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Are Low‐to‐Moderate Average Alcohol Consumption and Isolated Episodes of Binge Drinking in Early Pregnancy Associated with Facial Features Related to Fetal Alcohol Syndrome in 5‐Year‐Old Children?
Author(s) -
Kesmodel Ulrik Schiøler,
Nygaard Siv Steffen,
Mortensen Erik Lykke,
Bertrand Jacquelyn,
Denny Clark H.,
Glidewell Alex,
Astley Hemingway Susan
Publication year - 2019
Publication title -
alcoholism: clinical and experimental research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.267
H-Index - 153
eISSN - 1530-0277
pISSN - 0145-6008
DOI - 10.1111/acer.14047
Subject(s) - binge drinking , fetal alcohol syndrome , medicine , pregnancy , fetus , odds ratio , gestational age , prospective cohort study , cohort , pediatrics , physiology , poison control , environmental health , injury prevention , biology , genetics
Background Fetal alcohol syndrome (FAS) typically is observed among individuals with high prenatal alcohol exposures (PAE), but exposure histories obtained in clinical diagnostic settings are often inaccurate. The present analysis used the Lifestyle During Pregnancy Study ( LDPS ) to assess the potential effects of low‐to‐moderate average weekly alcohol consumption and binge drinking in early pregnancy on facial features associated with FAS among children 5 years of age. Methods The analysis is a prospective follow‐up study of 670 women and their children sampled from the LDPS cohort based on maternal alcohol consumption during pregnancy. The 4‐Digit Code FAS Facial Photographic Analysis Software was used to measure the magnitude of expression of the 3 diagnostic facial features of FAS from standardized digital photographs. Logistic regression was used to estimate the odds of presenting with the FAS /partial fetal alcohol syndrome ( PFAS ) facial phenotypes relative to different patterns of prenatal alcohol exposure. Results Ten children presented with the FAS / PFAS facial phenotypes. None of the children sampled met the central nervous system ( CNS ) criteria for FAS or PFAS at age 5 years. All remained at risk for PFAS since some types of CNS dysfunction associated with this diagnosis may only be assessed at older ages. The FAS / PFAS facial phenotypes were 8.5‐fold more likely among children exposed to an average of 1 to 4 drinks/wk and 2.5‐fold more likely among children with a single binge exposure in gestational weeks 3 to 4 compared to children with no such exposures. The magnitude of expression of the FAS facial phenotype was significantly correlated with all other diagnostic features of FAS : growth deficiency, microcephaly, and measures of CNS dysfunction. Conclusions These findings suggest that low‐to‐moderate levels of PAE or isolated binge exposures may place some fetuses at risk for FAS / PFAS . Thus, conservative advice is still for women to abstain from alcohol consumption during pregnancy.