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Cited by 28Prenatal Substance Exposure EffectsSubstance Abuse Treatment and OutcomesFetal and Pediatric Neurological Disorders

Characterizing Alcohol‐Related Neurodevelopmental Disorder: Prenatal Alcohol Exposure and the Spectrum of Outcomes

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Coles, Claire D., Kalberg, Wendy, Kable, Julie A., Tabachnick, Barbara, May, Philip A., Chambers, Christina D.·2020·Alcoholism: Clinical and Experimental Research
DOI 10.1111/acer.14325PMC PMC9183179
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Abstract

Background: The effects of prenatal alcohol exposure (PAE) are conceptualized as fetal alcohol spectrum disorder, with fetal alcohol syndrome (FAS) as the most severe. Many find it more difficult to characterize behavioral and cognitive effects of exposure on the central nervous system when physical signs are not present. In the current study, an operational definition of alcohol‐related neurodevelopmental disorder (ARND) was examined to determine its usefulness in discrimination of children classified as ARND based on behavior (ARND/B) and cognition (ARND/C) from children in 4 contrast groups: (i) children exposed to study‐defined “risky drinking”; (ii) children with any reported PAE; (iii) children classified as “Higher Risk” for developmental problems; and (iv) children classified as “Lower Risk.” Methods: A total of 1,842 children seen as part of a surveillance study (J Am Med Assoc, 319, 2018, 474) were evaluated for alcohol exposure and physical characteristics of FAS, and completed neurodevelopmental testing. Ninety‐one were identified as either ARND/B or ARND/C and contrasted with other groups to further identify distinguishing patterns. Multinomial logistic regression (MLR) was used to examine the accuracy of classification and to identify factors contributing to such classification. Results: Children described as ARND/C were distinct from other groups based on cognition and behavior as well as demographic factors (e.g., age, race, SES), child characteristics (e.g., gestational age; sex), and other drug exposures, while those described as ARND/B differed only on behavior and other drug exposures. MLR models successfully discriminated ARND groups from children in other groups with accuracy ranging from 79% (Higher Risk) to 86.7% (Low Risk). Conclusions: ARND has been a subject of debate. This analysis suggests the effects of alcohol on behavior and cognition even in the absence of the characteristic facial features and growth deficiency that can be identified. The results also indicate that it may be possible to distinguish such children from those in other high‐risk groups.

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  • Women who abused alcohol during pregnancy may deliver children with severe developmental delays, smaller brains and cognitive problems called Fetal Alcohol Syndrome (FAS).

    “In the early ‘70s it was found that women who abused alcohol during pregnancy may deliver children with severe developmental delays, smaller brains and cognitive problems called Fetal Alcohol Syndrome (FAS) [315].”

    From Development of prefrontal cortex (2022) · cites this paper as [315]

    The introductory passage under Abstract > Conclusions describes FAS as the most severe outcome of prenatal alcohol exposure and identifies neurobehavioral effects and growth deficiency. Methods > Study Design also treats small head circumference as a possible sign of FAS risk. These passages support the broad association, but do not establish the early-1970s discovery or specifically say that affected children have smaller brains and severe developmental delays. (LLM, conf=0.84)

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Research works printed but not linked: 5

  1. Beery KE, Beery NA (2004). The Beery-Buktenica Developmental Test of Visual-Motor Integration – 5th Edition. San Antonio, Texas: Pearson Assessment.
  2. Elliott CD (2007). Differential Ability Scales – Second Edition. San Antonio Texas: Pearson Assessment.
  3. Korkman M, Kirk U, Kemp S (2007). NEPSY-II. San Antonio, Texas: Pearson Assessment.
  4. Riniolo T (1999) Using a Large Control Group for Statistical Comparison: Evaluation of a Between-Groups Median Test. The Journal of Experimental Education, 68(1), 75– 88. Retrieved from http://www.jstor.org/stable/20152616
  5. Sparrow AS, Cicchetti DV, Balla DA (2005). Vineland Adaptive Behavior Scales – Second Edition. Bloomington, Minnesota: Pearson Assessment

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  • Development of prefrontal cortex

    Kolk, S. M., & Rakic, P. (2022) · Neuropsychopharmacology · doi:10.1038/s41386-021-01137-9 · Cited by 378 · see citing works

    “MRI studies showed reductions in brainstem as well as cerebellum volume in a primate FAS model and a sex-dependent change in functional connectivity and metabolism in prefrontal areas in a rat FAS model [317, 318].”
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Authors
Coles, C. D., Kalberg, W., Kable, J. A., Tabachnick, B., May, P. A., & Chambers, C. D.
Affiliations
  • Emory University (US)
  • University of New Mexico (US)
  • California State University, Northridge (US)
  • University of North Carolina at Chapel Hill (US)
  • University of California San Diego (US)
Corresponding author
Coles, Claire D.
ORCID
Venue
Alcoholism: Clinical and Experimental Research
Publisher
Wiley
Published
2020-05-20
Volume
44
Issue
6
Pages
1245-1260
ISSN
  • 0145-6008 (ISSN-L)
  • 1530-0277
DOI
10.1111/acer.14325
PMC
PMC9183179
OpenAlex
W3010674108
Cited by
28
References
46
Citations by year
2026: 4 · 2025: 3 · 2024: 3 · 2023: 7 · 2022: 5 · 2021: 2 · 2020: 4
FWCI
4.32
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Alcoholism Clinical and Experimental Research (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
National Institute on Alcohol Abuse and Alcoholism (UO1AA019879 andU01AA019894)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Fetal and Pediatric Neurological Disorders
Keywords
alcohol-related neurodevelopmental disorder, prenatal alcohol exposure, fetal alcohol spectrum disorders, fetal alcohol syndrome, hazardous drinking, child behavior, children's cognition, classification accuracy, developmental risk, drug exposure, gestational age, socioeconomic status
MeSH terms
Problem Behavior, Attention Deficit Disorder with Hyperactivity, Child, Preschool, Cognition, Female, Gestational Age, Humans, Disruptive, Impulse Control, and Conduct Disorders, Learning Disabilities, Male, Memory Disorders, Intellectual Disability, Neuropsychological Tests, Pregnancy, Prenatal Exposure Delayed Effects, Psychomotor Performance, Severity of Illness Index, Social Class, Logistic Models, Mood Disorders, Executive Function, Fetal Alcohol Spectrum Disorders

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