Focus On: Biomarkers of Fetal Alcohol Exposure and Fetal Alcohol Effects

By Bakhireva, Ludmila N.; Savage, Daniel D. | Alcohol Research, January 1, 2011 | Go to article overview
Save to active project

Focus On: Biomarkers of Fetal Alcohol Exposure and Fetal Alcohol Effects


Bakhireva, Ludmila N., Savage, Daniel D., Alcohol Research


One of the ongoing challenges for the accurate diagnosis and treatment of children with fetal alcohol spectrum disorders (FASD) is the difficulty of confirming whether a mother drank during her pregnancy. Commonly used screening questionnaires often are unreliable, and current established biomarkers of alcohol consumption are not sensitive enough for use with many pregnant women. These limitations underscore the critical need to develop novel biomarkers with greater sensitivity for detecting moderate levels of drinking during pregnancy for longer periods of time after the last drinking episode. In addition, developing reliable biomarkers of fetal alcohol effects that can identify children at risk for adverse neurobehavioral outcomes could lead to behavioral interventions earlier in development. The use of animal models of FASD in biomarker development could accelerate progress in this challenging field of research. KEY WORDS: Maternal alcohol exposure; prenatal alcohol exposure; pregnancy; fetal alcohol effects; fetal alcohol spectrum disorders; prenatal diagnosis; screening and diagnostic method; biomarkers

Despite publicawareness campaigns and warning labels on alcoholic beverages, roughly one of every eight women in the United States continues to drink during her pregnancy. The term fetal alcohol syndrome (FAS) was first used in the 1970s to describe a specific pattern of malformations associated with prenatal alcohol exposure (Jones et al. 1974). The continuum of clinical presentations caused by prenatal alcohol exposure is known as fetal alcohol spectrum disorders (FASD). Attempts to accurately estimate the prevalence of FASD have been challenging because of numerous methodological issues, including diagnostic criteria, passive versus active surveillance, and difficulties with ascertainment of milder cases of FASD in the absence of fetal alcohol-induced birth defects. The prevalence of FAS ranges from 0.5 to 7.0 per 1,000 live births in the general population and up to 9.8 per 1,000 live births in highrisk groups (May et al. 2001, 2009). The prevalence of the entire continuum of FASD might be as high as 1 to 5 percent in young school children in the United States (Lupton et al. 2004; May et al. 2001, 2009), which is higher than the prevalence of autism spectrum disorders.

A large majority of fetal alcohol-affected children may show no physical evidence of prenatal alcohol-associated birth defects. In the absence of characteristic FAS dysmorphology, recognition of FASD requires confirmation of maternal drinking during pregnancy. However, maternal drinking histories are generally unreliable, and the utility of currently available biomarkers of alcohol exposure is limited. Thus, one of the critical challenges for the fetal alcohol research community is to develop better methods for detecting drinking during pregnancy. This article will examine current methods for detecting maternal and fetal alcohol exposure, including selfreporting and biomarkers. The limitations of current methods, however, underscore the critical need to develop new biomarkers with greater sensitivity for detecting moderate levels of drinking during pregnancy for longer periods of time after the last drinking episode. Thus future research needs are reviewed as well.

The development of more sensitive and reliable biomarkers for alcohol use could serve two important objectives in clinical intervention. First, the ability to identify more women who are drinking during pregnancy, particularly early in pregnancy, would allow providers to educate such patients about the dangers of drinking during pregnancy and provide counseling to reduce the risk of subsequent drinking episodes. Effective intervention at this point would benefit not only the mother and fetus but also could reduce the risks of fetal alcohol damage in subsequent pregnancies. Second, a biomarker, or perhaps a combination of biomarkers and other clinical measures, could provide an early indication of whether a newborn child is at risk for developing behavioral and/or cognitive problems later in life, creating opportunities for earlier postnatal interventions that may reduce longerterm adverse consequences.

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
Loading One moment ...
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited article

Focus On: Biomarkers of Fetal Alcohol Exposure and Fetal Alcohol Effects
Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

While we understand printed pages are helpful to our users, this limitation is necessary to help protect our publishers' copyrighted material and prevent its unlawful distribution. We are sorry for any inconvenience.
Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.

Are you sure you want to delete this highlight?