Fetal alcohol spectrum disorders-- implications for child neurology, part 1: prenatal exposure and dosimetry

In the United States, approximately 80 000 women consume ethanol through all 3 trimesters of pregnancy each year. In this article, we review prevalence rates of prenatal alcohol exposure in the United States and discuss the mechanisms of prenatal alcohol exposure and placental-umbilical effects. Cigarette smoking and delayed prenatal care are often associated with prenatal alcohol exposure. In addition, increased risk for postnatal adversity is common, including maternal depression, foster care placement, and developmental delay. In part 2, we review prevalence rates and the diagnostic criteria for fetal alcohol spectrum disorder and the implications for child neurologists. We discuss management strategies and the importance of a long-term management plan and anticipatory management to prevent the development of secondary disabilities in fetal alcohol spectrum disorders. Child neurologists play a key role in diagnosis and the development of appropriate intervention programs for affected children and their families.