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Fetal alcohol-spectrum disorders: identifying at-risk mothers

Authors Montag A

Received 24 February 2016

Accepted for publication 26 May 2016

Published 21 July 2016 Volume 2016:8 Pages 311—323

DOI https://doi.org/10.2147/IJWH.S85403

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 5

Editor who approved publication: Professor Elie Al-Chaer


Annika C Montag

Department of Pediatrics, Division of Dysmorphology and Teratology, University of California San Diego, San Diego, CA, USA

Abstract: Fetal alcohol-spectrum disorders (FASDs) are a collection of physical and neuro­behavioral disabilities caused by prenatal exposure to alcohol. To prevent or mitigate the costly effects of FASD, we must identify mothers at risk for having a child with FASD, so that we may reach them with interventions. Identifying mothers at risk is beneficial at all time points, whether prior to pregnancy, during pregnancy, or following the birth of the child. In this review, three approaches to identifying mothers at risk are explored: using characteristics of the mother and her pregnancy, using laboratory biomarkers, and using self-report assessment of alcohol-consumption risk. At present, all approaches have serious limitations. Research is needed to improve the sensitivity and specificity of biomarkers and screening instruments, and to link them to outcomes as opposed to exposure. Universal self-report screening of all women of childbearing potential should ideally be incorporated into routine obstetric and gynecologic care, followed by brief interventions, including education and personalized feedback for all who consume alcohol, and referral to treatment as indicated. Effective biomarkers or combinations of biomarkers may be used during pregnancy and at birth to determine maternal and fetal alcohol exposure. The combination of self-report and biomarker screening may help identify a greater proportion of women at risk for having a child with FASD, allowing them to access information and treatment, and empowering them to make decisions that benefit their children.

Keywords: fetal alcohol-spectrum disorder (FASD), alcohol, pregnancy, screening, biomarkers, SBIRT

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