Infant Cardiac Orienting Responses Predict Later FASD in the Preschool Period. (6th January 2021)

• Record Type: Journal Article
• Authors: Kable, Julie A.; Coles, Claire D.; Jones, Kenneth L.; Yevtushok, Lyubov; Kulikovsky, Yaroslav; Zymak‐Zakutnya, Natalya; Dubchak, Iryna; Akhmedzhanova, Diana; Wertelecki, Wladimir; Chambers, Christina D
• Is Part Of: Alcoholism. Volume 45:Number 2(2021)
• Page Start: 386
• Page End: 394
• Publication Date: 2021-01-06
• Subjects: Fetal Alcohol Spectrum Disorders -- Information processing -- Early identification; Alcoholism -- Periodicals; Alcoholism -- Periodicals; Alcoolisme; Electronic journals; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.861005
• DOI: 10.1111/acer.14525
• Languages: English
• ISSNs: 0145-6008

Abstract

Abstract : Background: Prenatal alcohol exposure (PAE) has been identified as one of the leading preventable causes of developmental disabilities, but early identification of those impacted has been challenging. This study evaluated the use of infant cardiac orienting responses (CORs), which assess neurophysiological encoding of environmental events and are sensitive to the impact of PAE, to predict later fetal alcohol spectrum disorder (FASD) status. Methods: Mother–infant dyads from Ukraine were recruited during pregnancy based on the mother's use of alcohol. Participants ( n = 120) were then seen at 6 and 12 months when CORs were collected and in the preschool period when they were categorized as having (i) fetal alcohol syndrome (FAS), (ii) partial FAS (pFAS), (iii) alcohol‐related neurodevelopmental disorder (ARND), (iv) PAE and no diagnosis, or (v) no PAE and no diagnosis. To assess CORs, stimuli (auditory tones and pictures) were presented using a fixed‐trial habituation/dishabituation paradigm. Heart rate (HR) responses were aggregated across the first 3 habituation and dishabituation trials and converted to z‐scores relative to the sample's mean response at each second by stimuli. Z ‐scores greater than 1 were then counted by condition (habituation or dishabituation) to compute a total risk index. Results: Significant group differences were found on total deviation scores of the CORs elicited from visual but not auditory stimuli. Those categorized as pFAS/FAS had significantly higher total deviation scores than did those categorized as ARND or as having no alcohol‐related diagnosis with or without a history of PAE. Receiver operating characteristic curve analysis of the visual response yielded an area under the curve value of 0.765 for predicting to pFAS/FAS status. Conclusions: A score reflecting total deviation from typical HR during CORs elicited using visual stimuli in infancy may be useful in identifying individuals who need early intervention as a result of their PAE. Abstract : Cardiac orienting responses are decelerations in heart rate in response to novel or interesting events. The reduction in heart rate triggers a physiological response that directs oxygen to the brain. These responses are reliably identified in infants as early as 4‐6 months of age and individual differences in this response have predicted later developmental status. Using a prospective cohort collected in Ukraine, an index of deviations in this response collected during an infant habituation/dishabituation visual paradigm predicted preschool pFAS/FAS status.