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JFAS Int 2006;4:e13 - August 21, 2006
Attenuating the Effects of Prenatal Alcohol Exposure with Postnatal Interventions: Critical Review of Animal Studies and Applications to Clinical Research

Reuven Sussman, Gideon Koren
University of Toronto, Hospital for Sick Children, Motherisk Program, Toronto, Canada

Background
Alcohol exposure during pregnancy is associated with central nervous system dysfunction and behavioural problems. Animal studies provide researchers with a good analogy of fetal alcohol exposure in which more control can be asserted over the conditions of exposure and treatment, and where neurological outcomes can be examined in greater detail than in humans. The objective of this review is to identify possible evidence-based interventions that may be eventually applied to children exposed to alcohol in utero.

Methods
A search was conducted using Medline for all animal studies which examined interventions for the treatment of prenatal alcohol exposure. Interventions included environmental enrichment (EE), postnatal handling (PH), exercise, and therapeutic motor training (TMT). All publications matching the search criteria were included regardless of duration, timing or amount of exposure or of animal type. Literature is summarized and discussed critically.

Results
Several non-pharmacological interventions have been tested on rodents exposed to alcohol in utero with varying degrees of success. Postnatal EE may attenuate hind limb gait problems and ameliorate water maze learning, but neuroanatomical explanations for these findings are lacking. PH has been shown, in one study, to improve learning, but shows inconsistent results regarding HPA axis regulation. Exercise, in one study, was found to be a useful intervention for maze learning and long-term potentiation. Postnatal TMT is also an effective intervention tool as it permits exposed rats to perform at the same as non-exposed rats on tasks normally affected by prenatal alcohol.

Conclusions
All of the reviewed interventions hold some promise. It appears that a controlled simulation study in humans is a logical next step in examining these new and exciting findings.

Keywords: fetal alcohol syndrome, animal studies, postnatal interventions, neuroplasticity, in-utero exposure

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