Evolution of Health-Related Quality of Life Among Migrant Minors in Transit to the United States According to their Socioeconomic Context: An Exploratory Cross-Sectional Study in Mexico.

Prenatal alcohol exposure (PAE) can significantly alter fetal development by causing a range of structural and functional deficits affecting various organ systems, summarized as Fetal Alcohol Spectrum Disorders (FASD) [, ]. FASD has a prevalence of 8/1000 in the general population []. While 9.8% of women consume alcohol during pregnancy, 1/13 of women with PAE are expected to deliver a child with FASD [, ]. Alcohol-dependent changes to redox potential, nitric oxide metabolism, and hormonal imbalances have a profound effect on placental integrity [–]. PAE has been linked to structural and functional placental anomalies, including decreased placental size, impaired blood flow and nutrient transport, placental dysfunction, and consecutive endocrine changes within the fetus, increasing the risk for spontaneous abortion, stillbirth, preterm delivery, and low birthweight [, ]. While PAE may induce abnormal placental homeostasis and frequently results in premature placental ageing [–], we hypothesize that structural anomalies may also exacerbate the toxic effects of ethanol exposure. Numerous molecular and histological studies have documented placental involvement in ethanol-related disorders, however, to our knowledge, no previous data are available on PAE-associated placental findings in human fetal MRI. While ultrasound is the standard imaging-modality in prenatal diagnostics, MRI provides a three-dimensional depiction of the placenta (irrespective of maternal body composition and placental location) and advanced tissue contrast (e.g., detection of placental invasion of the uterus and other structural anomalies). Available imaging-based data on placental involvement in FASD is scarce: Most studies utilized ultrasound-based Doppler measurements and detected reduced umbilical cord, placental, and embryonic blood flow measurements following maternal alcohol consumption in rodents [–]. Data from previous studies assessing MRI findings of placental involvement in FASD is only available in primates: Dynamic contrast-enhanced MRI and blood oxygen level-dependent MRI have been applied in rhesus macaques to quantify maternal placental perfusion and placental blood oxygenation in alcohol exposed subjects [, ]. These results were correlated with a reduction in fetal biometry and weight and histological signs of placental postischemic injury and microscopic infarctions [, ].