Fetal alcohol syndrome

Craniofacial Manifestation and Oral Health Care Needs in Pediatric Population With Fetal Alcohol Syndrome: A Systematic Review

PURPOSE

This systematic review aims to investigate craniofacial symptoms, oral healthcare requirements, and management approaches for children diagnosed with Fetal Alcohol Spectrum Disorder (FASD).

METHODS

Electronic searches were conducted across five databases (PubMed, Embase, Cochrane Library, Scopus, Web of Science, and LILACS). The inclusion criteria focused on original research for children with FASD, up to 18 years, emphasizing craniofacial symptoms, oral health, and management protocols. Data extraction was performed independently by two researchers using predetermined criteria. The JBI Critical Appraisal Tool was used to assess the risk of bias in the selected studies. PICO criteria guided study selection, with a focus on low risk of bias. Data analysis was carried out independently by two researchers.

RESULTS

Among 361 identified papers, 215 were screened, and 16 studies meeting research criteria were included. The findings established a body of evidence linking characteristic craniofacial symptoms to FASD. They highlighted heightened oral health needs for children with FASD, emphasizing the significance of frequent recall and preventive measures.

CONCLUSION

This review solidifies the connection between maternal alcohol consumption during pregnancy and dentofacial complications in children with FASD, including cleft lip/palate, malocclusion, increased DMFT, and craniofacial dysmorphia. It underscores the pivotal role of pediatric dentists in early identification and intervention.

The effects of alcohol in newborns

The purpose of this article was to present a review of the effects of alcohol consumption by pregnant mothers on their newborn. Definitions, prevalence, pathophysiology, clinical features, diagnostic criteria, follow-up, treatment and prevention were discussed. A search was performed in Medline, LILACS, and SciELO databases using the following terms: "fetus", "newborn", "pregnant woman", "alcohol", "alcoholism", "fetal alcohol syndrome", and "alcohol-related disorders". Portuguese and English articles published from 2000 to 2009 were reviewed. The effects of alcohol consumed by pregnant women on newborns are extremely serious and occur frequently; it is a major issue in Public Health worldwide. Fetal alcohol spectrum disorders cause harm to individuals, their families, and the entire society. Nevertheless, diagnostic difficulties and inexperience of healthcare professionals result in such damage, being remembered rarely or even remaining uncovered. Alcohol-related injury to the fetus is fully avoidable; all it takes is for women not to drink alcoholic beverages during pregnancy. Therefore, detecting women who consume alcohol during pregnancy is paramount, as are specific programs to educate people about the consequences of alcohol use during pregnancy and breastfeeding.

Congenital malformations in newborns of alcoholic mothers

OBJECTIVE

To identify the presence of fetal alcohol syndrome, other alcohol-related congenital defects, and/or neurodevelopment disorders in newborns of mothers who consumed alcohol during gestation.

METHODS

In a public maternity in the city of São Paulo, 1,964 puerperal women were interviewed and 654 had consumed alcohol at some point during gestation. The newborns were clinically and laboratorially examined in order to identify the occurrence of fetal alcohol syndrome, congenital defects or neurodevelopment disorders related to alcohol.

RESULTS

Three children were found with fetal alcohol syndrome (1.5/1,000 live births), 6 with congenital defects related to alcohol (3.0/1,000 live births), and 67 with developmental disorders related to alcohol (34.1/1,000 live births). The congenital malformations found in these children were thin or absent corpus callosum, brain cyst, asymmetry of the cerebral ventricles, meningomyelocele, cleft lip, anteverted nose, low-set ears, megaureter, hydronephrosis, polydactyly, congenital clubfoot, aphalangia of the toes, cryptorchidism, and hypospadia.

CONCLUSION

Newborns of mothers who consumed alcohol may have congenital malformations of various organs and systems, and early diagnosis is fundamental for a probable and occasional more effective resolution and progress.

Nuanced but significant: how ethanol perturbs avian cranial neural crest cell actin cytoskeleton, migration and proliferation

Children with fetal alcohol syndrome (FAS) display striking craniofacial abnormalities. These features are proposed to result from perturbations in the morphology and function of cranial neural crest cells (cNCCs), which contribute significantly to the craniofacial complex. While certain pathways by which this may occur have been suggested, precise teratogenic mechanisms remain intensely investigated, as does the question of the teratogenic dose. The present study focused on examining how avian cNCC actin cytoskeleton, migratory distance, and proliferation are affected ex vivo by exposure to ethanol concentrations that simulate maternal intoxication. Chick cNCCs were cultured in 0.2% and 0.4% v/v ethanol. Distances migrated by both ethanol-treated and control cells at 24 and 48 h were recorded. Following phalloidin immunocytochemistry, treated and control cNCCs were compared morphologically and quantitatively. Apoptosis and proliferation in control versus treated cNCCs were also studied. Chick cNCCs cultured in ethanol lost their spindle-like shapes and their ordered cytoskeleton. There was a significant stage-dependent effect on cNCC migration at 24 h (p = 0.035), which was greatest at stage 10 (HH). Ethanol treatment for 48 h revealed a significant main effect for ethanol, chiefly at the 0.4% level. There was also an interaction effect between ethanol dose and stage of development (stage 9 HH). Actin microfilament disruption was quantitatively increased by ethanol at the doses studied while cNCC proliferation was increased but not significantly. Ethanol had no effect on cNCC apoptosis. At ethanol levels likely to induce human FAS, avian cNCCs exhibit various subtle, potentially significant changes in morphology, migration, and proliferation, with possible consequences for fated structures.