Hopp til hovedinnhold

Fosterskade ved alkoholbruk i svangerskap

Sist revidert:
Sist revidert av:

Definisjon:
Alkoholbruk i svangerskapet kan gi varierende grad av fosterpåvirkning. Det mest alvorlige resultatet er føtalt alkoholsyndrom (FAS)
Forekomst:
I Norge er det funnet at FAS har en prevalens på 0,5 av 1000 fødte. Om man inkluderer også mildere former for alkoholrelatert skade, vil tallet være langt høyere
Symptomer:
Barna med FAS har karakteristiske ansiktstrekk som nyfødte, vekstretardasjon peri- eller postnatalt. Senere kognitive forstyrrelser, læringsvansker, atferdsforstyrrelser, ev. andre anomalier
Funn:
Klinisk kan man finne liten øyespalte, flat filtrum (nesefure), smal overleppe, vekstretardasjon og ev. unormal nevrologisk undersøkelse. Senere utslag på nevropsykologiske tester
Diagnostikk:
Det finnes ingen diagnostiske tester, tester for kartlegging av evnenivå og spesifikke lærevansker benyttes
Behandling:
Tidlig diagnose er avgjørende for å tilrettelegge for best mulig utvikling
  1. Vaux KK. Fetal alcohol syndrome. Medscape, last updated Oct 22, 2016. emedicine.medscape.com  
  2. Elliott E. Fetal alcohol spectrum disorders. BMJ Best Practice, last updated April 2018. bestpractice.bmj.com  
  3. American Psychiatric Association. Neurobehavioral disorder associated with prenatal alcohol exposure. In: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), American Psychiatric Association, Arlington, VA 2013. p.798.
  4. Jones KL, Smith DW: Recognition of the fetal alcohol syndrome in early infancy. Lancet 1973; 2: 999-1001 PubMed  
  5. Abel EL, Sokol RJ. Fetal alcohol syndrome is now leading cause of mental retardation. Lancet 1986; 2: 1222. PubMed  
  6. Janisse J, Ager J, Martier S, Sokol, R. Re-estimation of threshold for fetal alcohol syndrome (FAS) using nonlinear regression. Am J Obstet Gynecol 2001; 184: 59. PubMed  
  7. Sande HA, Vold I, Lindemann R et al. Den gravide rusmiddelbruker. Tidsskr Nor Lægeforen 1985; 105: 2315-8. PubMed  
  8. Astley SJ. Profile of the first 1,400 patients receiving diagnostic evaluations for fetal alcohol spectrum disorder at the Washington State Fetal Alcohol Syndrome Diagnostic&Prevention Network. Can J Clin Pharmacol 2010; 17: e132-64. pmid:20335648 PubMed  
  9. Feldman HS, Jones KL, Lindsay S, et al. Prenatal alcohol exposure patterns and alcohol-related birth defects and growth deficiencies: a prospective study. Alcohol Clin Exp Res 2012; 36: 670. pmid:22250768 PubMed  
  10. Lægreid LM, Bruarøy S, Reigstad H. Fosterskade ved alkoholbruk i svangerskap. Tidsskr Nor Lægeforen 2005; 125: 445-7. PubMed  
  11. Alvik A, Aalen OO, Lindemann R. Early fetal binge alcohol exposure predicts high behavioral symptom scores in 5.5-year-old children. Alcohol Clin Exp Res 2013; 37: 1954-62. doi:10.1111/acer.12182 DOI  
  12. Sood B, Delaney-Black V, Covington C, Nordstrom-Klee B, Ager J, Templin T, et al. Prenatal alcohol exposure and childhood behaviour at age 6-7 years: dose response effect. Paediatrics 2001; 108: 34-5. PubMed  
  13. Mukherjee RAS, Hollins S, Abou-Saleh MT, Turk J. Low level alcohol consumption and the fetus. BMJ 2005; 330: 375-6. PubMed  
  14. Cook JL, Green CR, Lilley CM, et al. Fetal alcohol spectrum disorder: a guideline for diagnosis across the lifespan. CMAJ. 2016 Feb 16;188(3):191-7. www.cmaj.ca  
  15. Streissguth AP, Bookstein FL, Barr HM, et al. Risk factors for adverse life outcomes in fetal alcohol syndrome and fetal alcohol effects. J Dev Behav Pediatr 2004; 25: 228-38. pmid:15308923 PubMed  
  16. Elliott EJ, Payne J, Morris A, et al. Fetal alcohol syndrome: a prospective national surveillance study. Arch Dis Child. 2008 Sep;93(9):732-7. PubMed  
  17. Jacobson JL, Jacobson SW. Effects of prenatal alcohol exposure on child development. Alcohol Res Health 2002; 26: 282-6. PubMed  
  18. Strömland K. Visual impairment and ocular abnormalities in children with fetal alcohol syndrome. Addiction Biology 2004; 9: 153-7. PubMed  
  19. Muggli E, Matthews H, Penington A, et al. Association between prenatal alcohol exposure and craniofacial shape of children at 12 months of age. JAMA Pediatr. 2017 Aug 1;171(8):771-80. PubMed  
  20. Valborg L, Lonardson GR, Neff-Smith M et al. Characteristics of children who have full or incomplete fetal alcohol syndrome. J Pediatr 2004; 145: 635-40. PubMed  
  21. Burd L, Cotsonas-Hassel TM, Martsolf JT et al. Recognition and management of fetal alcohol syndrome. Neurotoxicol Teratol 2003; 25: 681-8. PubMed  
  22. Peadon E, Rhys-Jones B, Bower C, et al. Systematic review of interventions for children with fetal alcohol spectrum disorders. BMC Pediatr. 2009 May 25;9:35. DOI: 10.1186/1471-2431-9-35. DOI  
  23. Rangmar J, Hjern A, Vinnerljung B, et al. Psychosocial outcomes of fetal alcohol syndrome in adulthood. Pediatrics 2015; 135: e52-8. doi:10.1542/peds.2014-1915 DOI  
  24. May PA, Baete A, Russo J, et al. Prevalence and characteristics of fetal alcohol spectrum disorders. Pediatrics 2014; 134: 855-66. doi:10.1542/peds.2013-3319 DOI  
  • Terje Johannessen, professor i allmennmedisin, Trondheim

Tidligere fagmedarbeidere

  • Trine Hessevik Paulsen, allmennlege og redaksjonsmedarbeider i NEL
  • Bjørnar Grenne, PhD, konst. overlege, Klinikk for hjertemedisin, St. Olavs Hospital, Trondheim
  • Svein Skjøtskift, spesialist i psykiatri, overlege, Bjørgvin Familierådgivningskontor, Bergen