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Key Findings: Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure

Hispanic boy in doctor's office.

People with ND-PAE have problems with thinking, behavior, and life skills. ND-PAE occurs from being exposed to alcohol during pregnancy.

The journal Pediatrics has published a report to help healthcare providers identify, diagnose, refer, and care for children and youth with behavioral problems caused by alcohol exposure during pregnancy. This condition is called neurobehavioral disorder associated with prenatal alcohol exposure or ND-PAE. ND-PAE was first included as a recognized condition in the Diagnostic and Statistical Manual 5 (DSM 5) of the American Psychiatric Association (APA) in 2013. It is one of the group of conditions that can occur from being exposed to alcohol during pregnancy. This group of conditions is known as fetal alcohol spectrum disorders (FASDs). FASDs are physical, behavioral, and intellectual disabilities that last a lifetime. People with ND-PAE can have problems with thinking, behavior, and life skills.

The scientific article can be read here.

Main Highlights from this Report

A child or youth with ND-PAE will have problems in three areas:

  1. Thinking and memory, where the child may have trouble planning or may forget material he or she has already learned.
  2. Behavior problems, such as severe tantrums, mood issues (for example, irritability), and difficulty shifting attention from one task to another.  
  3. Trouble with day-to-day living, which can include problems with bathing, dressing for the weather, and playing with other children.

In addition, to be diagnosed with ND-PAE, the mother of the child must have consumed more than minimal levels of alcohol before the child’s birth, which APA defines as more than 13 alcoholic drinks per month of pregnancy (that is, any 30-day period of pregnancy) or more than 2 alcoholic drinks in one sitting.

While these are the minimal levels required for a diagnosis of ND-PAE, experts—including the U.S. Surgeon General, American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics—agree that there is no known safe amount of alcohol during pregnancy or when trying to get pregnant.

Basics about FASDs

  • Exposure to alcohol before birth can cause birth defects and developmental disabilities known as fetal alcohol spectrum disorders (FASDs). It is also linked to certain pregnancy problems, including miscarriage, stillbirth, and preterm (early) birth.
  • There is no known safe level of alcohol use at any time during pregnancy or when trying to get pregnant. All kinds of alcohol should be avoided, including red or white wine, beer, and liquor.
  • Alcohol can cause problems for a developing baby throughout pregnancy, including before a woman knows she is pregnant.
  • Fetal alcohol spectrum disorders are completely preventable if a baby is not exposed to alcohol before birth.

CDC Activities

The CDC has conducted FASD research, identification, and prevention efforts since 1991. Key activities include the following:

  • Monitoring alcohol consumption among women of reproductive age;
  • Supporting the implementation, adoption, and promotion of alcohol screening and brief counseling, including CHOICES;
  • Promoting effective treatments for children, adolescents, and young adults living with FASDs and their families;
  • Enhancing healthcare provider education on prevention, identification, and treatment of FASDs; and
  • Offering FASD-related educational information and materials for women of reproductive age, healthcare providers, and the general public.

About this Article

This article provides a description of ND-PAE that is useful for pediatricians. The report also provides a guide to help pediatric healthcare providers discuss alcohol use during pregnancy with parents of children who might have been exposed.

Key Findings Reference:

Hagan JF (Chair), Balachova T, Bertrand J, Chasnoff I, Dang E, Fernandez-Baca D, Kable J, Kosofsky B, Senturias YN, Singh N, Sloane M, Weitzman C, Zubler J on behalf of Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure Workgroup; American Academy of Pediatrics, Elk Grove, IL. Neurobehavioral disorder associated with prenatal alcohol exposure. Pediatrics Epub September 27, 2016; DOI 10.1542/peds.2015-1553.

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More Information

To learn more about fetal alcohol spectrum disorders, please visit https://www.cdc.gov/fasd.

To learn more about alcohol and pregnancy, please visit
https://www.cdc.gov/NCBDDD/fasd/alcohol-use.html

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