Cara Allen
Beloit College, Beloit, WI

Abstract

Alcohol consumption during pregnancy causes a range of physical and mental disabilities. What are the consequences of exposing fetuses to alcohol and how much alcohol is safe to consume during pregnancy? This research was obtained through a review of literature and internet sources. Alcohol is a teratogen which has a degenerative effect on the developing brain. According to the literature, no amount of alcohol has been found to be safe to consume during pregnancy. As no safe level of alcohol consumption has been determined, women are advised not to drink alcohol while they are pregnant. One drink may permanently damage the entire lifetime of the resulting offspring.

Introduction

Alcohol is a known teratogen, meaning that it can cause malformation of an embryo or fetus. When a pregnant woman drinks alcohol it enters her bloodstream and eventually reaches her developing child by crossing the placental barrier. In the Western world fetal alcohol exposure is believed to be the most common and preventable cause of mental retardation . Fetal Alcohol Spectrum Disorders (FASD) are disabilities that result from exposure to alcohol during the prenatal period. There is no cure for FASD. FASD is not a clinical diagnosis. Rather, it is an umbrella term that encompasses the following conditions: Fetal Alcohol Syndrome (FAS), Partial FAS (PFAS), Fetal alcohol effects (FAE), Alcohol-related birth defects (ARBD), and Alcohol-related neurodevelopmental disorder (ARND) (1).

The following features and behaviors are associated with FASD :
•Facial abnormalities such as small eye openings
•Small size for gestational age or small stature in relation to peers •Mental retardation or low IQ
•Problems with daily living
•Poor reasoning and judgment skills
•Sleep and sucking disturbances in infancy
•Poor coordination
•Hyperactive behavior
•Learning disabilities
•Developmental disabilities (e.g., speech and language delays)

Permanent damage to the central nervous system is the main effect of FASD (3). The severity of damage to the fetal brain depends on the amount, timing, and frequency of exposure to alcohol. Genetic predispositions can also play a role in the damaging effects of alcohol on the brain.

Fetal Alcohol Syndrome (FAS) is the most severe, as well as most recognizable form of FASD. FAS is characterized by three features (3):
1) growth deficiency deemed as height and/or weight at or below the 10th %ile; 2) damage to the central nervous system as neurological, structural, or functional impairment; and, 3) distinctive facial features. The three most diagnostically relevant facial features seen with FAS are a smooth philtrum (the area between the nose and upper lip), a thin upper lip, and shortened eye width. These features are strongly correlated with damage to the brain.

In the United States, according to the Centers for Disease Control (1), prevalence rates for FAS range from 0.2-1.5 per 1,000 live births. The rates for the other FASD conditions are estimated to occur 3 times as often as FAS.

Method

This information was obtained through a review of government, peer-reviewed, and other internet sources.

Results

How much alcohol is safe to drink during pregnancy? In 2005 U.S. Surgeon General Richard H. Carmona warned that women who are pregnant or planning on becoming pregnant should not drink alcohol, in order to prevent FASD (4). Carmona stated that there is no known safe amount of alcohol for pregnant women to drink. Due to the fact that the damaging effects of alcohol can occur in the early stages of pregnancy, women who may become pregnant should not drink alcohol.

What does alcohol do to the brain? A particularly damaging effect of alcohol is that it causes apoptotic neurodegeneration, or brain cell death. A certain amount of physiological cell death (PCD) is normal in the developing brain. However, Ikonomidou et al. (3), during animal studies, discovered that ethanol exposure during a specific brain developmental stage, known as synaptogenesis, causes widespread deletion of neurons from several major regions of the brain. Synaptogenesis is the process when new synapses are made to connect neurons properly. Involved in the damage are ethanol’s blocking action at NMDA glutamate receptors and its excessive activation of GABA-A receptors. Thus alcohol interferes with proper signaling between neurons. The researchers concluded that this can explain the reduction of brain mass and neurobehavioral disturbances attributed to fetal alcohol syndrome.

Discussion

Currently, no amount of alcohol has been found to be safe for pregnant women to consume. Drinking alcohol during pregnancy puts developing humans at risk for a lifetime of suffering from Fetal Alcohol Spectrum Disorders, which are potentially debilitating conditions with no known cures.

Research has found a possible explanation for the brain damage that occurs when developing brains are exposed to alcohol. As explained in the results, alcohol acts by a dual mechanism and initiates widespread cell death in the brain.

Based on the research, women who are pregnant or may become pregnant should abstain from drinking alcohol, in order to prevent Fetal Alcohol Spectrum Disorders.

The Consequences of Prenatal Exposure to Alcohol

Fig 1: Areas of brain that can be damaged in utero by maternal alcohol cons

Source: Alcohol Health & Research World, Vol. 18, No. 1, 1994

Fig 2: Reported Rates of Fetal Alcohol Syndrome, U.S. 1979-1993

Source: http://pubs.niaaa.nih.gov/publications/Social/Module1Epidemiology/Module1.h

References

1. Centers for Disease Control and Prevention. Fetal Alcohol Spectrum Disorders. Retrieved February 17, 2007, from http://www.cdc.gov/ncbddd/fas/fasask.htm

2. Fetal Alcohol Spectrum Disorder. (2007, February 17). In Wikipedia, The Free Encyclopedia. Retrieved February 17, 2007, from http://en.wikipedia.org/w/index.php?title=Fetal_Alcohol_Spectrum_Disorder& oldid=113293474

3. Ikonomidou, C., Bittigau, P., Ishimaru, M., Wozniak, D., Koch, C., Genz,
K., Price, M., Stefovska, V., Horster, F., Tenkova, T., Dikranian, K., & Olney, J. (2000, February 11). Ethanol-Induced Apoptotic Neurodegeneration and Fetal Alcohol Syndrome. Science, 287 (5455), 1056-1060.

4. U.S. Department of Health & Human Services

http://www.surgeongeneral.gov/pressreleases/sg02222005.html