Epidemiology of fetal alcohol syndrome among American Indians of the southwest

Abstract

The epidemiological features of Fetal Alcohol Syndrome (FAS) were examined among American Indians in the southwestern United States. All FAS suspects were screened in specific populations of Navajo, Pueblo, and Plains culture tribes. A total of 115 alcohol‐affected children were identified. The incidence of FAS was found to be highly variable from one cultural group to the next, ranging from 1.3 per 1,000 births (1/749) for the Navajo to 10.3 (1/97) for the Plains. The pattern of age‐specific prevalence indicates an increase over the past fifteen years. The overall rate of mothers who have produced fetal alcohol children was 6.1 per 1,000 women of childbearing age with a range of 4 to 33 per 1,000. These maternal prevalence rates were important for the accurate prediction of public health risk because 25 per cent of all mothers who had produced one affected child had also produced others. The average per mother was 1.3 alcohol‐affected children. Other findings indicate that the mothers of these children led highly disruptive and chaotic lives and were frequently isolated from mainstream social activities. In general, the gross social and cultural patterns of the tribes studied can readily explain the variation in incidence of FAS.     

Craniofacial and oral manifestations of fetal alcohol syndrome

Six representative patients with fetal alcohol syndrome (FAS) were studied for craniofacial and oral anomalies, dental development, and long-term bodily growth patterns. The craniofacial features observed were reduction of total head size, increased head-body ratio, the existence of upper and middle craniofacial asymmetry and telecanthus in some instances, and the features of a long face syndrome with a large gonial angle. Dental development was mildly to moderately delayed, and enamel anomalies were present. Analysis of growth patterns demonstrated compensatory growth in stature, weight, or head circumference and a delayed bone age in some instances. It is suggested that the semiquantitative score system for fetal alcohol syndrome study may fail to diagnose individual cases and that craniofacial features are more important in diagnosis than seems to have been appreciated in the past.     

The Klippel-Feil anomalad as part of the fetal alcohol syndrome

A brother and sister and described with malformations and handicaps consistent with both the Klippel-Feil Anomalad and the Fetal Alcohol Syndrome. The mother was known to be a chronic alcholic throughout both pregnancies. It is suggested that these anomalies are not purely fortuitous but rather that maternal alcoholism may cause errors in cervical vertebrae segmentation.     

Premature development of cardiac sympathetic neurotransmission in the fetal alcohol syndrome

The development of the ability of hypoglycemia to evoke centrally-mediated reflex activation of sympathetic efferent pathways was studied in rats whose mothers received ethanol. Hypoglycemia was elicited by insulin administration, and sympathetic stimulation was assessed by measuring heart ODC activity and depletion of adrenal catecholamines. In control rats, cardiac sympathetic neurotransmission was absent at 4 days of age and matured toward the end of the first week of postnatal age. In contrast, pups from ethanol-treated mothers displayed fully functional reflex responses as early as 4 days. This acceleration appeared to be independent of nutritional or body weight-related factors. In contrast, enhanced maturation of peripheral sympathetic neurotransmission in pups born to ethanol-fed mothers was not seen in the sympatho-adrenal pathway.     

Psychiatric investigations among American Indians and Alaska natives: A critical review

This review of psychiatric investigations among Native Americans opens with a discussion of the dominant theoretical perspectives in psychiatric anthropology in order to provide an analytic framework with which to assess the substantive findings of researchers in the field. Studies of culture-specific disorders, service utilization and patient population studies, psychiatric epidemiological studies, and studies designed to test the validity of certain diagnostic instruments are scrutinized for evidence of the nature of the role of indigenous cultures in the manifestations of psychiatric disorders among these populations. The review reveals that a universalist theoretical perspective, which tends to obscure the role of local interpretations in the phenomenology of psychiatric illness, dominates this field of inquiry. Nonetheless, evidence has accumulated which indicates the importance of native understandings for a more reliable and valid explanation of the nature of mental disorder among these peoples. The inadequacies of our current knowledge are examined and suggestions for directions in future work are presented in the concluding section. Recommendations include the direct investigation of the local meanings of the signs, symptoms, and syndromes of Western psychiatry; the concentrated search for potentially unique and powerful local signs of distress; and the study of the culturally-constituted social processes of illness.     

Lipid peroxidation changes in the brain in fetal alcohol syndrome]

The study was performed upon three groups of 12-week-old male rats. The first group of rats received ethanol/9 g/kg/day as 6% aqueous solution/during pregnancy and lactation, the second group received ethanol only during lactation and the third group, controls, received equicaloric sucrose solution. The concentrations of LPO products were determined in the homogenates of tissue from frontal cortex, striatum, hypothalamus, hippocamp and cerebellum. The concentration of fluorescent products in the brain structures of rats treated perinatally with ethanol was several-fold increased as compared with controls. The levels of diene conjugates were increased in most brain structures of rats with FAS. It should be pointed out that there was the same degree of increase of the levels of both fluorescent products and diene conjugates in two groups of rats with FAS. Having in mind that in the rat the increased growth of the brain occurs during the first 10 postnatal days, it might be assumed that this period is favorable for LPO.     

The fetal alcohol syndrome in mice: an animal model

CBA and C3H female mice were maintained on liquid diets--Metrecal plus ethanol--containing 15-35% ethanol-derived calories. These diets, which resulted in alcohol blood levels of 73-398 mg/100 ml blood in nonpregnant females, were the sole sustenance for the females for at least 30 days before and throughout gestation. Females were killed on day 18 of gestation and offspring examined for skeletal and soft tissue anomalies. Prenatal death and maldevelopment increased with the level of alcohol intake. Deficient occiput ossification, neural anomalies, and low fetal weight occurred with low ethanol diets, and cardiac and eye-lid dysmorphology with higher ethanol diets. This pattern of malformations, which exhibited both a dose-response effect and strain differences in susceptibility, indicated that chronic maternal alcoholism is embryolethal and teratogenic in mice.     

Enzyme histochemical studies on rat amygdala in fetal alcohol syndrome

Histochemical studies were made of the activity of oxidative and hydrolytic enzymes in rat amygdala in FAS (Foetal Alcohol Syndrome). Ethanol in a dose of 9 g/kg/day was administered to rats during pregnancy and lactation in 6% aqueous solution as the only available liquid. The control rats received an equivalent diet in which ethanol was substituted by an equicaloric amount of sucrose. The offsprings were examined at the end of the 6th postnatal week. The activity of the lysosome and membrane enzymes, as well of some enzymes participating in the neurotransmission, was changed. A different decrease of the activity of oxidoreductases of Krebs cycle, glycolysis and pentose cycle was observed. The changes in the enzyme activity in the amygdala in FAS suggest alterations in the metabolism of the nervous tissue, rather than structural damages of cell organelles.