Transcript Fetal Alcohol Spectrum Disorder (FASD)

Streissguth et al.(1994)
• Seattle Longitudinal study started in 1974 to
examined long term effects of PAE
• At this point there was little evidence that alcohol
was teratogenic
• Looked at 3 main teratogenic outcomes:
– Growth, morphology, function
• Prospective population-based study, that was
generalizable
• Interviewed 1529 women from two hospitals during
the 5th month of pregnancy
• Asked about many prenatal health factors.
• Drinking during pregnancy was common:
– Women tended to be honest
– Represented various SES
– Use of other drugs was low
• About 80% reported some alcohol use during
pregnancy
• Averaged over 1 drink per day before pregnancy
was known, and <1 drink per day at mid-pregnancy
• Average drinking occasions were 9 per month
• 39% were binge drinkers before pregnancy was
known and 25% were binge drinkers at midpregnancy
• 8% had a major alcohol problem
• Selected a follow-up cohort sample of 500 subjects
– Less than half were infrequent drinkers or abstained
from alcohol
– Others were light to heavy drinkers
– Majority were white, married, middle class
• IV: alcohol use during pregnancy
• Offspring were examined at day 1 and 2 of life, 8
and 18 months, 4, 7, and 14 years (teacher
evaluations at 8 and 11 years).
• At 14 years, 82% of original sample was retained
• Correlation between PAE and IQ of child
X: PAE
Y: IQ
X: PAE
Y: IQ
Z
X: PAE
Z
Y: IQ
X: PAE
Y: IQ
Z1
Z3
Z2
Multiple Regression is used when there is more
than one predictor variable.
• If you are predicting IQ scores in children you
may have many predictor variables: PAE, drug
use, smoking, maternal IQ, nutrition, SES
• You can predict DV (IQ) based on all multiple
predictors, which usually is more accurate than
one predictor.
• Allows the researcher to simultaneously consider
the influence of each predictor variable on the
outcome variable.
X: PAE
Z
Y: IQ
Partial Least Squares is used when there are
multiple predictor variables and multiple outcome
variables.
Y3: Memory
X: PAE
Y1: IQ
Z
Y2: Behavior
Infancy and early childhood
• Poor habituation, reflexes
• Low arousal, sleep-wake disruptions
• Tremors, poor sucking response
• 8 months: decreases in mental and motor
development
• 4 years: decrease in IQ, balance, reaction time,
arithmetic
School-age
• PAE no longer related to size, but still to facial
morphology in highly exposed children
• Deficits in spatial and verbal memory, problem
solving, and perceptual motor function
• Average 7 point decrease in IQ associated with 1+
ounces of alcohol per day
• Difficulties in arithmetic, reading, and digit span
Late childhood and adolescence
• Distractibility, restlessness, lack of persistence, not
meeting challenges
• Learning and reasoning problems
• Arithmetic, memory
• Attention, Inhibition
Conclusions
• Alcohol not consistency associated with growth
• Facial dysmorphology decreased with age
• Strongest effects on neurobehavioral functioning
• Effects were generally dose-dependent, no
threshold
• Binge drinking salient