[Alcoholic foetopathy: an update].

INTRODUCTION: In recent years a great deal of attention has been given to the role of prenatal exposure to alcohol in the production of a wide range of disorders known as foetal alcohol spectrum disorders (FASD). Foetal alcohol syndrome represents the classic syndrome and the most serious manifestation caused by the epigenetic changes induced by such exposure. It is considered to be the number one preventable cause of congenital defects and mental deficiency.

AIM: To update the body of knowledge on this group of disorders by reviewing the most important aspects in terms of the epidemiology, diagnostic criteria and treatment, with special emphasis on the associated cognitive and behavioural alterations.

DEVELOPMENT: The worldwide prevalence of alcohol spectrum disorders could be around 1%. Today there are a number of diagnostic systems available for FASD. The most commonly used are the diagnostic criteria of the Institute of Medicine. The cognitive and behavioural alterations cover a wide range of disorders that are associated to the psychosocial environment in which the child develops. The executive functions are usually found to be affected and most patients associate attention deficit hyperactivity disorder. Few studies have been conducted on the effectiveness of treatments such as methylphenidate or atomoxetine in this population.

CONCLUSIONS: It is necessary to know the clinical, physical and cognitive manifestations of intrauterine exposure to alcohol. Likewise, randomised placebo-controlled randomised studies are needed to estimate the effectiveness of psychostimulants and atomoxetine in the treatment of these children.