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Biomarker may lead to early fetal alcohol spectrum diagnosis

Queensland Health is reminding pregnant women there is no safe level of alcohol, as researchers look to biomarkers in the blood which may indicate risk for Fetal Alcohol Spectrum Disorder (FASD).

FASD is a lifelong neurodevelopmental condition that results from prenatal alcohol exposure.

It is the leading cause of non-genetic disability in Australia, and children with FASD can often experience significant challenges across range of areas of their life, including learning, memory, behaviour and their everyday life skills.

Brett McWhinney from Pathology Queensland (PQ) said his team were working with Dr Natasha Reid and Professor Karen Moritz from the University of Queensland, Child Health Research Centre to explore biomarkers in the blood, which are created by the body when exposed to alcohol.

"This research is still in its early days, but if we can identify early that a baby may have been exposed to alcohol prenatally and doctors can be on alert for the potential for FASD and intervene sooner," he said.

Mr McWhinney said that early diagnosis, intervention and treatment could lead to improved patient outcomes.

"Currently, FASD isn’t diagnosed in children until they’re between seven and 10 years old. This means that for much of their early lives there have been questions over their health and behaviour but few answers," he said.

"It’s not uncommon for these children to struggle in school and have trouble learning, which is often the result of being disruptive in class and other antisocial behaviours. This can marginalise a child and create life-long challenges.

According to the 2018 Chief Health Officers report, 82 per cent of Queensland women who drank alcohol prior to pregnancy continued to do so during pregnancy at lower levels.

Gold Coast Health Paediatrician Dr Doug Shelton, who runs an FASD clinic for children, said there was no safe lower limit of alcohol during pregnancy.

"Some people might drink very little and have a baby effected, it’s impossible to predict," Dr Shelton said.

"It depends on a whole host of variables including the type of drinking [binge], the mother’s size and genetics, how she metabolises alcohol, the baby’s genetics and how the baby metabolises alcohol."

Dr Shelton’s team provide a comprehensive multidisciplinary in-depth assessment including a paediatrician, neurologist, psychologist, occupational therapist, and social worker.

"We see children who have a definite history of pre-natal alcohol exposure and their parents or guardians are concerned about their children not developing or reaching milestones," he said.

"We are really trying to work out how their brain works. We then can understand their strengths and weaknesses.

"We develop an individualised assessment and management plan and can work with schools, parents, friends and sport coaches, to properly tailor their expectations to match the child’s capability.

"A mismatch of expectations about a child’s behaviour and abilities sets up an ongoing litany of failures. And the message the child gets when they fail these unrealistic expectations is that they are bad or dumb.

"Flip that expectation and if a teacher for example, knows that 10-year-old child has the ability of a seven-year-old, then those expectations can be managed."

Sam Pinnell founded the QLD FASD Parent Support Group after her son was diagnosed.

"He was the eighth child diagnosed with FASD at the clinic," Ms Pinnell said.

"I was devastated and needed other people to talk but the clinic was so new, at the time they didn’t have those support systems in place."

The closed Facebook group now has almost 780 members.

"It’s a lonely journey and you need people who have had similar experiences."

Dr Shelton and Ms Pinnell agreed there was a lot of misinformation about FASD and the dangers of drinking alcohol during pregnancy.

"Most people know that alcohol and pregnancy don’t mix. However, in Queensland 50 per cent of pregnancies are unplanned and those women continue to consume alcohol. By the time they find out they are six to 12 weeks pregnant, it’s too late the and the damage has been done," Dr Shelton said.

"I spoke at an event for pregnant women and midwives about FASD and a woman there was seven or eight months pregnant. She was very stressed and not coping - her obstetrician suggested she have a few wines and assured her that she was no longer in the first trimester and it was completely safe. It’s so concerning that this misinformation is out there," Ms Pinnell said.

FASD International Awareness Day is held on 9 September.

Last updated: 9 September 2019