Linda, a 27-year-old G3P2, is admitted to the labor and birth suite because of preterm rupture of membranes at an estimated 35 weeks’ gestation. She has received no prenatal care and reports this was an unplanned pregnancy. Linda appears distracted and very thin. She reports that her two previous children have been in foster care since birth because the child welfare authorities “didn’t think I was an adequate mother.” She denies any recent use of alcohol or drugs, but you smell alcohol on her breath. She has a spontaneous vaginal birth a few hours later, producing a 4-lb baby boy with Apgar scores of 8 at 1 minute and 9 at 5 minutes.
a. What aspects of this woman’s history may lead the nurse to suspect that this infant may be at risk for fetal alcohol spectrum disorder?
b. What additional screening or laboratory tests might validate your suspicion?
c. What physical and neurodevelopmental deficits might present later in life if the infant has fetal alcohol spectrum disorder?
