Communication Difficulties in a Young Child with Foetal Retinoid Syndrome: A Review

Tiara Febriati; Aribawa Ajid Bhaskara; Altaria Erthafauziah Opaladu; Mustika Ismayanti; Tri Agustina; Risti Dwi Ocktaviani

doi:10.55927/ijis.v5i8.59

Authors

Tiara Febriati Universitas Bengkulu
Aribawa Ajid Bhaskara Universitas Bengkulu
Altaria Erthafauziah Opaladu Universitas Bengkulu
Mustika Ismayanti Universitas Bengkulu
Tri Agustina Universitas Bengkulu
Risti Dwi Ocktaviani Universitas Bengkulu

DOI:

https://doi.org/10.55927/ijis.v5i8.59

Keywords:

Feotal Retinoid Syndrome; Isotretinoin; Communication Development; Hearing Impairment

Abstract

Foetal Retinoid Syndrome (FRS) is an embryopathy caused by prenatal retinoid exposure, resulting in craniofacial abnormalities and neurological deficits. FRS carries a risk of hindering a child’s communication development. Scientific literature specifically addressing this aspect remains highly limited. This literature review aims to summarize the latest evidence regarding the impact of prenatal retinoid exposure on communication development and the importance of early detection and intervention. This literature review evaluates literature such as systematic review, meta-analyses, and Randomized Controlled Trials (RCTs) from databases including PubMed, NCBI, and Google Scholar. The teratogenic effect of isotretinoin disrupts retinoic acids signaling and FOXP2 gene expression, which are essential for nervous system formation and auditory function. These deficits trigger communication development disorders in children with FRS, which include speech delay, receptive and expressive language barriers, pragmatic disorder, and difficulties in social interaction. Serial monitoring of hearing function accompanied by early multidisclipinary intervention and management are important to improve the child’s communication outcomes.

References

Alay, M. T., Kalayci, A., & Seven, M. (2023). A new perspective on isotretinoin in pregnancy: Pregnancy outcomes, evaluation of complex phenotypes, and importance of teratological counselling. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 291, 148–155.

Choi, E.J., Kim, N., Kwak, H.S., Han, H.J., Chun, K.C., Kim, Y.A., Koh, J.W., Han, J.Y., Joo, S.H., Lee, J.S. and Koren, G. (2021). The rates of major malformations after gestational exposure to isotretinoin: A systematic review and meta-analysis. Obstetrics & Gynecology Science, 64(4), pp.364–373.

Comptour, A., Rouzaire, M., Belville, C., Bouvier, D., Gallot, D., Blanchon, L., & Sapin, V. (2016). Nuclear retinoid receptors and pregnancy: placental transfer, functions, and pharmacological aspects. Cellular and Molecular Life Sciences, 73(20), 3823–3837.

Draghici, C.C., Miulescu, R.G., Petca, R.C., Petca, A., Dumitrașcu, M.C. and Șandru, F. (2021). Teratogenic effect of isotretinoin in both fertile females and males (Review). Experimental and Therapeutic Medicine, 21(5), p.534.

Feszak, I. J., Brzeziński, P., Feszak, S., Kitowska, A., Waśkow, M., Kawczak, P., & Bączek, T. (2025). Isotretinoin treatment for acne vulgaris: A five-year retrospective analysis of clinical and biochemical adverse effects. Journal of Clinical Medicine, 14(18), 6473.

Kritzinger, A. & Steenkamp, L. (2006). Communication development of a young child with Foetal Retinoid Syndrome: A seven year follow-up study. South African Journal of Communication Disorders, 53(1), 39–48.

Lai, J. & Barbieri, J. S. (2025). Acne relapse and isotretinoin retrial in patients with acne. JAMA Dermatology, 161(4), 367–374.

Mondal, D., Shenoy, R. S., & Mishra, S. (2017). Retinoic acid embryopathy. International Journal of Applied & Basic Medical Research, 7(4), 264–265.

Panda, P., Mohammad, S., & Dikshit, P. (2021). 13-cis-retinoic acid: Its therapeutic implications and adverse effects. Journal of Skin Care Research and Reports. https://dx.doi.org/10.51521/JSCRR.2021.1101

Pop, L., et al. (2021). Retinoids and teratogenicity. Romanian Journal of Pediatrics, LXX(4), 219–220.

Van Rhijn, J. R., & Vernes, S. C. (2015). Retinoic acid signaling: A new piece in the spoken language puzzle. Frontiers in Psychology, 6, 1816.

You, W., Choi, A., Lee, H., Han, J. Y., Lee, J. H., & Shin, J. Y. (2024). Adverse pregnancy and child outcomes in oral retinoid-exposed pregnancies: A nationwide population-based study. Journal of Korean Medical Science, 39(26), e201.