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Влияние фетального алкогольного синдрома на психическое и физическое развитие ребенка дошкольного возраста. Клинический случай
Марянян А.Ю., Молчанова Е.В., Молчанова А.М. Влияние фетального алкогольного синдрома на психическое и физическое развитие ребенка дошкольного возраста. Клинический случай. Гинекология. 2023;25(2):267–272. DOI: 10.26442/20795696.2023.2.202083
© ООО «КОНСИЛИУМ МЕДИКУМ», 2023 г.
© ООО «КОНСИЛИУМ МЕДИКУМ», 2023 г.
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Marianian AYu, Molchanova EV, Molchanova AM. The effect of fetal alcohol syndrome on the mental and physical development of a preschool child: a clinical case. Gynecology. 2023;25(2):267–272.
DOI: 10.26442/20795696.2023.2.202083
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Аннотация
В статье описан клинический случай, демонстрирующий влияние фетального алкогольного синдрома на развитие ребенка дошкольного возраста; демонстрируется сложность диагностики данной патологии, которая зачастую приводит к необратимым врожденным психическим и физическим дефектам. Сложность диагностики заключается в том, что не всегда врачам известен факт употребления матерью алкоголя во время беременности. Врачи могут предположить, что у ребенка есть Фетальный алкогольный синдром, по наличию лицевого дисморфизма и состоянию здоровья матери (выраженным признакам алкогольной зависимости). Описанные в статье клинические проявления негативного воздействия алкоголя на развитие ребенка указывают на необходимость организации ранней диагностики и комплексной абилитации.
Ключевые слова: алкоголь, беременность, фетальный алкогольный синдром, задержка психического развития, синдром дефицита внимания и гиперактивности, лицевой дисморфизм, фетальный алкогольный спектр нарушений
Ключевые слова: алкоголь, беременность, фетальный алкогольный синдром, задержка психического развития, синдром дефицита внимания и гиперактивности, лицевой дисморфизм, фетальный алкогольный спектр нарушений
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The article describes a clinical case demonstrating the effect of fetal alcohol syndrome on a preschool child's development, demonstrating the challenging diagnosis of this disorder, often leading to irreversible congenital mental and physical defects. The challenging diagnosis is because doctors are unaware of the mother's alcohol consumption during pregnancy. Doctors may suspect that the child has Fetal alcohol syndrome, according to the presence of facial dysmorphism and the state of health of the mother (pronounced signs of alcohol dependence). The clinical manifestations of the adverse effects of alcohol on the development of the child described in the article indicate the need to organize early diagnosis and comprehensive habilitation.
Keywords: alcohol, pregnancy, fetal alcohol syndrome, mental retardation, attention deficit hyperactivity disorder, facial dysmorphism, fetal alcohol spectrum disorders
Полный текст
Список литературы
1. World Health Organization. Global status report on alcohol and health. World Health Organization 2018. Available at: https://www.who.int/publications/i/item/9789241565639. Accessed: 14.09.2022.
2. Cook JL, Green CR, Lilley CM, at al. Fetal alcohol spectrum disorder: Aguideline for diagnosis across the lifespan. CMAJ. 2016;188(3):191-7. DOI:10.1503/cmaj.141593
3. Popova S, Lange S, Temple V, et al. Profile of Mothers of Children with Fetal Alcohol Spectrum Disorder: A Population-Based Study in Canada. Int J Environ Res Public Health. 2020;17(21):7986. DOI:10.3390/ijerph17217986
4. Bertrand J, Floyd RL, Weber MK, et al. National Task Force on FAS/FAE. Fetal Alcohol Syndrome: Guidelines for Referral and Diagnosis. Atlanta: GA: Centers for Disease Control and Prevention; 2004. Available at: https://www.cdc.gov/ncbddd/fasd/modules/FAS_guidelines_accessible-P.pdf. Accessed: 14.09.2022.
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DOI:10.1542/peds.2015-4256
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8. Hur YM, Choi J, Park S, Oh SS, Kim YJ. Prenatal maternal alcohol exposure: diagnosis and prevention of fetal alcohol syndrome. Obstet Gynecol Sci. 2022;65(5):385-94. DOI:10.5468/ogs.22123
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10. Marianian A, Atalyan A, Bohora S, et al. The effect of low alcohol consumption during pregnancy on the lipid peroxidation-antioxidant defense system of women, their alcohol-exposed infants, and growth, health, and developmental outcomes. Birth Defects Res. 2020;112(1):40-53. DOI:10.1002/bdr2.1582
11. Darenskaya MA, Kolesnikov SI, Rychkova LR, et al. Oxidative stress and antioxidant defense parameters in different diseases: Ethnic aspects. Free Radic Biol Med. 2018;120(20):60.
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14. Suttie M, Foroud T, Wetherill L, et al. Facial dysmorphism across the fetal alcohol spectrum. Pediatrics. 2013;131(3):e779-88. DOI:10.1542/peds.2012-1371
15. Kosyh EA, Balachova T, Bonner B, et al. Alcohol consumption by pregnant women in the Nizhny Novgorod region, Russia. Alcohol Clin Exp Res. 2010;34:111A.
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17. Bandoli G, Coles CD, Kable JA, et al. Patterns of prenatal alcohol use that predict infant growth and development. Pediatrics. 2019;143(2):e20182399. DOI:10.1542/peds.2018-2399
18. Hemingway SJA, Bledsoe JM, Brooks A, et al. Twin study confirms virtually identical prenatal alcohol exposures can lead to markedly different fetal alcohol spectrum disorder outcomes-fetal genetics influences fetal vulnerability. Adv Pediatr Res. 2018;5(3):23. DOI:10.24105/apr.2019.5.23
19. Mattson JT, Thorne JC, Kover ST. Relationship Between Task-Based and Parent Report-Based Measures of Attention and Executive Function in Children with Fetal Alcohol Spectrum Disorders (FASD). J Pediatr Neuropsychol. 2020;6(3):176-88.
20. Balachova T, Bonner B, Chaffin M, et al. Women's alcohol consumption and risk for alcohol-exposed pregnancies in Russia. Addiction. 2012;107(1):109-11.
DOI:10.1111/j.1360-0443.2011.03569.x
21. Varavikova EA, Balachova TN. Strategies to implement physician training in FAS prevention as a part of preventive care in primary health settings. Alcohol Clin Exp Res. 2010;34(8):119A.
22. Burina EA, Kulieva AK, Marianian AY. The risk of fetal alcohol syndrome in pregnant women and women planning pregnancy. Alcohol Clin Exp Res. 2018;42(6):75. DOI:10.1111/acer.13833
23. Popova S, Lange S, Probst C, et al. Estimation of national, regional, and global prevalence of alcohol use during pregnancy and fetal alcohol syndrome: A systematic review and meta-analysis. Lancet Glob Health. 2017;5(3):e290-9. DOI:10.1016/S2214-109X(17)30021-9
24. Subramoney S, Eastman E, Adnams C, et al. The Early Developmental Outcomes of Prenatal Alcohol Exposure: A Review. Front Neurol. 2018;9:1108. DOI:10.3389/fneur.2018.01108
25. Moore EM, Glass L, Infante MA, et al. Cross-Sectional Analysis of Spatial Working Memory Development in Children with Histories of Heavy Prenatal Alcohol Exposure. Alcohol Clin Exp Res. 2021;45(1):215-23.
26. Marianian AYu, Molchanova EV. Social and Economic Effect of Comprehensive Prevention of Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorders in Children: A Review. J Pharm Res Int. 2020;32(23):115-23.
27. Молчанова Е.В. Об опыте работы с детьми с ФАС. 2016 г. Режим доступа: https://old.mednet.ru/images/stories/files/obrachenie__mednet.pdf. Ссылка активна на 14.09.2022 [Molchanova EV. On the experience of working with children with FAS. 2016. Available at: https://old.mednet.ru/images/stories/files/obrachenie__mednet.pdf. Accessed: 14.09.2021 (in Russian)].
28. Молчанова Е.В. Опыт усыновления ребенка с ФАС. 2013 г. Режим доступа: https://old.mednet.ru/images/stories/files/fas/Molchanova_fas_09_09_2013.pdf. Ссылка активна на 14.09.2022 [Molchanova EV. Experience of adopting a child with FAS 2013. Available at: https://old.mednet.ru/images/stories/files/fas/Molchanova_fas_09_09_2013.pdf. Accessed: 14.09.2021 (in Russian)].
29. Фетальный алкогольный синдром: группа поддержки родителей. Режим доступа: https://www.facebook.com/groups/1263627697115550/?ref=group_header. Ссылка активна на 14.09.2021 [Fetal alcohol syndrome: parent support group. Available at: https://www.facebook.com/groups/1263627697115550/?ref=group_header. Accessed: 14.09.2021 (in Russian)].
2. Cook JL, Green CR, Lilley CM, at al. Fetal alcohol spectrum disorder: Aguideline for diagnosis across the lifespan. CMAJ. 2016;188(3):191-7. DOI:10.1503/cmaj.141593
3. Popova S, Lange S, Temple V, et al. Profile of Mothers of Children with Fetal Alcohol Spectrum Disorder: A Population-Based Study in Canada. Int J Environ Res Public Health. 2020;17(21):7986. DOI:10.3390/ijerph17217986
4. Bertrand J, Floyd RL, Weber MK, et al. National Task Force on FAS/FAE. Fetal Alcohol Syndrome: Guidelines for Referral and Diagnosis. Atlanta: GA: Centers for Disease Control and Prevention; 2004. Available at: https://www.cdc.gov/ncbddd/fasd/modules/FAS_guidelines_accessible-P.pdf. Accessed: 14.09.2022.
5. Hoyme HE, Kalberg WO, Elliott AJ, et al. Updated Clinical Guidelines for Diagnosing Fetal Alcohol Spectrum Disorders. Pediatrics. 2016;138(2):e20154256.
DOI:10.1542/peds.2015-4256
6. Ялтонская А.В., Ялтонский В.М., Колпаков Я.В. Потребление алкоголя во время беременности и фетальный алкогольный спектр нарушений в России: систематический обзор литературы. Наркология. 2014;6:81-90 [Yaltonskaya AV, Yaltonsky VM, Kolpakov YaV. Alcohol consumption during pregnancy and fetal alcohol spectrum disorders in Russia: a systematic literature review. Narkologiia. 2014;6:81-90 (in Russian)].
7. Jones KL, Smith DW. Recognition of the fetal alcohol syndrome in early infancy. Lancet. 1973;302(7836):999-1001.
8. Hur YM, Choi J, Park S, Oh SS, Kim YJ. Prenatal maternal alcohol exposure: diagnosis and prevention of fetal alcohol syndrome. Obstet Gynecol Sci. 2022;65(5):385-94. DOI:10.5468/ogs.22123
9. Пальчик А.Б., Легонькова С.В. Фетальный алкогольный синдром: манифестация и динамика. Обозрение психиатрии и медицинской психологии им. В.М. Бехтерева. 2011;3:17-20 [Palchik AB, Legonkova SV. Fetal alcohol syndrome: manifestation and dynamics. Obozrenie psihiatrii i medicinskoj psihologii im. VM Bekhtereva. 2011;3:17-20 (in Russian)].
10. Marianian A, Atalyan A, Bohora S, et al. The effect of low alcohol consumption during pregnancy on the lipid peroxidation-antioxidant defense system of women, their alcohol-exposed infants, and growth, health, and developmental outcomes. Birth Defects Res. 2020;112(1):40-53. DOI:10.1002/bdr2.1582
11. Darenskaya MA, Kolesnikov SI, Rychkova LR, et al. Oxidative stress and antioxidant defense parameters in different diseases: Ethnic aspects. Free Radic Biol Med. 2018;120(20):60.
12. Kolesnikova LI, Darenskaya MA, Kolesnikov SI. Free radical oxidation: A view of a pathophysiologist. Bulletin Sib Medicine. 2017;16(4):16-29.
13. Сафина Л.З., Шакирова А.З., Салманидина Д.Р. Фетальный алкогольный синдром и синдром абстиненции у новорожденных. Рос вестн перинатол и педиатр. 2016;61(5):174-8 [Safina LZ, Shakirova AZ, Salmanidina DR. Fetal alcohol syndrome and neonatal withdrawal syndrome. Ros Vestn Perinatol i Pediatr. 2016;61(5):174-8 (in Russian)].
14. Suttie M, Foroud T, Wetherill L, et al. Facial dysmorphism across the fetal alcohol spectrum. Pediatrics. 2013;131(3):e779-88. DOI:10.1542/peds.2012-1371
15. Kosyh EA, Balachova T, Bonner B, et al. Alcohol consumption by pregnant women in the Nizhny Novgorod region, Russia. Alcohol Clin Exp Res. 2010;34:111A.
16. Thomas JD, Warren KR, Hewitt BG. Fetal alcohol spectrum disorders: from research to policy. Alcohol Res Health. 2010;33(1-2):118-26.
17. Bandoli G, Coles CD, Kable JA, et al. Patterns of prenatal alcohol use that predict infant growth and development. Pediatrics. 2019;143(2):e20182399. DOI:10.1542/peds.2018-2399
18. Hemingway SJA, Bledsoe JM, Brooks A, et al. Twin study confirms virtually identical prenatal alcohol exposures can lead to markedly different fetal alcohol spectrum disorder outcomes-fetal genetics influences fetal vulnerability. Adv Pediatr Res. 2018;5(3):23. DOI:10.24105/apr.2019.5.23
19. Mattson JT, Thorne JC, Kover ST. Relationship Between Task-Based and Parent Report-Based Measures of Attention and Executive Function in Children with Fetal Alcohol Spectrum Disorders (FASD). J Pediatr Neuropsychol. 2020;6(3):176-88.
20. Balachova T, Bonner B, Chaffin M, et al. Women's alcohol consumption and risk for alcohol-exposed pregnancies in Russia. Addiction. 2012;107(1):109-11.
DOI:10.1111/j.1360-0443.2011.03569.x
21. Varavikova EA, Balachova TN. Strategies to implement physician training in FAS prevention as a part of preventive care in primary health settings. Alcohol Clin Exp Res. 2010;34(8):119A.
22. Burina EA, Kulieva AK, Marianian AY. The risk of fetal alcohol syndrome in pregnant women and women planning pregnancy. Alcohol Clin Exp Res. 2018;42(6):75. DOI:10.1111/acer.13833
23. Popova S, Lange S, Probst C, et al. Estimation of national, regional, and global prevalence of alcohol use during pregnancy and fetal alcohol syndrome: A systematic review and meta-analysis. Lancet Glob Health. 2017;5(3):e290-9. DOI:10.1016/S2214-109X(17)30021-9
24. Subramoney S, Eastman E, Adnams C, et al. The Early Developmental Outcomes of Prenatal Alcohol Exposure: A Review. Front Neurol. 2018;9:1108. DOI:10.3389/fneur.2018.01108
25. Moore EM, Glass L, Infante MA, et al. Cross-Sectional Analysis of Spatial Working Memory Development in Children with Histories of Heavy Prenatal Alcohol Exposure. Alcohol Clin Exp Res. 2021;45(1):215-23.
26. Marianian AYu, Molchanova EV. Social and Economic Effect of Comprehensive Prevention of Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorders in Children: A Review. J Pharm Res Int. 2020;32(23):115-23.
27. Молчанова Е.В. Об опыте работы с детьми с ФАС. 2016 г. Режим доступа: https://old.mednet.ru/images/stories/files/obrachenie__mednet.pdf. Ссылка активна на 14.09.2022 [Molchanova EV. On the experience of working with children with FAS. 2016. Available at: https://old.mednet.ru/images/stories/files/obrachenie__mednet.pdf. Accessed: 14.09.2021 (in Russian)].
28. Молчанова Е.В. Опыт усыновления ребенка с ФАС. 2013 г. Режим доступа: https://old.mednet.ru/images/stories/files/fas/Molchanova_fas_09_09_2013.pdf. Ссылка активна на 14.09.2022 [Molchanova EV. Experience of adopting a child with FAS 2013. Available at: https://old.mednet.ru/images/stories/files/fas/Molchanova_fas_09_09_2013.pdf. Accessed: 14.09.2021 (in Russian)].
29. Фетальный алкогольный синдром: группа поддержки родителей. Режим доступа: https://www.facebook.com/groups/1263627697115550/?ref=group_header. Ссылка активна на 14.09.2021 [Fetal alcohol syndrome: parent support group. Available at: https://www.facebook.com/groups/1263627697115550/?ref=group_header. Accessed: 14.09.2021 (in Russian)].
________________________________________________
1. World Health Organization. Global status report on alcohol and health. World Health Organization 2018. Available at: https://www.who.int/publications/i/item/9789241565639. Accessed: 14.09.2022.
2. Cook JL, Green CR, Lilley CM, at al. Fetal alcohol spectrum disorder: Aguideline for diagnosis across the lifespan. CMAJ. 2016;188(3):191-7. DOI:10.1503/cmaj.141593
3. Popova S, Lange S, Temple V, et al. Profile of Mothers of Children with Fetal Alcohol Spectrum Disorder: A Population-Based Study in Canada. Int J Environ Res Public Health. 2020;17(21):7986. DOI:10.3390/ijerph17217986
4. Bertrand J, Floyd RL, Weber MK, et al. National Task Force on FAS/FAE. Fetal Alcohol Syndrome: Guidelines for Referral and Diagnosis. Atlanta: GA: Centers for Disease Control and Prevention; 2004. Available at: https://www.cdc.gov/ncbddd/fasd/modules/FAS_guidelines_accessible-P.pdf. Accessed: 14.09.2022.
5. Hoyme HE, Kalberg WO, Elliott AJ, et al. Updated Clinical Guidelines for Diagnosing Fetal Alcohol Spectrum Disorders. Pediatrics. 2016;138(2):e20154256.
DOI:10.1542/peds.2015-4256
6. Yaltonskaya AV, Yaltonsky VM, Kolpakov YaV. Alcohol consumption during pregnancy and fetal alcohol spectrum disorders in Russia: a systematic literature review. Narkologiia. 2014;6:81-90 (in Russian).
7. Jones KL, Smith DW. Recognition of the fetal alcohol syndrome in early infancy. Lancet. 1973;302(7836):999-1001.
8. Hur YM, Choi J, Park S, Oh SS, Kim YJ. Prenatal maternal alcohol exposure: diagnosis and prevention of fetal alcohol syndrome. Obstet Gynecol Sci. 2022;65(5):385-94. DOI:10.5468/ogs.22123
9. Palchik AB, Legonkova SV. Fetal alcohol syndrome: manifestation and dynamics. Obozrenie psihiatrii i medicinskoj psihologii im. VM Bekhtereva. 2011;3:17-20 (in Russian).
10. Marianian A, Atalyan A, Bohora S, et al. The effect of low alcohol consumption during pregnancy on the lipid peroxidation-antioxidant defense system of women, their alcohol-exposed infants, and growth, health, and developmental outcomes. Birth Defects Res. 2020;112(1):40-53. DOI:10.1002/bdr2.1582
11. Darenskaya MA, Kolesnikov SI, Rychkova LR, et al. Oxidative stress and antioxidant defense parameters in different diseases: Ethnic aspects. Free Radic Biol Med. 2018;120(20):60.
12. Kolesnikova LI, Darenskaya MA, Kolesnikov SI. Free radical oxidation: A view of a pathophysiologist. Bulletin Sib Medicine. 2017;16(4):16-29.
13. Safina LZ, Shakirova AZ, Salmanidina DR. Fetal alcohol syndrome and neonatal withdrawal syndrome. Ros Vestn Perinatol i Pediatr. 2016;61(5):174-8 (in Russian).
14. Suttie M, Foroud T, Wetherill L, et al. Facial dysmorphism across the fetal alcohol spectrum. Pediatrics. 2013;131(3):e779-88. DOI:10.1542/peds.2012-1371
15. Kosyh EA, Balachova T, Bonner B, et al. Alcohol consumption by pregnant women in the Nizhny Novgorod region, Russia. Alcohol Clin Exp Res. 2010;34:111A.
16. Thomas JD, Warren KR, Hewitt BG. Fetal alcohol spectrum disorders: from research to policy. Alcohol Res Health. 2010;33(1-2):118-26.
17. Bandoli G, Coles CD, Kable JA, et al. Patterns of prenatal alcohol use that predict infant growth and development. Pediatrics. 2019;143(2):e20182399. DOI:10.1542/peds.2018-2399
18. Hemingway SJA, Bledsoe JM, Brooks A, et al. Twin study confirms virtually identical prenatal alcohol exposures can lead to markedly different fetal alcohol spectrum disorder outcomes-fetal genetics influences fetal vulnerability. Adv Pediatr Res. 2018;5(3):23. DOI:10.24105/apr.2019.5.23
19. Mattson JT, Thorne JC, Kover ST. Relationship Between Task-Based and Parent Report-Based Measures of Attention and Executive Function in Children with Fetal Alcohol Spectrum Disorders (FASD). J Pediatr Neuropsychol. 2020;6(3):176-88.
20. Balachova T, Bonner B, Chaffin M, et al. Women's alcohol consumption and risk for alcohol-exposed pregnancies in Russia. Addiction. 2012;107(1):109-11.
DOI:10.1111/j.1360-0443.2011.03569.x
21. Varavikova EA, Balachova TN. Strategies to implement physician training in FAS prevention as a part of preventive care in primary health settings. Alcohol Clin Exp Res. 2010;34(8):119A.
22. Burina EA, Kulieva AK, Marianian AY. The risk of fetal alcohol syndrome in pregnant women and women planning pregnancy. Alcohol Clin Exp Res. 2018;42(6):75. DOI:10.1111/acer.13833
23. Popova S, Lange S, Probst C, et al. Estimation of national, regional, and global prevalence of alcohol use during pregnancy and fetal alcohol syndrome: A systematic review and meta-analysis. Lancet Glob Health. 2017;5(3):e290-9. DOI:10.1016/S2214-109X(17)30021-9
24. Subramoney S, Eastman E, Adnams C, et al. The Early Developmental Outcomes of Prenatal Alcohol Exposure: A Review. Front Neurol. 2018;9:1108. DOI:10.3389/fneur.2018.01108
25. Moore EM, Glass L, Infante MA, et al. Cross-Sectional Analysis of Spatial Working Memory Development in Children with Histories of Heavy Prenatal Alcohol Exposure. Alcohol Clin Exp Res. 2021;45(1):215-23.
26. Marianian AYu, Molchanova EV. Social and Economic Effect of Comprehensive Prevention of Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorders in Children: A Review. J Pharm Res Int. 2020;32(23):115-23.
27. Molchanova EV. On the experience of working with children with FAS. 2016. Available at: https://old.mednet.ru/images/stories/files/obrachenie__mednet.pdf. Accessed: 14.09.2021 (in Russian).
28. Molchanova EV. Experience of adopting a child with FAS 2013. Available at: https://old.mednet.ru/images/stories/files/fas/Molchanova_fas_09_09_2013.pdf. Accessed: 14.09.2021 (in Russian).
29. Fetal alcohol syndrome: parent support group. Available at: https://www.facebook.com/groups/1263627697115550/?ref=group_header. Accessed: 14.09.2021 (in Russian).
Авторы
А.Ю. Марянян*, Е.В. Молчанова, А.М. Молчанова
ФГБНУ «Научный центр проблем здоровья семьи и репродукции человека», Иркутск, Россия
ФГБНУ «Научный центр проблем здоровья семьи и репродукции человека», Иркутск, Россия
________________________________________________
Anait Yu. Marianian*, Elena V. Molchanova, Anastasia M. Molchanova
Scientific Center for Family Health and Human Reproduction, Irkutsk, Russia
Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.