From Teratogens to Trajectories: Integrating Teratology and Developmental Origins of Health and Disease (DOHaD) Frameworks for a New Take on FASD

Research on the effects of prenatal alcohol exposure (PAE) developed within two research frameworks that progressed largely in parallel. Classical teratology was the dominant framework for many years, focusing on prenatal exposure to toxic agents that disrupted developmental processes, resulting in birth defects and neurobehavioral deficits. By contrast, recent studies have positioned PAE within the Developmental Origins of Health and Disease (DOHaD) framework, which suggests that low birth weight and other early life exposures reprogram developmental trajectories, increasing susceptibility to chronic, noncommunicable diseases later in life. Advances in both teratology and DOHaD research, however, have resulted in frameworks that are increasingly complementary and convergent. The two fields now study a similar and broad range of environmental, social and psychological exposures, consider similar critical/sensitive periods as well as a broad spectrum of outcomes, and have identified molecular mechanisms, including epigenetic modifications, as critical in mediating adverse outcomes of PAE. With this convergence, the two fields can be viewed as forming an integrated continuum, with particular relevance for understanding the spectrum of prenatal alcohol effects. An integrated teratology–DOHaD continuum offers a holistic approach to further our understanding of how alcohol and environmental factors interact to shape lifelong behavioral, functional and health outcomes, while guiding novel diagnostic, prevention and intervention strategies. This overarching framework engenders great optimism for future progress in the FASD field that will continue to improve quality of life and reduce adverse health outcomes for individuals with FASD. • Research on prenatal alcohol exposure (PAE) evolved within the teratology framework • Recent studies have positioned PAE research within the DOHaD framework • With advances, the two fields have converged and can be viewed as an integrated continuum • A teratology-DOHaD continuum offers a holistic approach to advancing PAE research