Can prenatal ultrasound detect the effects of in‐utero alcohol exposure? A pilot study

Objectives The aim of this pilot study was to explore possible ultrasound parameters for the early detection of alcohol‐mediated fetal somatic and central nervous system (CNS) maldevelopment. Maternal alcohol ingestion during pregnancy may lead to fetal alcohol spectrum disorders (FASD), which encompass a broad range of structural abnormalities including growth impairment, specific craniofacial features and CNS abnormalities. Early detection of fetuses at risk of FASD would support earlier interventions. Methods We performed a longitudinal prospective pilot study from 2004 to 2006 at two sites in Ukraine. A sample of pregnant women who reported consuming moderate‐to‐heavy amounts of alcohol participated in a comprehensive maternal interview, and received ultrasound evaluation of fetal growth and specific fetal brain measurements during the second and third trimesters. These measurements were compared with those collected from a group of pregnant women who consumed little‐to‐no alcohol during pregnancy, and who were recruited and followed in the same manner. Results From 6745 screened women, 84 moderate‐to‐heavy alcohol users and 82 comparison women were identified and ultrasound examinations performed. After controlling for maternal smoking, alcohol‐exposed fetuses had shorter mean femur length, caval–calvarial distance and frontothalamic measurements in the second trimester (P < 0.05), and alcohol‐exposed fetuses also had shorter frontothalamic distance measurements in the third trimester relative to comparison fetuses (P < 0.05). In addition, after controlling for maternal smoking, both mean orbital diameter and biparietal diameter measurements were significantly smaller on average in the alcohol‐exposed group in the third trimester relative to comparison fetuses (P < 0.05). Conclusions Significant differences in selected somatic and brain measurements were noted between alcohol‐exposed and comparison fetuses, suggesting these markers may be further explored for clinical utility in prenatal identification of affected children. Further study correlating these findings with alcohol‐related physical features of the newborn and subsequent comparisons of neuro‐developmental outcomes will help define potential uses of prenatal ultrasound for intervention and prevention of FASD. Copyright © 2009 ISUOG. Published by John Wiley & Sons, Ltd.