Failure to recognize fetal alcohol syndrome in newborn infants
B. B. Little, L. M. Snell, C. R. Rosenfeld, L. C. Gilstrap 3rd and N. F. Gant
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas 75235-9032.
A clinically distinct constellation of major and minor anomalies, termed
the fetal alcohol syndrome, occurs among infants whose mothers abuse
alcohol during pregnancy. In addition, significantly higher rates of
pregnancy complications, including perinatal deaths and fetal growth
retardation, occur among these women and their offspring. We studied the
medical records of 40 infants born to 38 alcohol abusers and the frequency
of characteristics associated with fetal alcohol syndrome. Physical
examinations of 6 infants revealed primary features consistent with a
diagnosis of fetal alcohol syndrome. Postnatal growth and development were
very poor in 17 (50%) of 34 liveborn alcohol-exposed infants. The diagnosis
of fetal alcohol syndrome did not appear in the medical records of any of
these infants despite the fact that the mothers' obstetric records included
a history of alcohol abuse during pregnancy. This finding emphasizes the
importance of good communication between obstetric and pediatric medical
staff at this hospital, particularly when providing care for pregnant women
and newborn infants at high risk for complications due to maternal alcohol
or other drug abuse.
