1. In this prospective cohort study, infants underwent developmental and dysmorphologic assessments at various times throughout early life. Researchers found that starting at 9 months of age, the total dysmorphology score was able to discriminate between children with and without a diagnosis of fetal alcohol spectrum disorders (FASD) at age 5.
2. Significant differences in developmental scores emerged between children with and without FASD between 18 and 42 months of age.
Evidence Rating Level: 2 (Good)
Study Rundown: Fetal alcohol spectrum disorders are the most common environmentally-induced category of intellectual disability in the world, and early identification and referral of at-risk children is crucial. Nonetheless, diagnosis of FASD is typically deferred until children are school-aged due to the challenges of evaluating phenotypes earlier in life. In this prospective cohort study, researchers used repeated longitudinal developmental and dysmorphology assessments of infants after birth at 6 weeks and 9, 18, 42, and 60 months of age and maternal interviews in order to identify infant features that predict a diagnosis of FASD at age 5. Starting at 9 months of age, the total dysmorphology score was able to discriminate between children with and without a diagnosis of FASD at age 5 to a significant degree. Several developmental differences became significant between 18 and 42 months of age.
The assessments were completed by expert dysmorphologists, of whom there are few, limiting the generalizability of the findings to resource-poor areas. Nonetheless, the study is strengthened by its prospective design and inclusion of both and unexposed children from the same community. For physicians, these findings highlight a promising tool to identify and aid in referring FASD at-risk infant at earlier ages than is currently possible.
In-Depth [prospective cohort]: Researchers recruited pregnant women from primary health care clinics and hospitals in two communities in South Africa with a high prevalence of FASD. (Read more…)