Activated microglia also exhibit changes in gene expression, function and produce an array of pro-inflammatory cytokines, chemokines and reactive oxygen species (ROS). Microglia polarize, much like T-cells, becoming relatively drunken baby syndrome pro- or anti-inflammatory depending on the surrounding environmental cues present (Nakagawa and Chiba, 2015). Microglia are also capable of clearing pathogens or cellular debris via phagocytosis.
Social and behavioral issues
Other issues, like learning disabilities or ADHD, may improve with appropriate therapies, medications, and other support. A child is considered to have partial fetal alcohol syndrome when they have been exposed to alcohol in the womb and have some but not all of the traits linked to FAS. According to the Centers for Disease Control and Prevention, the percentage of pregnant women who consume alcohol increased from 7.6% in 2012 to 10.2% in 2015, and the number of pregnant women reporting binge drinking (at least four alcoholic beverages at once) increased from 1.4% to 3.1%. Make sure that people who can become pregnant or are already pregnant learn that drinking alcohol while pregnant can be potentially harmful to their babies. If a pregnant person has a problem with using alcohol and cannot stop using, substance use treatment during pregnancy should be offered.
WHAT IS NEW ON THIS TOPIC: FETAL ALCOHOL SPECTRUM DISORDERS
Mitigating stigma is vital while addressing the structural and systemic factors that promote prenatal alcohol consumption35. Find resources and tools to support provision of a medical home for children with fetal alcohol spectrum disorders in your practice. An FASD diagnosis provides families, pediatricians and nonphysician clinicians a framework for understanding an individual’s behavior. Science indicates that therapeutic interventions, special education and support services improve outcomes for patients and families.
- Also, not all people who drink while pregnant feel comfortable talking to their healthcare provider.
- Application of a FASD prevention framework requires consideration of local policy and practices.
- Other studies report a high prevalence of vision and hearing problems among people with FASD265,266.
- If the child is more than 3 years of age, parents or caregivers can talk to a pediatrician and contact any nearby elementary school to ask for an evaluation.
- A National Institutes of Health-funded study led by Michael Rivkin, MD, of Neurology, suggests that such exposures may have effects on brain structure that persist into adolescence.
- The lifelong challenges and unmet needs of caregivers negatively affect family functioning and QOL281.
Genes associated with PAE
- In an earlier study, neurons cultured in conditioned media from astrocytes exposed in culture to 100 mM alcohol for 4 days displayed reduced DNA content, neurite length, number of serotonin neurons and serotonin uptake (Lokhorst and Druse, 1993).
- While FASDs can be caused by heavy drinking, any exposure to alcohol at any time during pregnancy may cause issues with a baby’s growth and development and lead to these conditions.
- For fetal alcohol syndrome—which is also characterized by growth deficiencies, distinct facial features, and other physical factors in addition to CNS involvement—confirmation of prenatal alcohol exposure is not required.
Indeed, microglia phagocytize neural precursor cells, particularly during late stages of cortical neurogenesis therefore regulating the size of the neural precursor cell pool in the developing cortex (Cunningham et al., 2013). Microglia also instruct neuronal apoptosis, engulf and phagocytize apoptotic neurons (Bessis et al., 2007; Marín-Teva et al., 2011) and induce synaptic pruning (Paolicelli et al., 2011). The ratio of macroglia (astrocytes and oligodendrocytes) to neurons increases as the evolutionary complexity of the species increases (Sherwood et al., 2006), suggesting that astrocytes play an important role in higher order cognition and brain development. In addition, astrocytes are tuned to sense neuronal cues as evidenced by the diverse array of neurotransmitter receptors they express (Steinhauser and Kettenmann, 2009).
- Even a small amount of alcohol can have adverse effects on a growing fetus.
- In mice, PAE during corticogenesis also disrupts radial migration and pyramidal cell development in the somatosensory cortex, which could be linked to decreased tactile sensitivity during adolescence140.
- If your child is diagnosed with an FASD, the diagnosis will be for a specific condition under the umbrella of FASDs, as listed above.
- This can cause the alcohol levels to remain high and stay in your baby’s body longer.
- In addition to the acute effects of withdrawal, babies often suffer the teratogenic (causing physical abnormalities) effects of alcohol.
Differential diagnosis
The volume of the parietal lobe in the cerebral cortex is consistently reduced in FASD individuals (Archibald et al., 2001). Further, the composition of cortical brain regions is also impacted, with FASD brains exhibiting increases in gray matter, but reductions in white matter in the perisylvian cortices of the parietal and temporal lobes (Sowell et al., 2001). Such disruptions of normal cortical development are thought to underlie deficits in executive functions, verbal learning and recall, visuospatial processing and language present in individuals with FASD (Riley and McGee, 2005; Norman et al., 2009; Lebel et al., 2011). Neurodevelopmental impairments may lead to lifelong ‘secondary’ disabilities, including academic failure, substance abuse, mental health problems, contact with law enforcement and inability to live independently or obtain/maintain employment267 (Box 2).
