Can prenatal ultrasound detect the effects of in-utero alcohol exposure? A pilot study.
OBJECTIVE
The aim of this pilot study was to explore possible ultrasound parameters for the early detection of alcohol-mediated fetal somatic and central nervous system (CNS) maldevelopment. Maternal alcohol ingestion during pregnancy may lead to fetal alcohol spectrum disorders (FASD), which encompass a broad range of structural abnormalities including growth impairment, specific craniofacial features and CNS abnormalities. Early detection of fetuses at risk of FASD would support earlier interventions.


METHODS
We performed a longitudinal prospective pilot study from 2004 to 2006 at two sites in Ukraine. A sample of pregnant women who reported consuming moderate-to-heavy amounts of alcohol participated in a comprehensive maternal interview, and received ultrasound evaluation of fetal growth and specific fetal brain measurements during the second and third trimesters. These measurements were compared with those collected from a group of pregnant women who consumed little-to-no alcohol during pregnancy, and who were recruited and followed in the same manner.


RESULTS
From 6745 screened women, 84 moderate-to-heavy alcohol users and 82 comparison women were identified and ultrasound examinations performed. After controlling for maternal smoking, alcohol-exposed fetuses had shorter mean femur length, caval-calvarial distance and frontothalamic measurements in the second trimester (P < 0.05), and alcohol-exposed fetuses also had shorter frontothalamic distance measurements in the third trimester relative to comparison fetuses (P < 0.05). In addition, after controlling for maternal smoking, both mean orbital diameter and biparietal diameter measurements were significantly smaller on average in the alcohol-exposed group in the third trimester relative to comparison fetuses (P < 0.05).


CONCLUSIONS
Significant differences in selected somatic and brain measurements were noted between alcohol-exposed and comparison fetuses, suggesting these markers may be further explored for clinical utility in prenatal identification of affected children. Further study correlating these findings with alcohol-related physical features of the newborn and subsequent comparisons of neuro-developmental outcomes will help define potential uses of prenatal ultrasound for intervention and prevention of FASD.
Kfir
M
M
Department of Reproductive Medicine, University of California San Diego, La Jolla, CA 92103-8433, USA.
Yevtushok
L
L
Onishchenko
S
S
Wertelecki
W
W
Bakhireva
L
L
Chambers
C D
CD
Jones
K L
KL
Hull
A D
AD
D000014:Abnormalities, Drug-Induced / Q000000981:diagnostic imaging* / Q000453:epidemiology; D000328:Adult; D004812:Epidemiologic Methods; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000000981:diagnostic imaging* / Q000453:epidemiology; D047109:Fetal Development / Q000187:drug effects; D006801:Humans; D008431:Maternal-Fetal Exchange; D010865:Pilot Projects; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011295:Prenatal Care; D011297:Prenatal Exposure Delayed Effects / Q000000981:diagnostic imaging* / Q000453:epidemiology; D014455:Ukraine; D016216:Ultrasonography, Prenatal / Q000379:methods*