In a prospective follow-up study at the University of Helsinki, Finland, 60 children exposed to alcohol in utero were assessed by a psychologist (Bayley Mental scale) and a speech therapist (Reynell Verbal Comprehension scale) at a mean age of 27 months. Forty-eight non-exposed children were also examined to set the -2 SD limit for subnormal performance. In children exposed to heavy drinking during the first trimester only, no definite effect on mental or language development was demonstrated. Children exposed throughout pregnancy scored significantly lower than those subjected to alcohol during the first trimester only. The diagnosis of fetal alcohol syndrome was made in 7 children, 1 exposed during the first and second trimesters, and 6 exposed throughout pregnancy. The lower limit for heavy drinking was more than 10 drinks a week, or more than 45 drinks per month. The drinking patterns of these mothers varied from 1 to 20 drinks per day. 
COMMENT. Fetal alcohol exposure causes a continuum of developmental defects ranging from mental retardation to slight developmental difficulties. The identification of mothers who are heavy drinkers in early pregnancy and effective counseling should help to preserve the developmental potential of the fetus.