Updated Clinical Guidelines for Diagnosing Fetal Alcohol Spectrum Disorders
Updated Clinical Guidelines for Diagnosing Fetal Alcohol Spectrum Disorders
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DOI：
10.1542/peds.2015-4256
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发表时间：
2016-08-01
期刊：
影响因子：
8
通讯作者：
May, Philip A.
中科院分区：
文献类型：
--
作者：
Hoyme, H. Eugene;Kalberg, Wendy O.;May, Philip A.
产前酒精暴露的不良影响构成残疾的连续性（胎儿酒精谱系障碍[FASD]）。1996年，美国医学研究所（Institute of Medicine）建立了诊断类别，描绘了谱系，但没有规定可据此分配诊断的临床标准。2005年，作者发表了实施医学研究所分类的实用指南，允许在临床环境中标准化FASD诊断。本报告的目的是在全面回顾文献和作者综合专业知识的基础上，提出最新的诊断指南，这些专业知识是基于在临床环境和与国家酒精滥用和酒精中毒研究所资助的研究、胎儿酒精谱系障碍合作倡议和FASD患病率合作的流行病学研究中对bb10000名儿童进行潜在FASD的评估。该指南是通过电话会议和在马里兰州罗克维尔的国家酒精滥用和酒精中毒研究所办公室举行的会议制定的。具体涉及的领域包括：产前酒精暴露记录的精确定义；胎儿酒精综合征、部分胎儿酒精综合征和酒精相关神经发育障碍诊断的神经行为标准修订酒精相关出生缺陷诊断标准；一个更新的综合研究畸形评分系统；还有一份针对白人的唇/中音指南，包含45度视角。该指南反映了FASD在畸形学、流行病学、神经病学、心理学、发育/行为儿科学和教育诊断等领域的大量经验丰富的研究人员的共识。其提高的清晰度和特异性将指导临床医生准确诊断婴儿和儿童产前暴露于酒精。
The adverse effects of prenatal alcohol exposure constitute a continuum of disabilities (fetal alcohol spectrum disorders [FASD]). In 1996, the Institute of Medicine established diagnostic categories delineating the spectrum but not specifying clinical criteria by which diagnoses could be assigned. In 2005, the authors published practical guidelines operationalizing the Institute of Medicine categories, allowing for standardization of FASD diagnoses in clinical settings. The purpose of the current report is to present updated diagnostic guidelines based on a thorough review of the literature and the authors' combined expertise based on the evaluation of >10 000 children for potential FASD in clinical settings and in epidemiologic studies in conjunction with National Institute on Alcohol Abuse and Alcoholism-funded studies, the Collaborative Initiative on Fetal Alcohol Spectrum Disorders, and the Collaboration on FASD Prevalence. The guidelines were formulated through conference calls and meetings held at National Institute on Alcohol Abuse and Alcoholism offices in Rockville, MD. Specific areas addressed include the following: precise definition of documented prenatal alcohol exposure; neurobehavioral criteria for diagnosis of fetal alcohol syndrome, partial fetal alcohol syndrome, and alcohol-related neurodevelopmental disorder; revised diagnostic criteria for alcohol-related birth defects; an updated comprehensive research dysmorphology scoring system; and a new lip/philtrum guide for the white population, incorporating a 45-degree view. The guidelines reflect consensus among a large and experienced cadre of FASD investigators in the fields of dysmorphology, epidemiology, neurology, psychology, developmental/behavioral pediatrics, and educational diagnostics. Their improved clarity and specificity will guide clinicians in accurate diagnosis of infants and children prenatally exposed to alcohol.