1
|
McQuire C, Frennesson NF, Parsonage J, Van der Heiden M, Troy D, Zuccolo L. Trends in fetal alcohol spectrum disorder research: A bibliometric review of original articles published between 2000 and 2023. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024. [PMID: 39118285 DOI: 10.1111/acer.15415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 07/16/2024] [Accepted: 07/16/2024] [Indexed: 08/10/2024]
Abstract
Fetal alcohol spectrum disorder (FASD) is a leading cause of neurodevelopmental disability globally. International organizations have highlighted an urgent need for improved prevention, diagnosis, and support. However, the evidence base needed to inform this is thought to be limited. We conducted two complementary reviews to (i) describe trends in the volume and characteristics of original FASD research articles (Review 1) and (ii) compare the volume of published research on FASD to that of other neurodevelopmental disorders (Review 2). In Review 1, we systematically searched MEDLINE, Embase, CINAHL and PsycInfo for original studies with FASD terms in the title, published between 2000 and 2023. We summarised study characteristics including the article topic(s), sample population, country of origin, and publication year using quantitative content analysis and time-series plots. A total of 854 studies were eligible. Studies showed a relative focus on diagnosis and screening, compared to prevention and intervention. FASD research originated from 31 countries, however most countries (68%) had fewer than 10 articles published over the 23-year review period. In Review 2, we searched PubMed for records published between 2000 and 2023 with FASD, autism, or attention-deficit-hyperactivity disorder (ADHD) terms in the title. We compared the volume of records for these conditions using descriptive statistics and time-series plots. Of the 64,069 records retrieved, 2% were for FASD, compared to 60% for autism and 38% for ADHD. FASD remains considerably under-researched. While there has been an increase in the number of original FASD research articles published annually over time, this is much lower than expected compared to publication trends for other neurodevelopmental conditions, and the wider scientific literature. Further research is needed to understand the impact of FASD across the lifespan, to inform evidence-based policy and support, and to advance progress in strength-based, stigma-reducing approaches to FASD research and practice.
Collapse
Affiliation(s)
- Cheryl McQuire
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Nessie Felicia Frennesson
- Tobacco and Alcohol Research Group, School of Psychological Science, University of Bristol, Bristol, UK
| | - James Parsonage
- Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health and Care Research, School for Public Health Research (NIHR SPHR), Newcastle University, Newcastle upon Tyne, UK
| | | | - David Troy
- Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Luisa Zuccolo
- Health Data Science Centre, Fondazione Human Technopole, Milan, Italy
- MRC Integrative Epidemiology Unit and Population Health Sciences Department, Bristol Medical School, University of Bristol, Bristol, UK
| |
Collapse
|
2
|
Bourne LE, Jayash SN, Michels LV, Hopkinson M, Guppy FM, Clarkin CE, Gard P, Brissett N, Staines KA. Sexually dimorphic effects of prenatal alcohol exposure on the murine skeleton. Biol Sex Differ 2024; 15:51. [PMID: 38890762 PMCID: PMC11186175 DOI: 10.1186/s13293-024-00626-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 06/11/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Prenatal alcohol exposure (PAE) can result in lifelong disabilities known as foetal alcohol spectrum disorder (FASD) and is associated with childhood growth deficiencies and increased bone fracture risk. However, the effects of PAE on the adult skeleton remain unclear and any potential sexual dimorphism is undetermined. Therefore, we utilised a murine model to examine sex differences with PAE on in vitro bone formation, and in the juvenile and adult skeleton. METHODS Pregnant C57BL/6J female mice received 5% ethanol in their drinking water during gestation. Primary calvarial osteoblasts were isolated from neonatal offspring and mineralised bone nodule formation and gene expression assessed. Skeletal phenotyping of 4- and 12-week-old male and female offspring was conducted by micro-computed tomography (µCT), 3-point bending, growth plate analyses, and histology. RESULTS Osteoblasts from male and female PAE mice displayed reduced bone formation, compared to control (≤ 30%). Vegfa, Vegfb, Bmp6, Tgfbr1, Flt1 and Ahsg were downregulated in PAE male osteoblasts only, whilst Ahsg was upregulated in PAE females. In 12-week-old mice, µCT analysis revealed a sex and exposure interaction across several trabecular bone parameters. PAE was detrimental to the trabecular compartment in male mice compared to control, yet PAE females were unaffected. Both male and female mice had significant reductions in cortical parameters with PAE. Whilst male mice were negatively affected along the tibial length, females were only distally affected. Posterior cortical porosity was increased in PAE females only. Mechanical testing revealed PAE males had significantly reduced bone stiffness compared to controls; maximum load and yield were reduced in both sexes. PAE had no effect on total body weight or tibial bone length in either sex. However, total growth plate width in male PAE mice compared to control was reduced, whilst female PAE mice were unaffected. 4-week-old mice did not display the altered skeletal phenotype with PAE observed in 12-week-old animals. CONCLUSIONS Evidence herein suggests, for the first time, that PAE exerts divergent sex effects on the skeleton, possibly influenced by underlying sex-specific transcriptional mechanisms of osteoblasts. Establishing these sex differences will support future policies and clinical management of FASD.
Collapse
Affiliation(s)
- Lucie E Bourne
- School of Applied Sciences, Centre for Lifelong Health, University of Brighton, Lewes Road, Brighton, BN2 4GT, UK
| | - Soher N Jayash
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian, EH25 9RG, UK
| | - Lysanne V Michels
- School of Biological Sciences, University of Southampton, Southampton, SO17 1BJ, UK
| | - Mark Hopkinson
- Comparative Biomedical Sciences, Royal Veterinary College, London, NW1 0TU, UK
| | - Fergus M Guppy
- Institute of Life and Earth Sciences, School of Energy, Geosciences, Infrastructure and Society, Heriot Watt University, Edinburgh, EH14 4AS, UK
| | - Claire E Clarkin
- School of Biological Sciences, University of Southampton, Southampton, SO17 1BJ, UK
| | - Paul Gard
- School of Applied Sciences, Centre for Lifelong Health, University of Brighton, Lewes Road, Brighton, BN2 4GT, UK
| | - Nigel Brissett
- School of Applied Sciences, Centre for Lifelong Health, University of Brighton, Lewes Road, Brighton, BN2 4GT, UK
| | - Katherine A Staines
- School of Applied Sciences, Centre for Lifelong Health, University of Brighton, Lewes Road, Brighton, BN2 4GT, UK.
| |
Collapse
|
3
|
Belama N, Desalew A, Lami M, Keneni M, Roba KT. Predictors of congenital anomalies among neonates admitted to public hospitals in eastern Ethiopia: a case-control study. J Int Med Res 2024; 52:3000605241233453. [PMID: 38459954 PMCID: PMC10924732 DOI: 10.1177/03000605241233453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2024] Open
Abstract
OBJECTIVE Over 8 million newborns worldwide have congenital anomalies; 3.2 million have resultant disabilities. Ethiopia has a high burden of neonatal congenital anomalies, but research on predictors is limited. This study investigated predictors of neonatal congenital anomalies in eastern Ethiopia. METHODS A facility-based unmatched case-control study on 387 mother-infant pairs (129 cases, 258 controls) in public hospitals was conducted. Data were obtained using an interviewer-administered structured questionnaire and a medical record review. Binary logistic regression with adjusted odds ratios (AOR) and 95% confidence intervals (CI) was used to identify predictors of congenital anomaly. RESULTS Nervous system anomalies were most common 84 (65.1%), followed by gastrointestinal system anomalies 20 (15.5%). Maternal anemia (AOR: 4.37, 95% CI: 2.48-7.69), alcohol consumption during index pregnancy (AOR: 4.01, 95% CI: 1.88-8.54), khat chewing (AOR: 1.73; 95% CI: 1.04-2.85), rural residence (AOR: 1.73, 95% CI: 1.04-2.85) and antenatal care attendance (AOR: 0.43, 95% CI: 0.22-0.84) were significant predictors of congenital anomaly. CONCLUSION Several risk factors for congenital anomalies were identified. To reduce risk, antenatal care services should be improved and mothers encouraged to avoid harmful substances during pregnancy and maintain a healthy lifestyle. Intervention strategies are needed to target these risk factors.
Collapse
Affiliation(s)
- Nano Belama
- School of Nursing and Midwifery, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Assefa Desalew
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Magarsa Lami
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mulualem Keneni
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kedir Teji Roba
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| |
Collapse
|
4
|
Wolfe M, Menon A, Oto M, Fullerton NE, Leach JP. Alcohol and the central nervous system. Pract Neurol 2023:pn-2023-003817. [PMID: 37328277 DOI: 10.1136/pn-2023-003817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2023] [Indexed: 06/18/2023]
Abstract
Ethanol use is common to most cultures but with varying doses and to varying extents. While research has focused on the effects on the liver, alcohol exerts a range of actions on the function and structure of the nervous system. In the central nervous system (CNS) it can provoke or exacerbate neurological and psychiatric disease; its effects on the peripheral nervous system are not included in this review. Sustained alcohol intake can predispose to acute neurochemical changes which, with continued ingestion and incomplete treatment, can lead to chronic structural changes in the CNS: these include generalised cortical and cerebellar atrophy, amnesic syndromes such as Korsakoff's syndrome, and specific white matter disorders such as central pontine myelinolysis and Marchiafava-Bignami syndrome. Alcohol in pregnancy commonly and significantly affects fetal health, though this receives less medical and political attention than other causes of fetal harm. This review looks at the range of disorders that can follow acute or chronic alcohol use, and how these should be managed, and we provide a practical overview on how neurologists might diagnose and manage alcohol addiction.
Collapse
Affiliation(s)
- Maytal Wolfe
- University of Glasgow, Glasgow, UK
- Queen Elizabeth University Hospital, Glasgow, UK
| | - Arun Menon
- University of Glasgow, Glasgow, UK
- Gartnavel Royal Hospital, Glasgow, UK
| | - Maria Oto
- Queen Elizabeth University Hospital, Glasgow, UK
| | - Natasha E Fullerton
- University of Glasgow, Glasgow, UK
- Queen Elizabeth University Hospital, Glasgow, UK
| | | |
Collapse
|
5
|
Gerstner T, Saevareid HI, Johnsen ÅR, Løhaugen G, Skranes J. Sleep disturbances in Norwegian children with fetal alcohol spectrum disorders (FASD) with and without a diagnosis of attention-deficit hyperactivity disorder or epilepsy. Alcohol Clin Exp Res 2023; 47:589-599. [PMID: 36811179 DOI: 10.1111/acer.15009] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/16/2022] [Accepted: 01/04/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND Fetal alcohol spectrum disorder (FASD) describes a combination of developmental, cognitive, and behavioral disabilities in children with prenatal exposure to alcohol. The literature suggests that there are higher rates of sleep disturbances in these children. Few studies have investigated sleep disturbances in relation to common comorbidities of FASD. We examined the prevalence of disturbed sleep and the relationship between parent-reported sleep problems in different FASD subgroups and comorbidities like epilepsy or attention-deficit hyperactivity disorder (ADHD) and impact on clinical functioning. METHODS In this prospective cross-sectional survey, caregivers of 53 children with FASD completed the Sleep Disturbance Scale for Children (SDSC). Information about comorbidities was collected, and EEG and assessment of IQ, daily-life executive and adaptive functioning were performed. Group comparisons and ANCOVA interaction models were used to test the associations between different sleep disturbances and clinical factors that could interfere with sleep. RESULTS An abnormal sleep score on the SDSC was very common, affecting 79% of children (n = 42) with equal prevalence in all FASD subgroups. Difficulty falling asleep was the most common sleep problem, followed by difficulty staying asleep and waking early. The incidence of epilepsy was 9.4%, with an abnormal EEG seen in 24.5%, and a diagnosis of ADHD in 47.2% of children. The distribution of these conditions was equal in all FASD subgroups. Children with signs of sleep disturbance had poorer working memory, executive function, and adaptive functioning. Children with ADHD had a greater prevalence of sleep disturbance than those without ADHD (OR 1.36; 95% CI 1.03 to 1.79). CONCLUSION Problems with sleep are very common in FASD children and seem independent of FASD subgroup and the presence of epilepsy or a pathological EEG finding, while those with ADHD had more sleep problems. The study underscores the importance of screening for sleep disturbances in all children with FASD as these problems may be treatable.
Collapse
Affiliation(s)
- Thorsten Gerstner
- Regional Competence for Children with Prenatal Alcohol/Drug Exposure, Department of Pediatrics, Sørlandet Hospital, Arendal, Norway.,Department of clinical and molecular medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Hans Inge Saevareid
- Department of Health and Nursing Sciences, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
| | - Åse Ribe Johnsen
- Department of Health and Nursing Sciences, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
| | - Gro Løhaugen
- Regional Competence for Children with Prenatal Alcohol/Drug Exposure, Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - Jon Skranes
- Regional Competence for Children with Prenatal Alcohol/Drug Exposure, Department of Pediatrics, Sørlandet Hospital, Arendal, Norway.,Department of clinical and molecular medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| |
Collapse
|
6
|
Brown J, Arvidson J, Carter MN, Spiller V. Fetal alcohol spectrum disorder and Risk-Need-Responsivity Model: A guide for criminal justice and forensic mental health professionals. Front Psychol 2023; 13:689837. [PMID: 36778163 PMCID: PMC9911866 DOI: 10.3389/fpsyg.2022.689837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 10/17/2022] [Indexed: 01/28/2023] Open
Abstract
Fetal alcohol spectrum disorder (FASD) is an umbrella term used to describe a range of significant neurodevelopmental, brain-based disorders and impairments that result from prenatal alcohol exposure. FASD is a high prevalence but underdiagnosed group of disorders affecting between 17 and 36% of individuals in criminal justice settings. Despite being a high-impact disorder associated with lifelong impairments with a significant need for services and interventions, little research has been completed on how to best support individuals with these conditions in criminal justice settings. This article proposes a renewed focus on applying and adapting the Risk-Need-Responsivity (RNR) approach to individuals with FASD in criminal justice settings. This will assist in better determining the needs and interventions likely to effect change and reduce recidivism for this prominent criminal justice-based population. The RNR approach has been used with multiple corrections populations to determine the need and most appropriate interventions, as well as how to best allocate scarce resources. As the prevalence of FASD becomes better understood and recognized, evidence-based approaches to addressing this specific sub-population are necessary to effect change and reduce recidivism and ongoing involvement in the criminal justice system.
Collapse
Affiliation(s)
- Jerrod Brown
- American Institute for the Advancement of Forensic Studies, St. Paul, MN, United States,Concordia University, St. Paul, MN, United States,*Correspondence: Jerrod Brown,
| | - Joe Arvidson
- Concordia University, St. Paul, MN, United States,Metropolitan State University, St. Paul, MN, United States,American Institute for the Advancement of Forensic Studies (AIAFS), St. Paul, MN, United States
| | - Megan N. Carter
- University of Washington, Seattle, WA, United States,Department of Social and Health Services, Special Commitment Center, Steilacoom, WA, United States
| | | |
Collapse
|
7
|
Chang G. Reducing Prenatal Alcohol Exposure and the Incidence of FASD: Is the Past Prologue? Alcohol Res 2023; 43:02. [PMID: 37114249 PMCID: PMC10127686 DOI: 10.35946/arcr.v43.1.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
PURPOSE This narrative review summarizes and synthesizes the clinical trials and randomized clinical trials that evaluated selected and targeted approaches to reducing preconception and prenatal alcohol exposure (PAE) and alcohol-exposed pregnancy (AEP) since 2011. SEARCH METHODS A professional hospital librarian completed the primary search using strategies specified within this review, resulting in 94 records returned in PubMed, Ovid MEDLINE, Clinical Key, the World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov. The author completed two supplementary literature searches. SEARCH RESULTS From the total of 238 records returned from the three searches, 217 records were eliminated. Elimination reasons included other medical problem (119); duplicate entry (34); no content/results (23); secondary analysis (16); focus on effects of PAE (9); treatment of childhood fetal alcohol spectrum disorders (FASD) (6); maternal risk factors (3); and other (7). The remaining 21 studies were included with four overarching themes: (1) case management efforts (n = 4); (2) preconception efforts to reduce AEP (n = 5); (3) motivational interviewing and screening, brief intervention, and referral to treatment (n = 2); and (4) use of technology to deliver the intervention (n = 10). DISCUSSION AND CONCLUSIONS Case management and home visits did not appear to have strong current empirical support. Study limitations included small sample sizes and no comparison groups, whereas larger efforts did not demonstrate definitive advantages to justify this intensive approach. The studies of preconception efforts, all based on the Project CHOICES approach, had similar outcomes, with the reduction in AEP risk largely due to improved contraception in women of childbearing age who were sexually active and drank alcohol but were not pregnant. It is unknown whether these women refrained from alcohol use when they became pregnant. Two studies of motivational interviewing to reduce prenatal alcohol use did not demonstrate the efficacy of the intervention. Both were small, with less than 200 pregnant women combined; moreover, the study samples had low baseline levels of alcohol use, allowing little opportunity for improvement. Finally, studies evaluating the impact of technological approaches to reducing AEP were reviewed. These exploratory investigations had small sample sizes and provided preliminary evaluations of techniques such as text messages, telephone contact, computer-based screening, and motivational interviewing. The potentially promising findings may inform future research and clinical efforts. Future directions may include research to address the limitations of the evidence to date and should reflect the complexities of FASD that include the biological and social context associated with prenatal alcohol use.
Collapse
Affiliation(s)
- Grace Chang
- Department of Mental Health, Veterans Administration Boston Healthcare System, Boston, Massachusetts, Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
8
|
Ujhelyi Gomez K, Goodwin L, Chisholm A, Rose AK. Alcohol use during pregnancy and motherhood: Attitudes and experiences of pregnant women, mothers, and healthcare professionals. PLoS One 2022; 17:e0275609. [PMID: 36454984 PMCID: PMC9714863 DOI: 10.1371/journal.pone.0275609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 09/13/2022] [Indexed: 12/03/2022] Open
Abstract
Alcohol is the most used substance by women of childbearing age. Alcohol exposed pregnancies can have serious consequences to the fetus, and the UK has one of the highest rates of drinking during pregnancy. Alcohol use during motherhood is also a public health concern, linked with potential harms to the woman and child. This qualitative study investigated the attitudes and experiences of pregnant/parenting women and healthcare professionals regarding maternal drinking. A semi-structured focus group and interviews were conducted in the North West of England with pregnant women, mothers, and healthcare professionals. Quantitative measures captured demographics, alcohol use, and screened for mental ill-health for pregnant women and mothers. Reflexive thematic analysis was used to analyse narratives. Findings revealed that most participants believed avoiding alcohol during pregnancy is the safest option. However, some pregnant women and mothers stated that there was insufficient evidence to demonstrate the harms of low-level drinking and that abstinence guidelines were patronising. All participants reported that low-level drinking during motherhood was acceptable. Heavy drinking was believed to pose serious harm during pregnancy and motherhood to the baby and mother, in addition to damaging relationships. Strong motives were revealed for choosing and avoiding to drink, such as coping with the difficulties of motherhood and parental responsibilities, respectively. Contradictions were found across quantitative and qualitative self-reports of consumption, reflecting potential underreporting of alcohol use. Additionally, drinking levels were discussed in extremes only (low/heavy) without considering 'grey area' drinking. Clear, consistent advice and guidelines are needed to support women in reducing their alcohol use during pregnancy and motherhood. These should include the unique potential risks regarding maternal drinking, and the harm attributable to non-clinically dependent alcohol use. The maternal participants in this study were middle-class, therefore, research is needed to capture the views and experiences of women of all socioeconomic backgrounds.
Collapse
Affiliation(s)
- Katalin Ujhelyi Gomez
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom
| | - Laura Goodwin
- Division of Health Research, Lancaster University, Lancaster, United Kingdom
| | - Anna Chisholm
- Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Abigail K. Rose
- School of Psychology, Liverpool John Moor University, Liverpool, United Kingdom
- * E-mail:
| |
Collapse
|
9
|
Smith V, Jones K. What a birth mother wants paediatricians to know about diagnosing a fetal alcohol spectrum disorder. Arch Dis Child 2022; 107:407-408. [PMID: 34301618 DOI: 10.1136/archdischild-2021-322333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/19/2021] [Indexed: 11/03/2022]
Affiliation(s)
- Vincent Smith
- Pediatrics Division of Newborn Medicine, Boston Medical Center, Boston, Massachusetts, USA
| | - Kenneth Jones
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA
| |
Collapse
|
10
|
“Now, with a bit more knowledge, I understand why I'm asking those questions.” Midwives’ perspectives on their role in the Greater Manchester Health and Social Care Partnership's programme to Reduce Alcohol Exposed Pregnancies (AEP). Midwifery 2022; 110:103335. [DOI: 10.1016/j.midw.2022.103335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 02/09/2022] [Accepted: 04/02/2022] [Indexed: 11/22/2022]
|
11
|
Selzer EB, Blain D, Hufnagel RB, Lupo PJ, Mitchell LE, Brooks BP. Review of Evidence for Environmental Causes of Uveal Coloboma. Surv Ophthalmol 2021; 67:1031-1047. [PMID: 34979194 DOI: 10.1016/j.survophthal.2021.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 12/22/2021] [Accepted: 12/27/2021] [Indexed: 10/19/2022]
Abstract
Uveal coloboma is a condition defined by missing ocular tissues and is a significant cause of childhood blindness. It occurs from a failure of the optic fissure to close during embryonic development,and may lead to missing parts of the iris, ciliary body, retina, choroid, and optic nerve. Because there is no treatment for coloboma, efforts have focused on prevention. While several genetic causes of coloboma have been identified, little definitive research exists regarding the environmental causes of this condition. We review the current literature on environmental factors associated with coloboma in an effort to guide future research and preventative counseling related to this condition.
Collapse
Affiliation(s)
- Evan B Selzer
- Ophthalmic Genetics & Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, MD
| | - Delphine Blain
- Ophthalmic Genetics & Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, MD
| | - Robert B Hufnagel
- Ophthalmic Genetics & Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, MD
| | - Philip J Lupo
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX
| | - Laura E Mitchell
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, Houston, TX
| | - Brian P Brooks
- Ophthalmic Genetics & Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, MD.
| |
Collapse
|
12
|
Affiliation(s)
- Neil Aiton
- One Stop Clinic, University Hospitals Sussex NHS Foundation Trust, Royal Sussex County Hospital, Brighton, UK
| |
Collapse
|
13
|
McCarthy R, Mukherjee RAS, Fleming KM, Green J, Clayton-Smith J, Price AD, Allely CS, Cook PA. Prevalence of fetal alcohol spectrum disorder in Greater Manchester, UK: An active case ascertainment study. Alcohol Clin Exp Res 2021; 45:2271-2281. [PMID: 34590329 PMCID: PMC9292152 DOI: 10.1111/acer.14705] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 08/24/2021] [Accepted: 08/30/2021] [Indexed: 12/26/2022]
Abstract
Background Despite high levels of prenatal alcohol exposure in the UK, evidence on the prevalence of fetal alcohol spectrum disorders (FASD) is lacking. This paper reports on FASD prevalence in a small sample of children in primary school. Methods A 2‐phase active case ascertainment study was conducted in 3 mainstream primary schools in Greater Manchester, UK. Schools were located in areas that ranged from relatively deprived to relatively affluent. Initial screening of children aged 8–9 years used prespecified criteria for elevated FASD risk (small for age; special educational needs; currently/previously in care; significant social/emotional/mental health symptoms). Screen‐positive children were invited for detailed ascertainment of FASD using gold standard measures that included medical history, facial dysmorphology, neurological impairment, executive function, and behavioral difficulties. Results Of 220 eligible children, 50 (23%) screened positive and 12% (26/220) proceeded to Phase 2 assessment. Twenty had a developmental disorder, of whom 4 had FASD and 4 were assessed as possible FASD. The crude prevalence rate of FASD in these schools was 1.8% (95% CI: 1.0%, 3.4%) and when including possible cases was 3.6% (2.1%, 6.3%). None of these children had previously been identified with a developmental diagnosis. Conclusions FASD was found to be common in these schools and most of these children's needs had not previously been identified. A larger, more definitive study that uses a random sampling technique stratified by deprivation level to select schools is needed to make inferences regarding the population prevalence of FASD.
Collapse
Affiliation(s)
- Robyn McCarthy
- School of Health and Society, University of Salford, Salford, UK
| | - Raja A S Mukherjee
- School of Health and Society, University of Salford, Salford, UK.,Fetal Alcohol Spectrum Disorder Service, Surrey & Borders Partnership NHS Foundatation Trust, Redhill, UK
| | - Kate M Fleming
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Jonathan Green
- Division of Neuroscience & Experimental Psychology, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK
| | - Jill Clayton-Smith
- Division of Evolution & Genomic Sciences, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK
| | - Alan D Price
- School of Health and Society, University of Salford, Salford, UK
| | - Clare S Allely
- School of Health and Society, University of Salford, Salford, UK
| | - Penny A Cook
- School of Health and Society, University of Salford, Salford, UK
| |
Collapse
|
14
|
Kruithof P, Ban S. A brief overview of fetal alcohol syndrome for health professionals. ACTA ACUST UNITED AC 2021; 30:890-893. [PMID: 34379462 DOI: 10.12968/bjon.2021.30.15.890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Fetal alcohol syndrome (FAS) and fetal alcohol spectrum disorders (FASDs) are caused by prenatal alcohol exposure (PAE). They cause epigenetic changes, permanent neurodevelopmental deficits, and anomalies in growth and facial structure. This article enforces the need for health and social care professionals to have a greater understanding and awareness of how FAS and FASD may impact on the individual, the family and the community, to enable them to provide the most effective preventive and supportive care possible.
Collapse
Affiliation(s)
- Peter Kruithof
- Lecturer Global Health, School of Psychology, Faculty of Health Sciences and Wellbeing, Sunderland University, Sunderland
| | - Sasha Ban
- Senior Lecturer, Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne
| |
Collapse
|