Fetal alcohol spectrum disorders in young adulthood.
OBJECTIVE
To test the hypothesis that fetal alcohol syndrome (FAS), with the full phenotype, and fetal alcohol effect (FAE), with some but not all of the features, can be combined under the umbrella term fetal alcohol spectrum disorders (FASD).


METHODS
We investigated the long-term sequelae of intrauterine alcohol exposure using physical examination, psychosocial interviews, and a behavioral checklist in a 20-year follow-up study of 37 patients with FASD originally diagnosed as having FAS or FAE in infancy and childhood.


RESULTS
Although the characteristic craniofacial malformations of FAS/FAE diminish over time, microcephaly, a poorly developed philtrum and a thin upper lip, and, to a lesser degree, short stature and underweight (in boys) persist. In females, adult body weight increases. Persistent mental handicaps, including intellectual disability, limited occupational options, and dependent living, are the major sequelae, and the scores for various behavioral problems are significantly increased.


CONCLUSIONS
The devastating effects of intrauterine exposure to alcohol persist into early adulthood and severely limit careers and independent living.
Spohr
Hans-Ludwig
HL
Department of Pediatrics, Hospital of the German Red Cross, Berlin, Germany. h.spohr@drk-kliniken-westend.de
Willms
Judith
J
Steinhausen
Hans-Christoph
HC
D000293:Adolescent; D017677:Age Distribution; D015992:Body Mass Index; D002648:Child; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011336:Probability; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution