Recognition of facial features of fetal alcohol syndrome in the newborn

The diagnosis of an infant, especially a newborn, with fetal alcohol spectrum disorder is difficult due to the fact that not all of the features are apparent at that time. Many cases are also missed due to inadequate knowledge of the mother's drinking pattern and because of the examining physician's lack of experience with the disorder. While conducting a study of the use of maternal blood markers to determine alcohol use in pregnancy, we have evaluated systematically the effects of alcohol on the newborn infant. We have developed a facial scoring system consisting of six of the features commonly seen in children with fetal alcohol syndrome (FAS) and present preliminary data about its use. By using a cutoff of four or more of these six features, there is a significant correlation with the presence of these features and the mother's self-reported alcohol use. In addition, there has been no significant difference in the frequency of positive scores between newborns of Caucasian or Black ancestry. We propose that this system may be useful in the assessment of newborn infants at high risk because of alcohol exposure during pregnancy. (C) 2004 Wiley-Liss, Inc.