Twenty six children of mothers who abused alcohol during pregnancies were followed throughout childhood and were examined at 11 to 14 years of age for neuropsychiatric, psychological, and social problems in the Sahlgren University Hospital, Goteborg, Sweden. Of 24 seen at follow-up, 10 had ADHD, 2 had low normal intelligence and Asperger syndrome, and one had mild mental retardation, spastic diplegia, and an autistic-like condition. Seventeen required special education, six for mental retardation, and only 7 attended regular schools without support services. Specific learning disabilities involved math, visual perception, short-term memory, and attention. Sixteen were in foster homes. The severity of the neuropsychiatric disorder was correlated with the degree of alcohol exposure in utero. [1]

COMMENT. The majority of children exposed to alcohol abuse in utero have attention deficits, poor motor control, and learning disorders. An autistic spectrum disorder, including Asperger syndrome, may occur in a minority. The severity of the neuropsychiatric disorders is correlated with the degree and duration of alcohol abuse. Children whose mothers discontinue alcohol consumption by the 12th week of gestation develop normally and are not likely to have learning difficulties in school. Biological, not psychosocial factors, are responsible for the neuropsychiatric disorders in fetal alcohol syndrome.

Fetal valproate syndrome (FVS) and autism are reported in a 5 year-old boy exposed to valproic acid (VPA) in utero [2]. The mother had taken VPA (500 mg 4xday) for 2 to 3 years before and through the 5th month of pregnancy. The infant’s speech and language were delayed, and he communicated primarily by gestures. His head circumference was 55.5 cm (>95th centile), the forehead high and bossed, the nasal bridge flat, and the upper lip thin. Neurologic abnormalities included hypotonia, hyperreflexia, and ankle clonus. This is the second report of FVS manifested by autism.