Claire D Coles1, Wendy Kalberg2, Julie A Kable1, Barbara Tabachnick3, Philip A May4, Christina D Chambers5. 1. From the, Department of Psychiatry and Behavioral Sciences and Pediatrics, (CDC, JAK), Emory University School of Medicine, Atlanta, Georgia. 2. Center on Alcoholism, Substance Abuse and Addictions, (WK), The University of New Mexico, Albuquerque, New Mexico. 3. California State University, (BT), Northridge, California. 4. Department of Nutrition, (PAM), Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Kannapolis, North Carolina. 5. Departments of Pediatrics and Family Medicine and Public Health, (CDC), University of California San Diego School of Medicine, La Jolla, California.
Abstract
BACKGROUND: The effects of prenatal alcohol exposure (PAE) are conceptualized as fetal alcohol spectrum disorder, with fetal alcohol syndrome (FAS) as the most severe. Many find it more difficult to characterize behavioral and cognitive effects of exposure on the central nervous system when physical signs are not present. In the current study, an operational definition of alcohol-related neurodevelopmental disorder (ARND) was examined to determine its usefulness in discrimination of children classified as ARND based on behavior (ARND/B) and cognition (ARND/C) from children in 4 contrast groups: (i) children exposed to study-defined "risky drinking"; (ii) children with any reported PAE; (iii) children classified as "Higher Risk" for developmental problems; and (iv) children classified as "Lower Risk." METHODS: A total of 1,842 children seen as part of a surveillance study (J Am Med Assoc, 319, 2018, 474) were evaluated for alcohol exposure and physical characteristics of FAS, and completed neurodevelopmental testing. Ninety-one were identified as either ARND/B or ARND/C and contrasted with other groups to further identify distinguishing patterns. Multinomial logistic regression (MLR) was used to examine the accuracy of classification and to identify factors contributing to such classification. RESULTS: Children described as ARND/C were distinct from other groups based on cognition and behavior as well as demographic factors (e.g., age, race, SES), child characteristics (e.g., gestational age; sex), and other drug exposures, while those described as ARND/B differed only on behavior and other drug exposures. MLR models successfully discriminated ARND groups from children in other groups with accuracy ranging from 79% (Higher Risk) to 86.7% (Low Risk). CONCLUSIONS: ARND has been a subject of debate. This analysis suggests the effects of alcohol on behavior and cognition even in the absence of the characteristic facial features and growth deficiency that can be identified. The results also indicate that it may be possible to distinguish such children from those in other high-risk groups.
BACKGROUND: The effects of prenatal alcohol exposure (PAE) are conceptualized as fetal alcohol spectrum disorder, with fetal alcohol syndrome (FAS) as the most severe. Many find it more difficult to characterize behavioral and cognitive effects of exposure on the central nervous system when physical signs are not present. In the current study, an operational definition of alcohol-related neurodevelopmental disorder (ARND) was examined to determine its usefulness in discrimination of children classified as ARND based on behavior (ARND/B) and cognition (ARND/C) from children in 4 contrast groups: (i) children exposed to study-defined "risky drinking"; (ii) children with any reported PAE; (iii) children classified as "Higher Risk" for developmental problems; and (iv) children classified as "Lower Risk." METHODS: A total of 1,842 children seen as part of a surveillance study (J Am Med Assoc, 319, 2018, 474) were evaluated for alcohol exposure and physical characteristics of FAS, and completed neurodevelopmental testing. Ninety-one were identified as either ARND/B or ARND/C and contrasted with other groups to further identify distinguishing patterns. Multinomial logistic regression (MLR) was used to examine the accuracy of classification and to identify factors contributing to such classification. RESULTS: Children described as ARND/C were distinct from other groups based on cognition and behavior as well as demographic factors (e.g., age, race, SES), child characteristics (e.g., gestational age; sex), and other drug exposures, while those described as ARND/B differed only on behavior and other drug exposures. MLR models successfully discriminated ARND groups from children in other groups with accuracy ranging from 79% (Higher Risk) to 86.7% (Low Risk). CONCLUSIONS: ARND has been a subject of debate. This analysis suggests the effects of alcohol on behavior and cognition even in the absence of the characteristic facial features and growth deficiency that can be identified. The results also indicate that it may be possible to distinguish such children from those in other high-risk groups.
Authors: Ashley L Ware; Leila Glass; Nicole Crocker; Benjamin N Deweese; Claire D Coles; Julie A Kable; Philip A May; Wendy O Kalberg; Elizabeth R Sowell; Kenneth L Jones; Edward P Riley; Sarah N Mattson Journal: Alcohol Clin Exp Res Date: 2014-03-21 Impact factor: 3.455
Authors: Julie A Kable; Mary J O'Connor; Heather Carmichael Olson; Blair Paley; Sarah N Mattson; Sally M Anderson; Edward P Riley Journal: Child Psychiatry Hum Dev Date: 2016-04
Authors: N L Day; D Jasperse; G Richardson; N Robles; U Sambamoorthi; P Taylor; M Scher; D Stoffer; M Cornelius Journal: Pediatrics Date: 1989-09 Impact factor: 7.124
Authors: Ashley L Ware; Nicole Crocker; Jessica W O'Brien; Benjamin N Deweese; Scott C Roesch; Claire D Coles; Julie A Kable; Philip A May; Wendy O Kalberg; Elizabeth R Sowell; Kenneth Lyons Jones; Edward P Riley; Sarah N Mattson Journal: Alcohol Clin Exp Res Date: 2012-05-15 Impact factor: 3.455
Authors: Philip A May; Julie M Hasken; Melanie A Manning; Luther K Robinson; Omar Abdul-Rahman; Margaret P Adam; Tamison Jewett; Amy J Elliott; Wendy O Kalberg; David Buckley; H Eugene Hoyme Journal: Am J Med Genet A Date: 2022-03-31 Impact factor: 2.578
Authors: Julie M Hasken; Linda S Adair; Stephanie L Martin; Amanda L Thompson; Anna-Susan Marais; Marlene M de Vries; Wendy O Kalberg; David Buckley; H Eugene Hoyme; Soraya Seedat; Charles D H Parry; Philip A May Journal: Curr Res Toxicol Date: 2022-05-20
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Authors: J A Kable; C D Coles; C L Keen; J Y Uriu-Adams; K L Jones; L Yevtushok; Y Kulikovsky; N Zymak-Zakutnya; Iryna Dubchak; D Akhmedzhanova; W Wertelecki; C D Chambers Journal: Alcohol Date: 2021-12-20 Impact factor: 2.405