Can prenatal screening for fetal alcohol spectrum disorder be justified? A commentary.

Fetal alcohol spectrum disorder (FASD) is the leading cause of non-genetic mental retardation in the USA, possibly exceeding even Down syndrome, which is currently approaching 1 in 500 live births. Alcohol consumption during pregnancy results in brain, craniofacial and heart defects, neurotoxicity, and immune dysfunction. The preferred action taken to prevent alcohol consumption during pregnancy is abstinence. However, the detection, diagnosis, and treatment of FASD remain a major public health need in this country and throughout the world. The biochemical molecules involved in the developmental abnormalities encompass a vast array of signal transduction and synaptic pathways which involve neurotransmitters and neurotrophic peptides. Recent advances in medicine-based therapies for FASD have been reported, and include the use of small molecule agonists, antagonists, and competitive inhibitors. Since biomarkers for FASD have previously been identified in clinical research reports, multicenter screening feasibility studies now seem warranted and could be initiated following adequate funding, protocols, procedures, and institutional review board approvals.