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Birth and Growth Without OH: Detection and Follow-Up From Pregnancy Until the End of Adolescence of Children at Risk of Neurobehavioral Disorders Through Exposure of Alcohol and Illegal Drugs

Abstract

Introduction: This integrated study examines the prevention and detection/follow-up of children at risk of neurobehavioral disorders associated with prenatal and/or postnatal exposure to alcohol and illegal drugs. We utilized the Elijo Mas Sano (Choose Healthier) registry of children at environmental risk from drugs and alcohol. Methods: For this descriptive study of environmental clinical history, we observed the first 39 patients of Elijo Mas Sano. We included clinical, social and neurodevelopmental evaluations. The Elijo Mas Sano criteria of inclusion was a) >20 g/day of alcohol and/or 3 incidents of binge drinking of ≥40 g/day during periconceptional, gestational, or lactation stages and/or b) fetal exposure to any illegal drug at least once a week. Ethical approval was granted by the Clinical Research Ethics Committee of the University Hospital Virgen de la Arrixaca. Results: The study group was comprised 39 subjects, 19 girls and 20 boys. The gestation period was an average of 38.26 weeks (min. 30; max. 41). There were 5 premature newborns (<36 gestation week). The average birth weight (≥36 gestation week) was 3,055 g (min. 2,433.9; max. 3,676.1). The average consumption of alcohol at early pregnancy in mothers was 33.55 g (con dence interval 95% 23.7-43.2). In the study group, 33% reported 3 or more incidents of binge drinking. Fetal exposure to illegal drugs occurred in 18% of the study group. Four patients had neonatal anthropometry (≥36 gestation week) with an average head circumference of <p10, a birth weight of <p10: 9, and 3 patients had a height of <p10. There were 6 patients with major congenital malformations. Two patients had chromosomal comorbidities. We evaluated 37 of the 39 patients’ facial features: palpebral fissure (<-2 standard deviation): 2, philtrum (4-5): 2, upper lip (4-5): 4. The Battelle test neurodevelopmental evaluation was given to 30 of the 39 subjects to examine personal and social, adaptive, motor, and communication domains. Twenty-eight showed delays on one domain and 21 in 3 or more. A negative correlation existed between g/day of ethanol and months of cognitive delay (-0.37, p<0.05). In the study, 35% had an average cognitive delay of -8.5 months (confidence interval 95% -0.5;-16.5). For some of the study group participants, growth curves and head circumference showed normalization by 2 years. Conclusions: Half of the children from the Elijo Mas Sano registry had neurodevelopmental delays before the age of 2. The program of prevention and harm reduction of intrauterine exposure to alcohol and other drugs has been implemented with good preliminary results: decreased alcohol consumption during pregnancy and syndromes and alcohol-related birth defects. The next step is to follow-up to children who are at risk of fetal alcohol spectrum disorders through adolescence.
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INTRODUCTION
INTRODUCTION
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METHODS
METHODS
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&*&/$1)1*-%%)K&&->&')4&$*)=-*5)/2 )$9&'(&2/$$)?/1/+
RESULTS
RESULTS
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@%)'+ ;, %/?+ A+ &$& B&$& M 5$&%/#$& '&B.-$'* @N; 9&*/D-' B&&CA+ & /4&$/9& .)$ B&)9 @J;
9&*/D-'B&&CAB/*;7MM9@%)'+7;;+H,%/?+;7O+A+&/4&$/9&1-'*#%5D-'->/21--2/&/$2=5$&9'/'1=)'
%-&$*B/*;;+MM9@1-'G(&'1&)'&$4/2HMP;+O;+A+
'&*#(=9$-#5;;P$&5-$&(;-$%-$&)'1)(&'*->.)'9&($)'C)'9+&/2&?5-*#$&-)22&9/2($#9*B/*LP+-#$
5/D&'* /( '&-'//2 /'$-5-%&$= @J; 9&*/D-' B&&CA B) /' /4&$/9& &/( 1)$1#%>&$&'1& -> N57 / .)$
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B-5/D&'*/(1$-%-*-%/21-%-$.)()D&*+
&&4/2#/&(;O -> & ;H 5/D&'*>/1)/2 >&/#$&* 5/25&.$/2 G**#$& @N*/'(/$ (&4)/D-'A 7 5)2$#% @MA 7
#55&$2)5@MA+&'&#$-(&4&2-5%&'/2&4/2#/D-'7/K&22&&*B/*9)4&'-;->&;H*#.F&1*-&?/%)'&
5&$*-'/2/'(*-1)/27/(/5D4&7%--$7/'(1-%%#')1/D-'(-%/)'*+B&'=&)9*-B&((&2/=*-'-'&(-%)'//'(
 )' ; -$ %-$&+  '&9/D4& 1-$$&2/D-' &?)** .&B&&' 9E(/= -> &/'-2 /'( %-'* -> 1-9')D4& (&2/= @+;O7
5N+MA+'&*#(=;MP/(/'/4&$/9&1-9')D4&(&2/=->L+M%-'*@1-'G(&'1&)'&$4/2HMP+M,+MA+
-%&->&*#(=9$-#55/$D1)5/'*79$-B1#$4&*/'(&/(1)$1#%>&$&'1&/('-$%/2)"/D-'.==&/$*+
CONCLUSIONS
CONCLUSIONS
/2>->&1)2($&'>$-%&2)F-/*/'-$&9)*$=/4&'&#$-(&4&2-5%&'/2(&2/=*
.&>-$&&/9&->+&5$-9$/%->5$&4&'D-'/'(/$%$&(#1D-'.=)'$/#&$)'&
&?5-*#$& - /21--2 /'( -&$ ($#9* /* .&&' )%52&%&'&( B) 9--( 5$&2)%)'/$=
$&*#2* (&1$&/*&( /21--2 1-'*#%5D-' (#$)'9 5$&9'/'1= /'( *='($-%&* /'(
/21--2$&2/&(.)$(&>&1*+&'&?*&5)*->-22-B#5-1)2($&'B-/$&/$)*C
->>&/2/21--2*5&1$#%()*-$(&$*$-#9/(-2&*1&'1&+
8th INTERNATIONAL NETWORK ON
CHILDREN´S HEALTH, ENVIROMENT AND SAFETY
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