Beyond the Brain: The Physical Health and Whole-Body Impact of Fetal Alcohol Spectrum Disorders.

Purpose: Individuals with fetal alcohol spectrum disorders (FASD) or neurodevelopmental disorder associated with prenatal alcohol exposure (PAE) can experience a wide range of whole-body health conditions. A survey by the International Adult Leadership Collaboration (ALC) FASD Changemakers found that many adults with FASD have comorbidities relating to metabolic disorders; body composition; cardio-renal, reproductive, and/or immune health; as well as difficulties with hearing/vision and sleep. This review summarizes current knowledge of these health domains and provides an overview of the latest literature on the whole-body effects of PAE/FASD across the life span.

Search methods: The literature search was conducted on July 8, 2024, using CINAHL, PubMed, and Web of Science databases. To investigate the whole-body health of individuals with PAE, search terms were based on the findings of the ALC FASD Changemakers Health Survey and covered areas relating to sleep; hearing/vision; body composition; and metabolic, cardiovascular, renal, immune, and reproductive health. The search was conducted in two phases. To summarize current knowledge on these topics, the latest systematic reviews and other reviews were identified for each health domain (phase one). In addition, recent primary research articles published since these review searches were completed were identified for each domain (phase two). Inclusion/exclusion was based on article relevance to the physical health challenges reported in the ALC FASD Changemakers Health Survey.

Search results: In phase one, 744 reviews were identified in the initial search, of which 722 articles were excluded and 22 recent and relevant reviews were included. In phase two, 1,102 articles were identified, with 665 screened at the title/abstract level and 169 articles undergoing full-text review. A total of 1,066 articles were excluded. Following the addition of five articles from other sources, 41 recently published primary articles were included in the current review.

Discussion and conclusions: A growing body of evidence suggests that individuals with PAE/FASD may experience comorbidities relating to metabolism; body composition; cardio-renal, immune, and/or reproductive health; as well as hearing, vision, and sleep difficulties. These findings support the concept of FASD as a whole-body diagnosis, emphasizing the importance of a holistic approach that supports the overall health and well-being of those with PAE. There are opportunities for future clinical research to focus on further understanding these physical health challenges, how they evolve, and how effective intervention approaches could improve outcomes for individuals with PAE/FASD.