Failure to recognize fetal alcohol syndrome in newborn infants

Article Abstract:

A condition called fetal alcohol syndrome (FAS) is the result of alcohol abuse by the mother during pregnancy. Infants with FAS suffer mental retardation, which may be mild or severe, behavioral abnormalities, and facial deformities. Estimates of rates of FAS are limited by the lack of recognition of this syndrome by physicians. Also, because the drinking patterns of mothers are not always known, the diagnosis of FAS may be missed. The medical records of women who were known to have abused alcohol during pregnancy were extracted from a database containing reports of over 28,000 births which occurred between September 1977 and December 1980 in Dallas County, Texas. Out of the 5,602 records that had information on alcohol usage, 38 contained documentation of alcohol abuse by the mother during pregnancy. Out of this subgroup, 40 babies were born (there were two sets of twins), and 38 infants survived long enough to be evaluated. A group of 80 women who also gave birth, but were not reported to have abused alcohol during pregnancy, were used for comparison (controls); 81 infants were born to this group. Most demographic factors in the two groups were comparable, except that the alcohol-abusing group contained more white women than the control group. Higher infant mortality and rates of pregnancy complications occurred in the alcohol-abusing group. Half of the infants exposed to alcohol during pregnancy had very poor postnatal growth and development. Six of these infants had physical features which were consistent with FAS. Although these observations were made and the mother's medical records indicated alcohol abuse during pregnancy, none of the infants had any mention of FAS as a possible diagnosis in their medical records. These results suggest that FAS is dramatically underdiagnosed, and that affected infants are not given adequate follow-up medical care for FAS. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Causes of, Complications and side effects, Statistics, Pregnancy, Complications of, Pregnancy complications

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Alcohol abuse during pregnancy: changes in frequency in a large urban hospital

Article Abstract:

The adverse effects of alcohol abuse on the developing fetus are well-established. Alcohol abuse can cause birth defects, fetal alcohol syndrome, low birth weight, spontaneous abortion and fetal death. More white women drink alcohol; alcohol abuse is more prevalent among blacks, hispanics and women who are less educated. The incidence of alcohol abuse among white women is increasing steadily. Alcohol abuse was studied among 5,602 women obtaining prenatal care at a large urban hospital. Alcohol abuse was defined as four or more alcoholic drinks per day (two ounces of absolute alcohol). Alcohol abuse during pregnancy was reported in 38 women (0.7 percent) between 1977 and 1980. When pregnant women were surveyed in 1987, alcohol abuse was reported in 1.4 percent of 1,032 women. The increase in reported alcohol abuse almost doubled over the 10-year period. This disparity may be explained, in part, by several factors: women may have become more willing to report alcohol abuse, total alcohol consumption may not have been accurately measured, and the information was not collected over a nine-month period. However, women who are habitual drinkers rarely change their drinking patterns. The overall findings indicate that alcohol abuse as a risk factor for poor pregnancy outcome has increased among pregnant women treated at this urban hospital. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Fetus, Pregnant women, Alcohol use

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Prediction of the severity of meconium aspiration syndrome

Article Abstract:

Factors associated with an increased risk of meconium aspiration syndrome requiring assisted breathing include fetal heart rate abnormalities during labor and difficulty in breathing after delivery requiring intubation. Other factors include low five-minute Apgar scores and delivery by cesarean section. Meconium is a material present in the intestines of the newborn. Meconium inhalation can block a newborn's air passages and lead to serious complications. Of the 43,906 infants studied between 1987 and 1989, 18% had meconium present in the amniotic fluid. One percent of these had meconium aspiration syndrome and were admitted to a special care nursery. Almost half of those 82 infants received mechanical aid in breathing. Using the above variables, 68.3% of the cases of severe meconium aspiration syndrome requiring assisted breathing were predicted.

Prognosis, Diseases, Infants (Newborn), Neonatal diseases, Meconium aspiration syndrome

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