Prevention of fetal alcohol spectrum disorders

Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Prevention Research Branch, Fetal Alcohol Syndrome Prevention Team, Atlanta, Georgia 30333, USA.
Developmental Disabilities Research Reviews (Impact Factor: 2.75). 01/2009; 15(3):193-9. DOI: 10.1002/ddrr.75
Source: PubMed


Alcohol use among women of childbearing age is a leading, preventable cause of birth defects and developmental disabilities in the United States. Although most women reduce their alcohol use upon pregnancy recognition, some women report drinking during pregnancy and others may continue to drink prior to realizing they are pregnant. These findings emphasize the need for effective prevention strategies for both pregnant and nonpregnant women who might be at risk for an alcohol-exposed pregnancy (AEP). This report reviews evidence supporting alcohol screening and brief intervention as an effective approach to reducing problem drinking and AEPs that can lead to fetal alcohol spectrum disorders. In addition, this article highlights a recent report of the National Task Force on Fetal Alcohol Syndrome and Fetal Alcohol Effect that describes effective interventions to reduce alcohol use and AEPs, and outlines recommendations on promoting and improving these strategies. Utilizing evidence-based alcohol screening tools and brief counseling for women at risk for an AEP and other effective population-based strategies can help achieve future alcohol-free pregnancies.

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Available from: Rosa Louise Floyd, Jul 15, 2014
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    • "The relative efficacy of clinical and alternative settings in screening for alcohol-related health problems among pregnant women is of practical and research interest. This pertains to outcomes regarding the detection and prevention of prenatal alcohol exposure, and for early diagnosis of Fetal Alcohol Spectrum Disorder (FASD) (Fleming, Lund, Wilton, Landry, & Scheets, 2008; Floyd, Weber, Denny, & O'Connor, 2009; Neushotz & Fitzpatrick, 2008). Primary care providers are in a unique position to provide developmental surveillance, screening, and treatment referrals (Loock, Conry, Cook, Chudley, & "
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    ABSTRACT: Despite the availability of clinical tools and evidence-based screening recommendations, there has been little discussion regarding screening of prenatal alcohol exposure in community-based settings, including adoption and implementation. This study's aim is to evaluate and validate-through surveys and focus groups-obstacles and challenges that shape efficacious implementation of the BAI at two Illinois health departments. Results suggest that BAI implementation is facilitated by staff perceptions of its benefits, readiness to implement the intervention, and organizational support for it. Limitations of the management information system, ambiguous screening questions, and high case-loads present barriers to effective BAI implementation.
    Substance Use &amp Misuse 02/2014; 49(7). DOI:10.3109/10826084.2014.880484 · 1.23 Impact Factor
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    • "The approach also includes an emphasis on the individual’s responsibility for his/her own consumption, empathic attitude, counseling toward changing those behaviors based on the identification of strategies for interrupting or decreasing consumption and stimulus to the patient’s self-efficacy perception. Moreover, the setting of goals to be achieved and reassessed at follow-up sessions is common practice in this type of intervention [4,6,9,16,17]. "
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    ABSTRACT: Problems related to alcohol consumption are priority public health issues worldwide and may compromise women's health. The early detection of risky alcohol consumption combined with a brief intervention (BI) has shown promising results in prevention for different populations. The aim of this study was to examine data from recent scientific publications on the use of BI toward reducing alcohol consumption among women through a systematic review. Electronic searches were conducted using Web of Science, PubMed(Medline) and PsycInfo databases. In all databases, the term "brief intervention" was associated with the words "alcohol" and "women", and studies published between the years 2006 and 2011 were selected. Out of the 133 publications found, the 36 scientific articles whose central theme was performing and/or evaluating the effectiveness of BI were included. The full texts were reviewed by content analysis technique. This review identified promising results of BI for women, especially pregnant women and female college students, in different forms of application (face-to-face, by computer or telephone) despite a substantial heterogeneity in the clinical trials analyzed. In primary care, which is a setting involving quite different characteristics, the results among women were rather unclear. In general, the results indicated a decrease in alcohol consumption among women following BI, both in the number of days of consumption and the number of doses, suggesting that the impact on the woman's reproductive health and the lower social acceptance of female consumption can be aspects favorable for the effectiveness of BI in this population.
    Substance Abuse Treatment Prevention and Policy 09/2013; 8(1):31. DOI:10.1186/1747-597X-8-31 · 1.16 Impact Factor
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    • "Of these, nearly one third are due to the consumption of alcohol during pregnancy (Cynthia, 1996; Floyd & Sidhu, 2004; Hoyme et al., 2005). As a result, 9.1 cases per 1000 live births exhibit some degree of fetal alcohol spectrum disorder, which can vary from barely detectable to severe functional and cognitive birth defects (Becker, Diaz-Granados, & Randall, 1996; Floyd, Weber, Denny, & O'Connor, 2009). Despite years of intense study, both the biochemical mechanisms of alcohol-induced teratogenesis and the developmental origins of fetal alcohol spectrum disorders remain poorly defined. "
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    ABSTRACT: Identification of the transcriptional networks disrupted by prenatal ethanol exposure remains a core requirement to better understanding the molecular mechanisms of alcohol-induced teratogenesis. In this regard, quantitative reverse-transcriptase polymerase chain reaction (qPCR) has emerged as an essential technique in our efforts to characterize alterations in gene expression brought on by exposure to alcohol. However, many publications continue to report the utilization of inappropriate methods of qPCR normalization, and for many in vitro models, no consistent set of empirically tested normalization controls have been identified. In the present study, we sought to identify a group of candidate reference genes for use within studies of alcohol exposed embryonic, placental, and neurosphere stem cells under both conditions maintaining stemness as well as throughout in vitro differentiation. To this end, we surveyed the recent literature and compiled a short list of fourteen candidate genes commonly used as normalization controls in qPCR studies of gene expression. This list included: Actb, B2m, Gapdh, Gusb, H2afz, Hk2, Hmbs, Hprt, Mrpl1, Pgk1, Ppia, Sdha, Tbp, and Ywhaz. From these studies, we find no single candidate gene was consistently refractory to the influence of alcohol nor completely stable throughout in vitro differentiation. Accordingly, we propose normalizing qPCR measurements to the geometric mean C(T) values obtained for three independent reference mRNAs as a reliable method to accurately interpret qPCR data and assess alterations in gene expression within alcohol treated cultures. Highlighting the importance of careful and empirical reference gene selection, the commonly used reference gene Actb was often amongst the least stable candidate genes tested. In fact, it would not serve as a valid normalization control in many cases. Data presented here will aid in the design of future experiments using stem cells to study the transcriptional processes driving differentiation, and model the developmental impact of teratogens.
    Alcohol (Fayetteville, N.Y.) 01/2013; 47(2). DOI:10.1016/j.alcohol.2012.12.003 · 2.01 Impact Factor
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