Denny LeeAnne, Coles Sarah, Blitz Robin
University of Arizona College of Medicine, Phoenix, AZ, USA.
Am Fam Physician. 2017 Oct 15;96(8):515-522.
Fetal alcohol syndrome (FAS) and fetal alcohol spectrum disorders (FASD) result from intrauterine exposure to alcohol and are the most common nonheritable causes of intellectual disability. The percentage of women who drink or binge drink during pregnancy has increased since 2012. FAS is commonly missed or misdiagnosed, preventing affected children from receiving needed services in a timely fashion. Diagnosis is based on the presence of the following clinical features, all of which must be present: prenatal and/or postnatal growth retardation, facial dysmorphology, central nervous system dysfunction, and neurobehavioral disabilities. FASD is a broader diagnosis that encompasses patients with FAS and others who are affected by prenatal alcohol exposure but do not meet the full criteria for FAS. Management is multidisciplinary and includes managing comorbid conditions, providing nutritional support, managing behavioral problems and educational difficulties, referring patients for habilitative therapies, and educating parents. The Centers for Disease Control and Prevention and other organizations recognize no safe amount of alcohol consumption during pregnancy and recommend complete abstinence from alcohol. All women should be screened for alcohol use during preconception counseling and prenatal care, and alcohol use should be addressed with brief interventions.
胎儿酒精综合征(FAS)和胎儿酒精谱系障碍(FASD)是由子宫内接触酒精引起的,是智力残疾最常见的非遗传性原因。自2012年以来,孕期饮酒或暴饮的女性比例有所上升。FAS通常被漏诊或误诊,导致受影响的儿童无法及时获得所需服务。诊断基于以下临床特征的存在,所有这些特征都必须具备:产前和/或产后生长发育迟缓、面部畸形、中枢神经系统功能障碍和神经行为残疾。FASD是一个更宽泛的诊断,包括患有FAS的患者以及其他受产前酒精暴露影响但不符合FAS全部标准的人。管理是多学科的,包括管理合并症、提供营养支持、处理行为问题和教育困难、为患者转介康复治疗以及教育家长。疾病控制与预防中心及其他组织认为孕期没有安全的饮酒量,并建议完全戒酒。所有女性在孕前咨询和产前检查时都应接受酒精使用筛查,并且应通过简短干预来解决酒精使用问题。