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Blood test may predict severity of fetal alcohol syndrome

A new blood test may help predict how severely a baby will be affected by alcohol exposure during pregnancy.

Fetal alcohol syndrome is a severe form of a spectrum of mental and physical disabilities, called fetal alcohol spectrum disorders (FASD), that can affect children’s development with long-lasting consequences. Children and adults affected by FASD may have a range of symptoms, from physical changes like a small head and subtle differences in the face, to learning difficulties and behavioral issues.

“Early diagnosis is important because it permits early intervention to minimize the harm due to prenatal alcohol exposure.”

Despite widespread prevention efforts, alcohol exposure during pregnancy is a huge problem, says Rajesh Miranda, a professor in the Texas A&M College of Medicine and co-senior author of the study published in PLOS ONE.

“But we might not realize the full scope because infants born with normal-looking physical features may be missed, making many cases difficult to diagnose early.”

Consequently, there is a need for early biomarkers that can assist with predicting infant disability.

Same amount of alcohol, different outcomes

Miranda and colleagues looked at birth outcomes for 68 pregnant women enrolled in the study at two perinatal care clinics in western Ukraine. The team obtained detailed health and alcohol consumption histories and second and third trimester blood samples from each woman.

The results indicated that moderate to high levels of alcohol exposure during early pregnancy resulted in significant differences in some circulating small RNA molecules, termed microRNAs (miRNAs), in maternal blood. These differences were particularly notable in those mothers whose infants showed some physical or neurobehavioral signs of alcohol effects in the first 12 months of life.

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“Collectively, our data indicate that maternal plasma miRNAs may help predict infant outcomes and may be useful to classify difficult-to-diagnose FASD subpopulations,” Miranda says.

Part of the reason FASD may be difficult to diagnose is infants exposed to the same amount of prenatal alcohol may have vastly different outcomes.

“Although it is generally true that binge-drinking during pregnancy presents the greatest risk, not all women who consume substantial amounts of alcohol in pregnancy will have a child who is clearly affected,” says Christina Chambers, professor of pediatrics at UC San Diego School of Medicine, principal investigator on the Ukraine project, and co-senior author on the study. “That’s why we examined specific biomarkers in the mother’s blood in the second and third trimester of her pregnancy to determine if they are useful in identifying children who could benefit from early interventions.”

Although FASD cannot be cured, early diagnosis is vital.

“Early diagnosis is important because it permits early intervention to minimize the harm due to prenatal alcohol exposure,” says Wladimir Wertelecki, the research team leader for the study investigators in the Ukraine. “Good nutrition, better perinatal health care, lowering stress levels and infant care interventions can all improve the outcome of alcohol-affected pregnancies.”

The team’s next steps include repeating this work in other and larger samples of mothers and infants, and determining if these early markers are predictive of longer term developmental outcomes for children exposed to alcohol.

“If we can reset developmental trajectories earlier in life, it is a lot easier than trying to treat disabilities later in life,” Miranda says. “We hope this work will lead to a test that can allow health care providers to identify the mothers and infants most at risk and provide them with extra care for the best outcome possible.”

The National Institutes of Health funded the work.

Source: Texas A&M University

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