"Fetal Ultrasound Measures as Predictors of Alcohol-Related Physical Features in the Newborn: Preliminary Results"
Jones, K. L. et al
University of California at San Diego
Presented at the 2007 meeting of the American Teratology Society
For children with fetal alcohol syndrome (FAS) or fetal alcohol spectrum disorders (FASD), earlier identification leads to opportunities for more effective prevention and intervention. Although prenatal ultrasound-documented alterations of fetal brain development have been correlated with prenatal alcohol exposure, the use of prenatal ultrasound as a means of earlier diagnosis of FASD has not been evaluated.
Between 2004 and 2006, 84 risky drinking and 82 minimally exposed or abstaining pregnant women were recruited from two areas of Ukraine. Specially trained ultrasonographers performed between one and five standardized scans on women depending on when in gestation they were recruited. Live born infants were examined by Ukrainian physicians who had been trained by one of us, and who were blinded to prenatal alcohol exposure status.
Using data from 142 second trimester and 141 third trimester ultrasounds, we compared infants who had some features of FAS on the newborn physical exam (n = 21) to infants who did not (n = 120-121). Significant differences on the second trimester ultrasounds were noted for mean estimated fetal weight, head circumference, abdominal circumference and femur length percentile, as well as mean outer orbital distance and interorbital distance, after adjustment for gestational age and tobacco use (p<0.05). Significant differences on the third trimester ultrasounds were noted for mean estimated fetal weight, biparietal diameter, head circumference, and femur length percentile, adjusted for gestational age and tobacco use (p<0.05). In addition, the difference in adjusted mean frontothalamic distance in the third trimester was of borderline significance (p = .080). No significant differences in the second or third trimester were noted for adjusted mean orbital diameter; however, the difference in measurement was in the expected direction.
These data suggest that specific prenatal ultrasound measures may have some utility in earlier identification of fetuses who will subsequently demonstrate structural features related to alcohol exposure. Further research is needed to determine if these measures, or others, are also predictive of subsequent neurobehavioral impairment in exposed infants.
Date of report: June 1, 2007