UMN Medical School Leads the Way on Fetal Alcohol Spectrum Disorder Research and Care

Fetal alcohol spectrum disorders (FASD) are lifelong, irreversible conditions with which a child can be born that involve physical, cognitive, emotional, and behavioral disabilities. The number of estimated new cases per year exceeds the number of cases of SIDS, Down Syndrome and cerebral palsy combined.  However, unlike these other conditions, FASDs are completely preventable.

FASD results when a fetus is exposed to alcohol during pregnancy.  Newer studies estimate that between 1% and 5% of children in the US have FASD and similar rates are seen around the world. These recent reports indicate a significantly higher prevalence of FASD than previously reported, mostly because of increased identification of cases 

“FASD should be on the radar for health professionals, teachers, social workers and families when they are working with the child who may be struggling with attention, learning and/or behavior,” said Judith K. Eckerle, MD, Adoption Medicine Physician with University of Minnesota Health and Associate Professor, Division of Global Pediatrics University of Minnesota.

Symptoms include low birth weight, short stature, slow growth, physical anomalies, developmental delays, and learning disabilities. Behavioral symptoms such as aggression, social difficulties, hyperactivity, and irritability are also common. There are physical symptoms which are common as well, such as distinctive facial features, hearing or vision issues 

There is currently no known cure for FASD, but because FASD is preventable, efforts to educate the public and care providers are critically important in reducing the rate of FASD.  

“By implementing universal screening and education regarding alcohol use into routine visits, and delivering a consistent message of prevention through abstinence from alcohol in women who are pregnant or may become pregnant, we hope to reduce the number of new cases of FASD” said Yasuko Yamamura, MD, Assistant Professor, Department of Obstetrics, Gynecology & Women’s Health University of Minnesota.

There is also research happening worldwide, looking at the possibility of reversing the brain effects from prenatal exposure.

“At the University Minnesota, we are researching a vitamin called choline to see if this might be something that can improve brain function in kids who were prenatally exposed,” explained Eckerle.

As the Medical Director of the Adoption Medicine Clinic (AMC) at the University Minnesota Masonic Children's Hospital and a University of Minnesota Medical School faculty member, Dr. Eckerle has an opportunity to be involved with both the research and patient care, hands on.

“When I first started seeing internationally adopted children I formed a special interest in fetal alcohol spectrum disorder and prenatal exposures. That interest has expanded now to include research, as well as clinically evaluating in diagnosing children with FASD,” said Eckerle.

Dr. Yamamura works with women with high-risk pregnancies, but also serves as the ACOG District VI representative in the Fetal Alcohol Spectrum Disorders Prevention Program, which is a collaborative effort between ACOG and CDC to provide Ob-Gyn with resources to communicate with and educate their patients about the risks of alcohol use during pregnancy.

“Some may think that certain types of alcohol are safe, such as beer or wine, or that one glass of wine with dinner is fine, or that consuming alcohol later in pregnancy is safe.  There is no known safe amount, safe time and no safe type of alcohol to drink while pregnant,” said Yamamura.

Both Dr. Eckerle and Dr. Yamamura participated in a PBS special about FASD, to help raise awareness about the condition and lessen the stigma of the medical condition.

Jeffrey Wozniak, PhD, LP, Professor, Department of Psychiatry, University of Minnesota Medical School, is also featured in this two-part special. Dr. Wozniak's primary research interest is in (FASD) and he co-directs the University's FASD Program. Part of his work involves neuroimaging studies in FASD. Dr. Wozniak's research group is part of the Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CIFASD) and is involved in multiple imaging, neurobehavioral, genetic, and facial dysmorphology projects. Dr. Wozniak is also leading the first randomized controlled trial of choline supplementation in children with FASD, searching for a treatment for the neurodevelopmental aspects of the disorder.

“We are at a unique point in time in that public awareness about FASD is higher than ever and the science is developing quickly, but mass media trends seem to be moving toward increased skepticism of experts and increased reliance on opinion as opposed to the results of careful science,” said Wozniak.  “My hope is for the mass media and social media to set aside sensationalism and move more toward consistently presenting balanced stories on the science and the human aspects surrounding the complex issue of prenatal alcohol exposure.”