INCIDENCE OF RENAL ANOMALIES IN CHILDREN PRENATALLY EXPOSED TO ETHANOL

Objective. Based on a number of studies involving animals as well as h uman case reports indicating an association between prenatal ethanol e xposure and renal malformations, it has been suggested that children w ith fetal alcohol syndrome (FAS) should be screened for renal anomalie s. The purpose of this study was to evaluate a group of children prena tally exposed to alcohol to determine the incidence of renal anomalies and to evaluate the need for such a screening procedure. Methods. Ren al ultrasounds were performed on a total of 84 patients (68 children, 13 adolescents, and three adults). In addition to screening for malfor mations, renal size was studied. Data were analyzed using both chronol ogic and height-age as determinants of kidney size. Patients. Of these 84 patients, 51 (61%) had FAS, and 33 (39%) had a history of prenatal ethanol exposure but did not have FAS. Results. Three (3.6%) patients (one with FAS, two with prenatal ethanol exposure who did not have FA S) had significant renal abnormalities. This incidence was not signifi cantly different from that found in ultrasound screening of newborns. The kidneys of children with both FAS and prenatal ethanol exposure wh o did not have FAS were significantly smaller than normal for both chr onologic and height-age. When children were compared across chronologi c ages, those with FAS had significantly smaller kidneys than those wh o had no evidence of FAS. After adjusting for height, the difference b etween these two groups was no longer significant. Conclusions. Based on these data, children prenatally exposed to ethanol do not need to b e screened for renal anomalies.