Of 698 pregnant women interviewed about alcohol consumption at the maternity hospital in Roubaix, France, 156 of the offspring were investigated at age 4 and 1/2 years, using a standardized neuropsychological assessment. A posture score was not related to alcohol consumption, whereas a lower general cognitive index (GCI) and a minor neurological sign score were directly related to consumption of 21 drinks/week (3 drinks/day). The minor neurogic signs found at the neuromotor evaluation included synkinesis or mirror movements, finger-nose incoordination, hopping dyspraxia, and impaired ability to walk on heels. The high number of neurologic abnormalities was associated with prenatal alcohol consumption, after controlling for a lower GCI. 
COMMENT. Children born to mothers who consumed 21 or more alcoholic drinks per week (11% of the sample) had more minor neurologic abnormalities than those exposed to less alcohol. Levels of alcohol consumption lower than those associated with fetal alcohol syndrome can cause impairments of neurologic function recognized on clinical examination.
Twelve-year follow-up of children exposed to alcohol in utero, at the University of Helsinki, found that the longer the exposure and the more severe the fetal alcohol syndrome, the more often the children required special education and were behaviorally impaired . Follow-up should be focussed not only on the child’s cognitive and neuromotor development but on parental and foster family support and counseling and the prevention of secondary behavioral problems.