Journal Mobile Options
Table of Contents
Vol. 69, No. 2, 2010
Issue release date: March 2010
Gynecol Obstet Invest 2010;69:128–130

Can Prenatal Screening for Fetal Alcohol Spectrum Disorder Be Justified? A Commentary

Mizejewski G.J.
Division of Translational Medicine, Wadsworth Center, New York State Department of Health, Albany, N.Y., USA

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


Fetal alcohol spectrum disorder (FASD) is the leading cause of non-genetic mental retardation in the USA, possibly exceeding even Down syndrome, which is currently approaching 1 in 500 live births. Alcohol consumption during pregnancy results in brain, craniofacial and heart defects, neurotoxicity, and immune dysfunction. The preferred action taken to prevent alcohol consumption during pregnancy is abstinence. However, the detection, diagnosis, and treatment of FASD remain a major public health need in this country and throughout the world. The biochemical molecules involved in the developmental anomalities encompass a vast array of signal transduction and synaptic pathways which involve neurotransmitters and neurotrophic peptides. Recent advances in medicine-based therapies for FASD have been reported, and include the use of small molecule agonists, antagonists, and competitive inhibitors. Since biomarkers for FASD have previously been identified in clinical research reports, multicenter screening feasibility studies now seem warranted and could be initiated following adequate funding, protocols, procedures, and institutional review board approvals.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Meschke LL, Holl JA, Messelt S: Assessing the risk of fetal alcohol syndrome: understanding substance use among pregnant women. Neurotoxicol Teratol 2003;25:667–674.
  2. West JR, Perrotta DM, Erickson CK: Fetal alcohol syndrome; a review for Texas physicians 1998;94:61–67.
  3. Hopkins RB, Paradis J, Roshanker T, et al: Universal or targeted screening for fetal alcohol exposure: a cost-effectiveness analysis. J Stud Alcohol Drugs 2008;69:510–519.
  4. Church MW, Eldis F, Blakley BW, Bawle EV: Hearing, language, speech, vestibular, and dentofacial disorders in fetal alcohol syndrome. Alcohol Clin Exp Res 1997;21:227–237.
  5. Chang G, McNamara TK, Orav EJ, Koby D, Lavigne A, Ludman B, Vincitorio NA, Wilkins-Haug L: Brief intervention for prenatal alcohol use: a randomized trial. Obstet Gynecol 2005;105:991–998.
  6. Eckardt MJ, File SE, Gessa GL, Grant KA, Guerri C, Hoffman PL, Kalant H, Koob GF, Li TK, Tabakoff B: Effects of moderate alcohol consumption on the central nervous system. Alcohol Clin Exp Res 1998;22:998–1040.
  7. Cortese BM, Moore GJ, Bailey BA, Jacobson SW, Delaney-Black V, Hannigan JH: Magnetic resonance and spectroscopic imaging in prenatal alcohol-exposed children: preliminary findings in the caudate nucleus. Neurotoxicol Teratol 2006;28:597–606.
  8. Spong CY, Auth J, Vink J, Goodwin K, Abebe DT, Hill JM, Brenneman DE: Vasoactive intestinal peptide mRNA and immunoreactivity are decreased in fetal alcohol syndrome model. Regul Pept 2002;108:143–147.
  9. Yamada Y, Nagase T, Nagase M, Koshima I: Gene expression changes of sonic hedgehog signaling cascade in a mouse embryonic model of fetal alcohol syndrome. J Craniofac Surg 2005;16:1055–1063.
  10. Datta S, Turner D, Singh R, Ruest LB, Pierce WM Jr, Knudsen TB: Fetal alcohol syndrome in C57BL/6 mice detected through proteomics screening of the amniotic fluid. Birth Defects Res 2008;82:177–186.
  11. Halmesmäki E, Autti I, et al: Prediction of fetal alcohol syndrome by maternal α-fetoprotein, human placental lactogen, and pregnancy specific β1-glycoprotein. Alcohol Alcohol 1987;1(suppl):473–476.
  12. Halmesmäki E, Autti I, Granström ML, Stenman UH, Ylikorkala O: Estradiol, estriol, progesterone, prolactin, and human chorionic gonadotropin in pregnant women with alcohol abuse. J Clin Endocrinol Metab 1987;64:153–156.
  13. Cook JD: Biochemical markers of alcohol use in pregnant women. Clin Biochem 2003;36:9–19.
  14. Olney JW, Wozniak DF, Jevtovic-Todorovic V, Ikonomidou C: Glutamate signaling and the fetal alcohol syndrome. Ment Retard Dev Disabil Res Rev 2001;7:267–275.
  15. George DT, Gilman J, Hersh J, Thorsell A, Herion D, Geyer C, Peng X, Kielbasa W, Rawlings R, Brandt JE, Gehlert DR, Tauscher JT, Hunt SP, Hommer D, Heilig M: Neurokinin-1 receptor antagonism as a possible therapy for alcoholism. Science 2008;319:1536–1539.
  16. Toso L, Roberson R, Abebe D, Spong CY: Neuroprotective peptides prevent some alcohol-induced alteration in γ-aminobutyric acid A-β3, which plays a role in cleft lip and palate and learning in fetal alcohol syndrome. Am J Obstet Gynecol 2007;196:259.e1–259.e5.
  17. Brenneman DE, Spong CY, Hauser JM, Abebe D, Pinhasov A, Golian T, Gozes I: Protective peptides that are orally active and mechanistically nonchiral. J Pharmacol Exp Ther 2004;309:1190–1197.
  18. Halmesmaki E, Ylikorkala O, Alfthan G: Concentrations of zinc and copper in pregnant problem drinkers and their newborn infants. Br Med J Clin Res Ed 1985;291:1470–1471.
  19. Stade B, Ungar B, Stevens J, Koren G: Cost of fetal alcohol spectrum disorder in Canada. Can Fam Phys 2007;53:1303–1304.
  20. Abel EL: An update on the incidence of FAS. FAS is not an equal opportunity birth defect. Neurotoxicol Teratol 1995;17:437–443.

Pay-per-View Options
Direct payment This item at the regular price: USD 33.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 23.00