Novel Interventions on Comorbidities in Patients with Fetal Alcohol Spectrum Disorder (FASD): An Integrative Review

Biomedicines. 2024 Feb 22;12(3):496. doi: 10.3390/biomedicines12030496.

Abstract

Prenatal exposure to alcohol can cause Fetal Alcohol Spectrum Disorders (FASDs) after birth, encompassing a spectrum of physical, cognitive, and behavioral abnormalities. FASD represents a severe non-genetic disability avoidable through alcohol abstinence during pregnancy and when planning it. Clinical severity depends on alcohol impact, symptomatology, and resulting disabilities. FASD is a permanent disability with no recognized specific medical care. Conversely, secondary FASD-related disabilities can be symptomatically treated. This integrative review aims to provide information about the novel pharmacological treatments of FASD-associated comorbidities by selecting the last ten years of studies carried out on animals and humans. PRISMA guidelines were followed to search human/animal model studies of pharmacological interventions on FASD comorbidities, using different databases (PubMed, Cochrane, etc.). From 1348 articles, 44 met the criteria after full-text analysis. Firstly, all the reported studies point out that early diagnosis and tailored interventions are the principal tools to reduce FASD-related secondary disabilities, due to the fact that there is currently no approved pharmacological treatment for the tissue damage which produces FASD. Despite limitations in study designs and small sample sizes, these review results highlight how the treatment strategies of children with FASD have changed. In the past, studies focused on treating symptoms, but in the last years, researchers have turned their attention to the prevention targeting central nervous system embryogenesis. Novel treatments like choline and natural antioxidants and nutritional supplements are the most investigated treatments in humans with promising results. More follow-up studies need to be performed, to confirm and generalize reported efficacy to a wide sample size.

Keywords: early diagnosis; fetal alcohol spectrum disorders; follow-up studies; interventions; prenatal exposure delayed effects.

Publication types

  • Review

Grants and funding

This research was supported by Red de Salud Materno-Infantil y del Desarrollo (SAMID) (RD12/0026/0003 and RD16/0022/0002) and Instituto de Salud Carlos III (ISCIII) (PI19/01853 and PI21/01415), and co-funded by Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) (RD21/0012/0017), teams RG6 and RG19 (supported V.A., M.V.) funded by Instituto de Salud Carlos III (ISCIII) and European Union NextGenerationEU/Mecanismo para la Recuperación y la Resiliencia (MRR)/Plan de Recuperación, Transformación y Resiliencia (PRTR). This study has also been carried out thanks to the support of the Departament de Recerca i Universitats de la Generalitat de Catalunya al Grup de Recerca Infància i Entorn (GRIE) (2021 SGR 01290) and of Fundación Mutua Madtileña (2023 AP183662023). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.