scholarly journals Adverse reproductive outcomes associated with fetal alcohol exposure: a systematic review

Reproduction ◽  
2019 ◽  
Vol 157 (4) ◽  
pp. 329-343 ◽  
Author(s):  
L K Akison ◽  
K M Moritz ◽  
N Reid
Keyword(s):  
Systematic Review ◽  
Alcohol Exposure ◽  
Spectrum Disorder ◽  
Reproductive Age ◽  
Preclinical Studies ◽  
Reproductive Outcomes ◽  
Fetal Alcohol Exposure ◽  
Fetal Alcohol ◽  
Wide Range ◽  
Prenatal Alcohol

Fetal alcohol exposure results in well-characterised neurobehavioural deficits in offspring, which form the basis for diagnosing fetal alcohol spectrum disorder. However, there is increasing interest in the full range of health complications that can arise in children and adults with this disorder. We used a systematic review approach to locate all clinical and preclinical studies across a broad range of health outcomes in offspring exposed to prenatal alcohol. Our search encompassed four databases (PubMed, CINAHL, EMBASE and Web of Science) and titles/abstracts from retrieved studies were screened against strict inclusion/exclusion criteria. This review specifically evaluated studies reporting on reproductive outcomes in both males and females. A total of 23 studies were included, 5 clinical and 18 preclinical. Although there was a wide range in the quality of reporting across both clinical and preclinical studies, and variable results, trends emerged amongst the reproductive measures that were investigated. In females, most studies focussed on age at first menarche/puberty onset, with evidence for a significant delay in alcohol-exposed offspring. In males, offspring exposed to prenatal alcohol had altered testosterone levels, reduced testes and accessory gland weights and reduced sperm concentration and semen volume. However, further studies are required due to the paucity of clinical studies, the narrow scope of female reproductive outcomes examined and inconsistencies in outcomes across preclinical studies. We recommend that adolescents and individuals of reproductive age diagnosed with f-etal alcohol spectrum disorder be assessed for reproductive dysfunction to allow appropriate management of their reproductive health and fertility.

Postnatal nutritional treatment of neurocognitive deficits in fetal alcohol spectrum disorder

2018 ◽  
Vol 96 (2) ◽  
pp. 213-221 ◽  
Author(s):  
A. Bastons-Compta ◽  
M. Astals ◽  
V. Andreu-Fernandez ◽  
E. Navarro-Tapia ◽  
O. Garcia-Algar
Keyword(s):  
Fetal Alcohol Spectrum Disorder ◽  
Prenatal Alcohol Exposure ◽  
Alcohol Exposure ◽  
Spectrum Disorder ◽  
Neurocognitive Deficits ◽  
Fetal Alcohol ◽  
Nutritional Treatment ◽  
Wide Range ◽  
Prenatal Alcohol ◽  
Fetal Alcohol Spectrum

Ethanol is the most important teratogen agent in humans. Prenatal alcohol exposure can lead to a wide range of adverse effects, which are broadly termed as fetal alcohol spectrum disorder (FASD). The most severe consequence of maternal alcohol abuse is the development of fetal alcohol syndrome, defined by growth retardation, facial malformations, and central nervous system impairment expressed as microcephaly and neurodevelopment abnormalities. These alterations generate a broad range of cognitive abnormalities such as learning disabilities and hyperactivity and behavioural problems. Socioeconomic status, ethnicity, differences in genetic susceptibility related to ethanol metabolism, alcohol consumption patterns, obstetric problems, and environmental influences like maternal nutrition, stress, and other co-administered drugs are all factors that may influence FASD manifestations. Recently, much attention has been paid to the role of nutrition as a protective factor against alcohol teratogenicity. There are a great number of papers related to nutritional treatment of nutritional deficits due to several factors associated with maternal consumption of alcohol and with eating and social disorders in FASD children. Although research showed the clinical benefits of nutritional interventions, most of work was in animal models, in a preclinical phase, or in the prenatal period. However, a minimum number of studies refer to postnatal nutrition treatment of neurodevelopmental deficits. Nutritional supplementation in children with FASD has a dual objective: to overcome nutritional deficiencies and to reverse or improve the cognitive deleterious effects of prenatal alcohol exposure. Further research is necessary to confirm positive results, to determine optimal amounts of nutrients needed in supplementation, and to investigate the collective effects of simultaneous multiple-nutrient supplementation.

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