary sections were immunohistochemically processed for choline acetyltransferase (ChAT) or two aminergic receptors that mediate excitatory drive to motoneurons, α1-adrenergic (α1-R) and serotonin 2A (5-HT2A-R), and c-Fos. Based on ChAT labeling, AE rats had reduced numbers of motoneurons in the ventral XIIn (XIIn-v; 35.4±1.3 motoneurons per side and section vs. 40.0±1.2, p=0.022), but not in the dorsal XIIn or Xdn. Consistent with ChAT data, both the numbers of α1-R-labeled motoneurons in the XIIn-v and the area of the XIIn-v measured using 5-HT2A-R staining were significantly smaller in AE rats (19.7±1.5 vs. 25.0±1.4, p=0.031 and 0.063 mm2 ±0.002 vs. 0.074±0.002, p=0.002, respectively). Concurrently, both 5-HT2A-R and c-Fos staining tended to be higher in AE rats, suggesting an increased activation. Thus, postnatal AE causes motoneuronal loss in the XIIn-v. This may compromise upper airway control and contribute to increased risk of upper airway obstructions and sudden infant death in FASD victims.

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“…11 Abnormalities such as mandibulofacial dysostosis (eg, Treacher Collins syndrome and Crouzon disease), coronal craniosynostosis, and midfacial and nasal hypoplasia associated with fetal alcohol syndrome may be apparent on initial inspection, and can cause nasal obstruction. 12,13 Anterior rhinoscopy may reveal nasal pyriform aperture stenosis or traumatic septal deviation, which may occur in as many as 1% of newborns. 14 Nasolacrimal duct cysts can also be seen, and may be associated with epiphora.…”

Section: Discussionmentioning

confidence: 99%

Congenital Salivary Gland Anlage Tumor of the Nasopharynx

et al. 2003

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The diagnosis of a nasopharyngeal mass lesion should be considered in neonates with nasal obstructive symptoms. It is wise to place an index finger in the oropharynx when passing catheters to rule out choanal atresia to feel a dislodged mass lesion before it can become an airway foreign body. Should passage of nasal catheters result in bleeding and/or respiratory distress, the possibility of a displaced mass lesion must be considered immediately to institute prompt intervention.

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Upper Airway Obstruction in Infants With Fetal Alcohol Syndrome

Cited by 6 publications

References 6 publications

Sleep in Infants and Children with Prenatal Alcohol Exposure

Sleep in Infants and Children with Prenatal Alcohol Exposure

Loss of motoneurons in the ventral compartment of the rat hypoglossal nucleus following early postnatal exposure to alcohol

Congenital Salivary Gland Anlage Tumor of the Nasopharynx

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