Publications by authors named "Philip A May"
Article Synopsis
- The study aimed to identify risk factors for fetal alcohol spectrum disorders (FASD) by interviewing mothers of first-grade children, both with FASD diagnoses and controls.
- Results revealed significant differences in alcohol consumption patterns between mothers of children with FASD and control mothers, with those with FASD generally consuming more alcohol before and during pregnancy.
- The analysis highlighted maternal factors such as alcohol intake, liver issues, depression, and late prenatal care as key risk indicators for FASD, with less influence from paternal alcohol consumption once maternal drinking was accounted for.
Fetal alcohol spectrum disorders (FASD) are a significant global challenge characterized by complex diagnosis and research. The diagnostic process is complicated due to overlapping symptoms with other conditions, as well as factors such as maternal nutrition, socioeconomic status, and mental health, which can affect the severity of FASD traits differently in individuals. Risky drinking behaviors are prevalent in young adults, especially those aged 20-24, which coincides with high rates of unplanned pregnancies, increasing the risk of FASD.
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- - The study aimed to assess whether prenatal alcohol exposure (PAE) influences the physical and cognitive/behavioral development of first-grade children, comparing three groups: those with fetal alcohol spectrum disorders (FASD), those with PAE but without FASD, and children without PAE.
- - Results indicated significant differences in physical traits like height, weight, and head circumference between the groups, while neurodevelopmental differences were more pronounced in three-group comparisons than in two-group comparisons.
- - The findings suggest that children with PAE, despite appearing typically developing, tend to show poorer growth and cognitive/behavioral outcomes compared to children without PAE, highlighting the importance of alcohol abstinence during pregnancy.
This study evaluated criteria for neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE). Kable et al. (Child Psychiatry Hum Dev 55:426, 2022) assessed the validity of this diagnosis in a sample with low exposure to alcohol.
View Article and Find Full Text PDFNutritional status during pregnancy can impact fetal development, yet less is known about how alcohol may interact with nutritional status to influence infant outcomes. Pregnant women (n=196) completed 2, 24-hour dietary recalls and provided a venous blood sample to be analyzed for liver enzymes (GGT -gamma-glutamyl transferase; ALT -alanine transaminase; and AST -aspartate transferase), iron, ferritin, and zinc concentrations. Infants were assessed at 6 weeks of age.
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- Maternal risk factors for Fetal Alcohol Spectrum Disorders (FASD) include alcohol use patterns, physical health, socio-economic status, and childhood trauma, impacting the likelihood of having a child with FASD.
- A study in South Africa assessed mothers of first-graders for FASD, using surveys to evaluate mental health and trauma, revealing a modest association between higher childhood trauma and FASD rates.
- While maternal childhood trauma doesn't directly influence FASD diagnoses, it may indirectly raise the risk by affecting factors like alcohol consumption during pregnancy.
This study evaluated criteria for Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE). Kable et al. (2022) assessed the validity of this diagnosis in a sample with low exposure to alcohol.
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- The study examines how both maternal and paternal drinking habits influence the risk of having a child with fetal alcohol spectrum disorder (FASD), using data from interviews with 2,515 mothers.
- Results show that mothers of children with fetal alcohol syndrome (FAS) had significantly higher alcohol consumption during pregnancy compared to those with partial FAS (PFAS) or typical development, and both maternal and paternal binge drinking patterns were more common among fathers of children with FASD.
- Key findings highlight that even low levels of maternal alcohol consumption (less than 1 drink per day) increase the likelihood of FASD, and drinking in the first trimester poses a particularly high risk, amplifying the odds of FASD by over
Maternal risk factors for fetal alcohol spectrum disorders: Distal variables.
Alcohol Clin Exp Res (Hoboken)
February 2024
Article Synopsis
- A study analyzed maternal risk factors associated with fetal alcohol spectrum disorders (FASD) by interviewing 2,515 mothers of first-grade students, focusing on health, demographics, and personal history.
- Results showed that mothers of children with FASD were generally smaller, experienced higher pregnancy complications, had lower education levels, and faced more mental health challenges than mothers of typically developing children.
- Regression analysis revealed that maternal variables accounted for a significant percentage of the variance in FAS diagnoses, suggesting these factors are important in understanding the risks associated with FASD.
Article Synopsis
- Maternal diet during pregnancy may play a significant role in the risk of fetal alcohol spectrum disorders (FASD), especially among women in South Africa, where dietary deficiencies are common.
- A study involving 196 pregnant women showed that over half were below the average requirements for several essential vitamins and minerals, with over 90% lacking adequate intake of many key nutrients.
- The research found a correlation between alcohol consumption and decreased intake of important nutrients, linking inadequate maternal nutrition and alcohol exposure to poor growth outcomes in infants and an increased risk of FASD.
In the literature on alcohol use biomarkers, there has been debate as to what a valid and/or utilitarian cut off level should be for various research applications. In this manuscript, we assessed the sensitivity and specificity of multiple cutoff values for phosphatidylethanol (PEth) from bloodspots relative to self-report, the Alcohol Use Disorder Identification Test (AUDIT) scores, and another alcohol use biomarker ethyl glucuronide (EtG) from fingernails in a sample of 222 pregnant women in the Western Cape Province of South Africa. Receiver operating characteristic (ROC) curves were used to assess the area under the curve (AUC) and assess PEth cutoff values of ≥2, ≥4, ≥8, ≥14, and ≥20 nanograms per milliliter (ng/ml).
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- - The study explored a relationship-based intervention aimed at enhancing development in children who were prenatally exposed to alcohol, involving caregiver/child dyads in South Africa and using the AUDIT to assess risk levels.
- - Significant improvements in the home environment were observed after the intervention, with marked enhancements in the HOME scores, especially in the area of responsivity.
- - Although children from the heavily alcohol-exposed group initially scored lower on developmental assessments, those with the lowest performance showed noticeable improvements over time, highlighting the intervention's effectiveness.
Article Synopsis
- Pregnant women considered high-risk drinkers participated in a multifaceted case management program aimed at reducing alcohol consumption and preventing Fetal Alcohol Spectrum Disorders (FASD) during pregnancy.
- Results showed that children of women who underwent case management had better outcomes, with a lower incidence of FASD and fetal alcohol syndrome compared to those who received standard antenatal care.
- Although there were mixed results in neurodevelopmental scores at 18 months, by five years, the performance of both groups equalized on certain assessments, indicating potential long-term benefits from the case management intervention.
Prenatal alcohol exposure can produce offspring growth deficits and is a leading cause of neurodevelopmental disability. We used untargeted metabolomics to generate mechanistic insight into how alcohol impairs fetal development. In the Western Cape Province of South Africa, 52 women between gestational weeks 5-36 (mean 18.
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- * At the 1.0 diagnostic threshold, children at risk for ND-PAE showed higher rates of self-regulation and adaptive impairments, while at the 1.5 threshold, they exhibited more neurocognitive and self-regulation impairments.
- * The study found that having an IQ below 70 was not a reliable predictor for ND-PAE diagnosis, but adjusting the IQ criteria enhanced predictive accuracy; however, identifying prenatal alcohol exposure remains essential for an accurate diagnosis.
Background: This study is the ninth cross-sectional community study of fetal alcohol spectrum disorders (FASD) conducted by the multidisciplinary Fetal Alcohol Syndrome Epidemiology Research team in the Western Cape Province of South Africa. It is the third comprehensive study of FASD in a rural, agricultural region of South Africa.
Methods: Population-based, active case ascertainment methods were employed among a school-based cohort to assess child physical and neurobehavioral traits, and maternal risk factor interviews were conducted to identify all children with FASD to determine its prevalence.
Background: Mothers of children with fetal alcohol spectrum disorders tend to have lower weight compared to other mothers. Yet how alcohol and maternal weight may predispose infants to poorer physical growth and neurodevelopmental trajectories is relatively unexplained.
Methods: South African mothers ( = 406) were recruited prenatally and their offspring were provided standardized dysmorphology and neurodevelopment examinations at 6 weeks and 9 months of age.
We compared growth, physical features, and minor anomalies in 131 first-grade children with fetal alcohol spectrum disorders (FASD) to those of a representative comparison group of typically developing children from the same populations (n = 1212). The data were collected from three regional sites in the NIAAA-funded Collaboration on FASD Prevalence (CoFASP). Dysmorphology examinations were performed by a team of expert clinical geneticists, and FASD diagnoses were assigned according to the Revised Institute of Medicine Guidelines, which include assessments of growth, dysmorphology, neurobehavior, and maternal risk interviews.
View Article and Find Full Text PDFBackground: This study aimed to develop an efficient and easily calculable risk score that can be used to identify an individual's risk of having been exposed to alcohol prenatally.
Methods: Data for this study were collected as part of the Collaborative Initiative on Fetal Alcohol Spectrum Disorders, Phases 2 and 3. Two cohorts (ages 5 to 17 years) completed a comprehensive neurobehavioral battery and a standard dysmorphology exam: a development cohort (DC; n = 325) and a comparative cohort (CC; n = 523).
Objective: Utilize a random sample to estimate the prevalence, child traits, and maternal risk for fetal alcohol spectrum disorders (FASD) in a Southeastern United States county.
Methods: From all first-grade students (n = 1073) a simple random sample was drawn, and 32 % (n = 231) were consented. All 231 children were examined for dysmorphology and growth, 84 were tested and rated on neurobehavior, and 72 mothers were interviewed for maternal risk.
Objective: To investigate gestational age and growth at birth as predictors of fetal alcohol spectrum disorders (FASD).
Methods: The sample analyzed here comprises 737 randomly selected children who were assessed for growth, dysmorphology, and neurobehavior at 7 years of age. Maternal interviews were conducted to ascertain prenatal alcohol exposure and other maternal risk factors.
Background: Rating scales are designed to complement traditional performance-based measures, and both can provide useful information about the functioning of youth with histories of prenatal alcohol exposure. Few studies, however, have compared ratings from multiple informants or the relationship between these subjective rating scale scores and the objective results from laboratory performance-based scales.
Methods: The current study addressed both of these questions in 3 study groups: children with histories of prenatal alcohol exposure (n = 47), attention-deficit/hyperactivity disorder (ADHD; n = 41), and typically developing controls (CON; n = 73).
Background: Prevalence and characteristics of fetal alcohol spectrum disorders (FASD) have been described previously in this community.
Methods: Active case ascertainment methods were employed in a new cross-sectional study with Revised Institute of Medicine criteria among first grade students (n = 735) via dysmorphology examinations and neurobehavioral assessments. Their mothers were interviewed regarding risk factors.
Fetal alcohol spectrum disorders (FASD) describe a range of physical, behavioral, and neurologic deficits in individuals exposed to alcohol prenatally. Reduced palpebral fissure length is one of the cardinal facial features of FASD. However, other ocular measurements have not been studied extensively in FASD.
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