Day 1: 99 Days to FASDay: First Published Study Linking Prenatal Alcohol Use and Birth Defects

Welcome to Day 1 of a 99 day journey of all things FASD (Fetal Alcohol Spectrum Disorder), leading up to International FASD Awareness Day or FASDay on September 9. For the third year, I am pleased to re-present the 99 Days to FASDay Series, as part of my participation in the Red Shoes Rock to Stop FASD Campaign. This year the 99 Days has a fresh new look, some days have updated information and other days have new information as more relevant facts, quotes, tips or trivia have been published since the first series in 2017.

I hope you enjoy taking this journey again and finding something new and interesting!

All efforts have been made to use information from a variety of reliable sources, however if you find an error or inaccuracy, please don’t hesitate to contact me.

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Today’s Fact obtained from a Fact Sheet on the CanFASD website.

Although this wasn’t the first study – Dr. Paul Lemoine (1917 – 2006) discovered a thesis in his research, completed by Jacqueline Rouquette entitled Influences of the parental alcoholic intoxication on the physical and psychological development of young children (Paris 1957) which had seemingly been ignored, much to his surprise.

In 2018, Dr. Lemoine was featured as one of the Red Shoes Rock FASD Pioneers. This is what they had to say about his work:

Twenty-five children had distinct features related to prenatal alcohol exposure. Dr. Lemoine called this alcoholic embryopathy. Sadly, his findings were overlooked, that is until Jones and Smith contacted him, before publishing their Lancet paper. 

This is what Dr. Lemoine had to say about his work:

Fortunately in 1973, Smith in Seattle, after reading the abstract of my work in the French Pediatric Archives, published 8 cases with the same conclusions. He wrote to me asking for my complete text. This is an amusing fact: the 127 cases of a modest pediatrician from Brittany did not create any interest, whereas 8 American cases became immediately convincing and the syndrome became rapidly known in France and in the world. Thanks go to Smith for being able to impose the existence of this reality and its dramatic consequences.

In 1997, Dr. Lemoine wrote about his follow up with the children he had studied. Here is an excerpt, translated by and published on the S.A.F. Ocean Indien website:

For a long time, I had wanted to know the outcome of the children I had diagnosed. As soon as I retired, I undertook this task.

The first ones found were all severely debilitated, which was easily explained by the category of the targeted establishments. This follow-up could not be of value unless I could find all of the individuals of a given group, thus avoiding selection bias. Hence, among my cases of fetopathy, I compiled the list of all those who had reached 18 years of age and were born in Loire Atlantique, so I could have some chance of finding them. I then embarked upon the task of finding them all, searching in the Loire Atlantique and some peripheral areas.

I searched in all the establishments, agencies and organizations in charge of housing, employing or placing the handicapped. In all, I contacted close to one hundred establishments. It did not mean a few months of work as I had planned at first, but rather ended up taking years, hundreds of letters, phone calls and thousands of kilometers of travel. I succeeded. I located all of the 50 Papotiere cases, that were the most severe, as I was always well received by the directors and the doctors in these establishments. I was missing two individuals, and so I visited the local registry in their places of birth. One was from Saint Nazaire where I found out that he had died at a young age. The other was from Nantes where I learned that though he was alive, he was a gypsy and difficult to locate.   I also succeeded in two-thirds of the other cases, though I was slowed down by two major organizations that should have been especially interested in my work. Retreating behind professional confidentiality, they refused to show me their files. It seemed ironic that they did not have the right to reveal a diagnosis that I had myself established 20 years earlier!

Among the 105 fetopathies seen again at an adult age I observed that:

  1. the facial dysmorphy had changed, often with a large nose and large chin (contrary to the newborn);
  2. the statural and ponderal hypotrophy were attenuated;
  3. the microcephaly persisted significantly(between 2-6 standard deviations);
  4. the intellectual deficits persisted, as did the maladaptive behaviour.

An important finding has struck and worried me most — 14 offspring of alcoholic mothers, considered normal at birth with no visible facial dysmorphy, have been found as adults to have the same psychological problems and maladaptive behaviour. They also exhibit a slight trend toward microcephaly (-1 or -2 standard deviation). None had reached the average adult head circumference.

In 1985 Dr. Lemoine was invited to the International Congress on Alcohol and Toxicology held in Calgary (Alberta, Canada) to receive the Jellinek Award  (along with Dr. Ann P. Streissguth).

The Jellinek Memorial Fund was established in 1965 to commemorate Dr. E.M. Jellinek’s great contribution to the field of alcohol studies.  The Fund is used to provide an annual award to a scientist who has made an outstanding contribution to the advancement of knowledge in the alcohol/alcoholism field.

Stay tuned for Day 2 in our 99 Day journey to International Fetal Alcohol Spectrum Disorder Awareness Day!

5 thoughts on “Day 1: 99 Days to FASDay: First Published Study Linking Prenatal Alcohol Use and Birth Defects

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