New research suggests the only sign of fetal alcohol exposure may be signs of abnormal intellectual or behavioral development.
Researchers at the National Institutes of Health have discovered that the facial features classically attributed to fetal alcohol syndrome do not develop in a majority of children.
Rather, nervous system abnormalities in children may manifest as challenged intellect and behavioral development, including language delays, hyperactivity, attention deficits or intellectual delays. Researchers define deficits or abnormalities as functional neurologic impairments.
In the study, authors documented an abnormality in one of these areas in about 44 percent of children whose mothers drank four or more drinks per day during pregnancy.
In contrast, abnormal facial features were present in about 17 percent of alcohol exposed children.
Fetal alcohol syndrome refers to a pattern of birth defects found in children of mothers who consumed alcohol during pregnancy.
These involve a characteristic pattern of facial abnormalities, growth retardation, and brain damage.
Neurological and physical differences seen in children exposed to alcohol prenatally — but who do not have the full pattern of birth defects seen in fetal alcohol syndrome — are classified as fetal alcohol spectrum disorders.
“Our concern is that in the absence of the distinctive facial features, health care providers evaluating children with any of these functional neurological impairments might miss their history of fetal alcohol exposure,” said Devon Kuehn, M.D.
“As a result, children might not be referred for appropriate treatment and services.”
The study may be found online in Alcoholism: Clinical and Experimental Research.
The research was conducted as part of a long-term study of heavy drinking in pregnancy known as the NICHD–University of Chile Alcohol in Pregnancy Study.
The investigation began by researchers asking over 9000 women at a community health clinic in Santiago, Chile about their alcohol use during pregnancy.
They found 101 pregnant women, who had four or more drinks per day during their pregnancies and matched them with 101 women having similar characteristics but who consumed no alcohol when they were pregnant.
After these women gave birth, the researchers evaluated the infants’ health and conducted regular assessments of their physical, intellectual and emotional development through age 8.
The researchers documented that children exposed to alcohol presented an increased risk of:
- Abnormal facial features (16 percent);
- Delayed growth (14 percent);
- Cognitive delays (including intellectual) (29 percent);
- Language delays (18 percent);
- Hyperactivity (25 percent).
Some of the women with heavy drinking habits also engaged in binge drinking (5 or more drinks at a time). Even though these women already had high levels of alcohol consumption, the researchers found that this habit increased the likelihood of poor outcomes for their children.