Toluene embryopathy: delineation of the phenotype and comparison with fetal alcohol syndrome.
OBJECTIVE
To determine if maternal toluene abuse produces any structural or developmental disabilities in the developing fetus, a cohort of toluene-exposed infants was ascertained and examined.


METHODS
Eighteen infants with a history of in utero toluene exposure were examined at birth. Nine of these infants were reexamined 3 to 36 months after their initial evaluations. The clinical findings in these patients were compared with those of similarly exposed children from the literature and with patients who had the fetal alcohol syndrome.


RESULTS
Thirty-nine percent of all toluene-exposed infants described in this and other studies were born prematurely, and 9% died during the perinatal period. Fifty-four percent were small for gestational age, and 52% exhibited continued postnatal growth deficiency. A 33% incidence of prenatal microcephaly, a 67% incidence of postnatal microcephaly, and an 80% incidence of developmental delay were observed. Eighty-three percent of the patients had craniofacial features similar to the fetal alcohol syndrome, and 89% of these children had other minor anomalies.


CONCLUSIONS
Data from the patients herein described and the available scientific literature suggest that the mechanism of alcohol craniofacial teratogenesis may be nonspecific, with a variety of teratogens, including toluene, giving rise to phenotypic facial abnormalities similar to those of the fetal alcohol syndrome. We propose a common mechanism of craniofacial teratogenesis for toluene and alcohol, namely a deficiency of craniofacial neuroepithelium and mesodermal components due to increased embryonic cell death.
Pearson
M A
MA
Department of Pediatrics, University of Arizona College of Medicine, Tucson.
Hoyme
H E
HE
Seaver
L H
LH
Rimsza
M E
ME
D000014:Abnormalities, Drug-Induced; D000293:Adolescent; D000328:Adult; D002658:Developmental Disabilities / Q000139:chemically induced; D004622:Embryo, Mammalian / Q000187:drug effects*; D000431:Ethanol / Q000494:pharmacology; D005145:Face / Q000002:abnormalities*; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders; D006801:Humans; D007231:Infant, Newborn; D008431:Maternal-Fetal Exchange; D008831:Microcephaly / Q000139:chemically induced*; D010641:Phenotype; D011247:Pregnancy; D011248:Pregnancy Complications; D011297:Prenatal Exposure Delayed Effects; D012886:Skull / Q000002:abnormalities*; D019966:Substance-Related Disorders / Q000150:complications; D014050:Toluene / Q000009:adverse effects* / Q000494:pharmacology
D014050:Toluene; D000431:Ethanol