Spectrum of MRI findings of foetal alcohol syndrome disorders—what we know and what we need to know!

The exposure to alcohol in utero has been known to damage the developing foetus. Foetal alcohol spectrum disorders is an umbrella term that highlights a range of adverse effects linked to alcohol exposure in utero. Multiple studies have shown specific brain abnormalities, including a reduction in brain size, specifically in the deep nuclei and cerebellum, and parietal and temporal lobe white matter changes. While studies ascertained that other prenatal risk factors, such as maternal use of illicit drugs or lack of pre-natal care, and post-natal risk factors, such as physical or sexual abuse and low socioeconomic status, may be involved in the pathology of variances in foetal neurological abnormalities, prenatal alcohol exposure remained the strongest factor for effects on brain structure and function. Particularly, the number of days of alcohol consumption per week and drinking during all three trimesters of the pregnancy indicating the strongest relationship with brain abnormalities. Further studies are needed to explain pre-natal risk factors in isolation as well as in combination for neurodevelopmental outcomes. The diverse phenotypic presentations described indicate that the diagnostic criteria of foetal alcohol spectrum disorder must be refined to better represent the range of neurologic anomalies.