Maternal drinking behavior and Fetal Alcohol Spectrum Disorders in adolescents with criminal behavior in southern Brazil.

Prenatal alcohol exposure can have serious and permanent adverse effects. The developing brain is the most vulnerable organ to the insults of prenatal alcohol exposure. A behavioral phenotype of prenatal alcohol exposure including conduct disorders is also described. This study on a sample of Brazilian adolescents convicted for criminal behavior aimed to evaluate possible clinical features of Fetal Alcohol Syndrome (FAS). These were compared to a control group of school adolescents, as well as tested for other environmental risk factors for antisocial behavior. A sample of 262 institutionalized male adolescents due to criminal behavior and 154 male students aged between 13 and 21 years comprised the study population. Maternal use of alcohol was admitted by 48.8% of the mothers of institutionalized adolescents and by 39.9% of the school students. In this sample of adolescents we could not identify individual cases with a clear diagnosis of FAS, but signs suggestive of FASD were more common in the institutionalized adolescents. Social factors like domestic and family violence were frequent in the risk group, this also being associated to maternal drinking during pregnancy. The inference is that in our sample, criminal behavior is more related to complex interactions between environmental and social issues including prenatal alcohol exposure.

Prenatal alcohol exposure as a risk factor for dysfunctional behaviors: the role of the pediatrician.

OBJECTIVE: Although the classic features of fetal alcohol syndrome have been recognized since 1968, research on alcohol teratogenesis has only recently demonstrated that the brain is the organ in the body most vulnerable to the effects of prenatal alcohol exposure. In this present article, we reviewed the literature focusing mainly on behavioral disturbances related to prenatal ethanol exposure. SOURCES: We performed a PubMed search on the literature published between 1968 and 2006 using the terms ethanol, pregnancy and behavior. We limited our search to studies on humans. SUMMARY OF THE FINDINGS: The data presented in this review suggested that youths with fetal alcohol spectrum disorder are at risk of disruptive social behavior, among other neurobehavioral abnormalities. CONCLUSIONS: Although it is still impossible to completely separate brain teratogenesis secondary to alcohol exposure from environmental postnatal influences as the definite cause for these outcomes, the pediatrician should be encouraged to early diagnose children affected by fetal alcohol syndrome and fetal alcohol spectrum disorder. This provides proper management and care and avoids long-term consequences on their behavior, besides ensuring better and productive school and social adaptation.

A exposição pré-natal ao álcool como fator de risco para comportamentos disfuncionais: o papel do pediatra: [revisão] / Prenatal alcohol exposure as a risk factor for dysfunctional behaviors: the role of the pediatrician: [review]

OBJETIVO: Ainda que as características clássicas da síndrome fetal alcoólica tenham sido descritas desde 1968, a pesquisa sobre a teratogênese do álcool apenas recentemente demonstrou que o cérebro é o órgão do corpo mais vulnerável aos efeitos da exposição pré-natal ao álcool. No presente artigo, fazemos uma revisão da literatura focalizando principalmente os distúrbios comportamentais relacionados à exposição pré-natal ao álcool. FONTES DOS DADOS: Foi realizada uma pesquisa com base no PubMed sobre a literatura publicada entre 1968 e 2006, com as palavras-chave etanol, gestação e comportamento. Foram estabelecidos limites a estudos em humanos. SÍNTESE DOS DADOS: Os dados apresentados nesta revisão sugerem que jovens com efeitos do espectro do álcool fetal estão sob risco maior de terem comportamento social disruptivo, entre outros problemas neurocomportamentais. CONCLUSÕES: Ainda que seja impossível separar completamente a teratogênese sobre o cérebro decorrente da exposição ao álcool de influências ambientais pós-natais como a causa definitiva desses resultados, o pediatra deve ser estimulado ao diagnóstico precoce de crianças afetadas pela síndrome fetal alcoólica e efeitos do espectro do álcool fetal. Isso permite iniciar o manejo e cuidados apropriados para evitar as conseqüências em longo prazo no comportamento e assegurar uma adaptação social e escolar melhor e mais produtiva.

OBJECTIVE: Although the classic features of fetal alcohol syndrome have been recognized since 1968, research on alcohol teratogenesis has only recently demonstrated that the brain is the organ in the body most vulnerable to the effects of prenatal alcohol exposure. In this present article, we reviewed the literature focusing mainly on behavioral disturbances related to prenatal ethanol exposure. SOURCES: We performed a PubMed search on the literature published between 1968 and 2006 using the terms ethanol, pregnancy and behavior. We limited our search to studies on humans. SUMMARY OF THE FINDINGS: The data presented in this review suggested that youths with fetal alcohol spectrum disorder are at risk of disruptive social behavior, among other neurobehavioral abnormalities. CONCLUSIONS: Although it is still impossible to completely separate brain teratogenesis secondary to alcohol exposure from environmental postnatal influences as the definite cause for these outcomes, the pediatrician should be encouraged to early diagnose children affected by fetal alcohol syndrome and fetal alcohol spectrum disorder. This provides proper management and care and avoids long-term consequences on their behavior, besides ensuring better and productive school and social adaptation.

Prospective evaluation of pregnant women vaccinated against rubella in southern Brazil.

The rubella virus is a potent human teratogen. The highest risk of this infection occurs during pregnancy, as the virus may cause fetal damage known as congenital rubella syndrome (CRS). Since the rubella vaccine is made with attenuated live virus, there is a high level of anxiety concerning exposure during pregnancy. Although no case of CRS has been proved in children of immunized susceptible pregnant women, a risk below 1.6% cannot be ruled out. Our main purpose was to evaluate the occurrence of CRS in women who were vaccinated against rubella and did not know that they were pregnant, or became pregnant within 30 days after vaccination. We collected, prospectively, data on 171 pregnant women who were susceptible at the time of vaccination and compared them with data on the total population of pregnant women in the state of Rio Grande do Sul (RS), Brazil. A serologic sample was collected in 149 infants of susceptible mothers. A total of 10 infants (6.7%) had anti-rubella antibodies. When these were compared with the results obtained in the total population of births in RS, no difference was found in mean birth weight, low birth weight and sex. None of the ten infants with IgM(+) presented congenital defects involving CRS, during the physical examinations performed at the time of birth and at 3 months of age. Our study allows the safety of rubella vaccination to be extended to pregnant women.

Avaliação prospectica de gestantes vacinadas contra rubéola no sul do Brasil / Prospective evaluation of pregnant women that received rubella vaccine in south

Objetivos: Avaliar a ocorrência de Síndrome da Rubéola Congênita em mulheres que foram vacinadas contra rubéola e que não sabiam que estavam grávidas, ou que engravidaram até 30 dias após a vacinação. Métodos: foram coletados, prospectivamente, dados de 171 gestantes que se encontravam suscetíveis no momento da vacinação. No momento do parto foi colhido sangue dos recém-nascidos para exames. Todos os bebês com IgM anti rubéola positiva foram clinicamente avaliados conforme protocolo para detecção de sequelas da síndrome da rubéola congênita. Foi realizada a coleta de secreção nasofaríngea para isolamento e identificação viral. Resultados: foi coletada amostra sorológica de 152 bebês, filhos de mãe suscetíveis. Um total de 10 bebês (6,3%) apresentou presença de anticorpos IgM anti-rubéola, ou seja, foram infectados pelo vírus vacinal durante a gestação. Nenhum deles apresentou defeitos congênitos relacionados à rubéola. Conclusões: o estudo permite ampliar a segurança da vacinação para rubéola em mulheres grávidas.

Reproductive risk factors related to socioeconomic status in pregnant women in southern Brazil.

To evaluate patterns of drug use during pregnancy and other potential reproductive risks in pregnant women, we applied a standard questionnaire to 412 pregnant women classified as low socioeconomic status (SES) or as middle/high SES, in two cities of South Brazil. 77% of the women used at least one medication during pregnancy. We observed significant differences, when comparing low SES and middle/high SES groups, for the following variables: teenage pregnancies (28.4 vs. 12.4%); self-medication (21.8 vs. 13.1%); smoking habits (21.5 vs. 5.1%); unplanned pregnancies (69.5 vs. 51.8%); unwanted pregnancies (31.3 vs. 10.9%), and abortion attempts (13.1 vs. 5.8%). The average number of drugs consumed, however, was not different between low SES and middle/high SES. We believe that better education and conditions for family planning are key points to improve this scenario.