# Correlating Dose and Time of Prenatal Alcohol, Smoking, and Drug Exposure on Craniofacial Morphology: A Systematic Review

## TL;DR

This review examines how the amount and timing of prenatal exposure to alcohol, smoking, and drugs affect facial and brain development in children.

## Contribution

The study systematically reviews evidence on dose and timing of prenatal substance exposure and craniofacial outcomes.

## Key findings

- Prenatal exposure to teratogens is linked to craniofacial and CNS abnormalities.
- Higher exposure levels and specific timing increase the risk of developmental anomalies.
- Findings are based on a prospectively monitored, unselected sample of pregnancies.

## Abstract

The aim of this systematic review is to identify the dose and timing associated with the risk of in-utero substance exposure to craniofacial dysmorphia. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, considering articles written in English up to March 2024. Cochrane, Medline, and Google Scholar databases were considered. After reading all eligible studies in full text, the two reviewers discussed their results and re-read those studies for which results differed in order to find a consensus. A total of 300 studies were extracted from the databases. Eleven articles were selected in the first screening, and one more article was included after the cursory screening. This study provides data on the prevalence of growth abnormalities, as well as facial and central nervous system (CNS) anomalies in children heavily exposed to teratogens in utero, based on an unselected sample from prospectively monitored pregnancies.