Alcohol intake during pregnancy and fetal alcohol syndrome

Social Science & Medicine, 1990

Since 1974 numerous clinical studies have made it clear that heavy alcohol consumption during pregnancy (in excess of 80 g or 8 units daily) can result in a child being born with a specific combination of physical and mental disabilities known as the Fetal Alcohol Syndrome. More moderate levels of intake (as little as IO g of I unit daily) are associated with other fetal problems known as Fetal Alcohol Effects.

Journal of Epidemiology & Community Health, 1990

Study objective-The aim was to investigate the effect of low or moderate alcohol consumption upon fetal outcome. Design-This was a Australia. Subsequently, a sample of 605 motherinfant pairs was selected for follow up to obtain a

Alcoholism: Clinical and Experimental Research, 2012

Pediatria i Medycyna Rodzinna

Introduction: Alcohol is one of the strongest teratogens. Since the 1960s, information campaigns have been conducted to address its harmful effect and promote quitting drinking, especially by pregnant women. The aim of this paper includes a review of literature concerning research on alcohol use by pregnant women and learning about their knowledge of the detrimental effects of ethanol on the health of themselves and their unborn children. This paper shall also assess social campaigns devoted to informing this group of women about the harmful effects of alcohol consumption. Description of state of knowledge: The review explicitly confirmed data on the harmful effect of alcohol on the formation of morphological and behavioural changes stigmatising children, which are not always visible from birth, and often take the form characteristic of foetal alcohol syndrome only in schoolchildren. The results of molecular and psychological tests have raised the question as to whether the acceptab...

Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism, 2011

In addition to fetal alcohol syndrome and fetal alcohol spectrum disorders, prenatal alcohol exposure is associated with many other adverse pregnancy and birth outcomes. Research suggests that alcohol use during pregnancy may increase the risk of miscarriage, stillbirth, preterm delivery, and sudden infant death syndrome. This research has some inherent difficulties, such as the collection of accurate information about alcohol consumption during pregnancy and controlling for comorbid exposures and conditions. Consequently, attributing poor birth outcomes to prenatal alcohol exposure is a complicated and ongoing task, requiring continued attention to validated methodology and to identifying specific biological mechanisms.

Developmental Medicine and Child Neurology, 2002

Foetal alcohol syndrome (FAS) was first described in 1973 by Jones and colleagues. 1 Since then, results of epidemiological studies and clinical experience have shown that exposure of the foetus to high maternal alcohol consumption has a range of consequences. It can result in both major and minor malformations, permanent impairment of growth with a disproportionately low weight-to-height ratio and reduced head growth, and CNS dysfunction ranging from learning disability* to specific learning disorders -all characteristics that can, however, have other causes. Effects within all domains can range from mild to severe. Effects seen in a child and the diagnosis reached depend on the duration of exposure to substantial maternal alcohol consumption during pregnancy, the range and timing of peak blood-alcohol levels, the nutritional state of the mother, and individual susceptibility. 2

Clinical Obstetrics and Gynecology, 2013

Alcohol consumption during pregnancy remains a common occurrence and is associated with a multitude of adverse birth and long-term outcomes. Binge drinking in particular is shown to be particularly harmful to the developing fetus. Effects include full fetal alcohol syndrome, with characteristic facial dysmorphology, growth restriction, and developmental to delays. Exposed children may also have partial fetal alcohol syndrome, alcohol-related birth defects, and alcohol-related neurodevelopmental disorders. These effects are preventable, and efforts must begin with accurate identification of women who consume alcohol during pregnancy. Several screening tools have been developed and validated for use in prenatal care settings, and the most recently proposed brief and easy to use T-ACER3 has demonstrated high sensitivity and specificity in both identifying risk drinking during pregnancy and predicting long-term neurobehavioral outcomes in exposed children. Once identified, effective interventions are available for use with pregnant women consuming alcohol. Brief interventions, which can be delivered by a health professional and involve motivational interviewing, have been demonstrated to significantly reduce alcohol consumption during pregnancy. These approaches, recommended by American College of Obstetricians and Gynecologist (ACOG), help move patients toward increased readiness to positively change their drinking behavior. Ultimately, all prenatal care providers should routinely screen all patients for alcohol use using validated tools, and where appropriate, should offer intervention.

FETAL ALCOHOLIC SYNDROME: BIBLIOGRAPHIC REVIEW (Atena Editora), 2022

Introduction: Alcohol use has a teratogenic effect throughout pregnancy, especially in the first trimester, and can lead to Fetal Alcohol Syndrome (FAS), identified by abnormal facial features, growth failure and neural problems. Goal: The present study aims to review articles in the national and foreign literature on FAS, analyzing causes, consequences and possible actions to prevent alcohol intake by pregnant women. Methodology: Searches for scientific articles were carried out in the virtual databases: SciELO, Google Scholar, PubMed, published between 2010 and 2018, and the most important references for the topic in question were selected. Review: The use of alcohol during pregnancy can harm fetal development and even cause miscarriage. Affected children have phenotypic changes common to Fetal Alcohol Syndrome Spectrum Disorder (FASD) or Fetal Alcohol Spectrum Disorders (FASD). Among the spectrum diagnoses, FAS is the most severe, evidenced by craniofacial deformities, microcephaly, thin upper lip, smooth philtrum, hearing loss and low birth weight. It can also favor the development of psychiatric illnesses by the mother and the child. Alcohol consumption by women is influenced by economic, personal and social factors. Conclusion: Fetal Alcohol Syndrome is dose-dependent, but there is no consensus on the minimum amount. Therefore, its prevention is carried out through abstinence. Since its incidence has increased in Brazil, it constitutes a public health problem. Therefore, immediate interventions are needed to raise awareness among pregnant women and encourage pre- and postnatal care.

International Journal of Health Science

Introduction: Alcohol use has a teratogenic effect throughout pregnancy, especially in the first trimester, and can lead to Fetal Alcohol Syndrome (FAS), identified by abnormal facial features, growth failure and neural problems. Goal: The present study aims to review articles in the national and foreign literature on FAS, analyzing causes, consequences and possible actions to prevent alcohol intake by pregnant women. Methodology: Searches for scientific articles were carried out in the virtual databases: SciELO, Google Scholar, PubMed, published between 2010 and 2018, and the most important references for the topic in question were selected. Review: The use of alcohol during pregnancy can harm fetal development and even cause miscarriage. Affected children have phenotypic changes common to Fetal Alcohol Syndrome Spectrum Disorder (FASD) or Fetal Alcohol Spectrum Disorders (FASD). Among the spectrum diagnoses, FAS is the most severe, evidenced by craniofacial deformities, microcephaly, thin upper lip, smooth philtrum, hearing loss and low birth weight. It can also favor the development of psychiatric illnesses by the mother and the child. Alcohol consumption by women is influenced by economic, personal and social factors. Conclusion: Fetal Alcohol Syndrome is dose-dependent, but there is no consensus on the minimum amount. Therefore, its prevention is carried out through abstinence. Since its incidence has increased in Brazil, it constitutes a public health problem. Therefore, immediate interventions are needed to raise awareness among pregnant women and encourage preand postnatal care.

Archivos Argentinos De Pediatria, 2021

Looking at the history of humankind, the harmful effects caused by alcohol use among pregnant women is a problem recognized in several instances. Aristotle himself, in the 4 th century BC, warned about them: "Drunken women most often bring forth children like unto themselves, morose and languid...". During the epidemic in 1700, with gin consumption in London, fetal, newborn, and infant mortality increased sharply among floppy and hypotonic cases. However, the early medical descriptions published regarding the effects of prenatal exposure to alcohol (PEA) were the work of two French pediatricians, Jacqueline Rouquette (1957) and Paul Lemoine (1968). 1 In spite of this, most articles about this topic mention Smith and Jones as those who first described and defined, in 1973, "fetal alcohol syndrome" (FAS). 2 To date, this definition has not significantly changed and encompasses three typical aspects: characteristic facial features, pre-and post-natal growth deficiencies, and neurodevelopmental and behavioral alterations. Since then and so far, approximately 17 000 scientific articles have been published that have helped to establish a broad range of effects that depend on alcohol doses consumed during pregnancy. Such broad range of physical, neurocognitive, and behavioral effects related to PEA has been referred to as "fetal alcohol spectrum disorder" (FASD). FAS is the most severe presentation of FASD. 1-3 FASD is considered a major public health problem worldwide that has been barely included in health policy planning, pre-and postgraduate training, and medical practice in our country. Specifically, in perinatology and pediatrics, it is little recognized and diagnosed although a child's and their family's quality of life depends on its detection and a timely intervention. FASD currently represents the leading preventable congenital cause of intellectual disability in the Western world. 4 I n 2 0 1 0 , S e r g i o E v r a r d , M. D. , d i d a n excellent review on this subject published in Archivos Argentinos de Pediatría by describing the characteristics typical of FAS and FASD. 1 This article provides details about the basic requirements for the diagnosis of both of the above-mentioned conditions. The criteria have been refined in subsequent publications, which

Maternal and Child Health Journal, 2006

American Journal of Epidemiology, 2002

The authors evaluated the association between alcohol intake during pregnancy and risk of stillbirth and infant death in a cohort of pregnant women receiving routine antenatal care at Aarhus University Hospital (Aarhus, Denmark) between 1989 and 1996. Prospective information on alcohol intake, other lifestyle factors, maternal characteristics, and obstetric risk factors was obtained from self-administered questionnaires and hospital files, and 24,768 singleton pregnancies were included in the analyses (116 stillbirths, 119 infant deaths). The risk ratio for stillbirth among women who consumed ≥5 drinks/week during pregnancy was 2.96 (95% confidence interval: 1.37, 6.41) as compared with women who consumed <1 drink/week. Adjustment for smoking habits, caffeine intake, age, prepregnancy body mass index, marital status, occupational status, education, parity, and sex of the child did not change the conclusions, nor did restriction of the highest intake group to women who consumed 5-14 drinks/week (risk ratio = 3.13, 95% confidence interval: 1.45, 6.77). The rate of stillbirth due to fetoplacental dysfunction increased across alcohol categories, from 1.37 per 1,000 births for women consuming <1 drink/week to 8.83 per 1,000 births for women consuming ≥5 drinks/week. The increased risk could not be attributed to the effect of alcohol on the risk of low birth weight, preterm delivery, or malformations. There was little if any association between alcohol intake and infant death. Am J Epidemiol 2002;155:305-12. alcohol drinking; fetal death; infant mortality; pregnancy

Addiction, 1985

Alcoird um~nption in pregnancy um proavU a spccman of abtlormalirics in the dcocloping factus, ranging from minor ruordarion of gnnuth w thefulty developed 'factal olcolrol ryndromc'. This syndtvme comprises a constellation of plrysical ad mental dcfccts a s & with a characteriseic facial appuarance thar is found in childnn born w chronic alcoholic women. Although U urns thought w be extremely rare in the U.K., setma1 cnse studies have d y appuared in the liurotwe, and its i n d e n u is pvbably inmating. In moderately drinking pregnant women i d rates of qnnmnww abortion, stillbirth and wngcnitul m a l f d as well as gnnuth retardation hawe been rcpacd, though some o)'thesefindings awU confbmation. It is likdycrlso thatcatcrin belraoiolrrel abnormcrluta are umuquent on m a m d alcohol tntcrkc. The major U.K.finding so far is thal umsum* of more than loogakoholpcr WUR in the early stages ofpcsnarrcr is associated with reduced birth wight. Thmisnodmrbt that alcohol is teratogmic in labor-animalsand that t h e e f f t c t s a r e d . In humans the threshold dose ?wassaty wp.oducc damage w the fmtus and the time inprcgnrmcv that d ? h o l is paiculmlv likely w have delueriow cffccu ham not* been established. In the present state of knanluige there mc d i '

BJOG: An International Journal of Obstetrics and Gynaecology, 1982

The outcome of pregnancy is reported for 23 women who had been drinking alcohol heavily and w h o were delivered in Belfast maternity hospitals during the last 4 years. Twenty-one (91%) of the babies were small-for-gestational age and many had head circumference measurements < 5th centile. Ten babies (44%) had abnormal facies consistent with the 'fetal alcohol syndrome' and 10 babies had congenital malformations of the heart, palate, genitalia and kidneys. Perinatal problems which included breech presentation, birth asphyxia, hypoglycaemia, polycythaemia, hypocalcaemia and withdrawal symptoms were frequently present. Most of the babies have shown delayed postnatal growth and six of the ten who are aged over 1 year have delayed development.

BJOG: An International Journal of Obstetrics & Gynaecology, 2009

Objective To investigate the relationship between prenatal alcohol exposure and fetal growth and preterm birth and to estimate the effect of dose and timing of alcohol exposure in pregnancy. Design A population-based cohort study linked to birth information on the Western Australian Midwives Notification System. Setting Western Australia. Population A 10% random sample of births restricted to nonindigenous women who had delivered a singleton infant (n = 4719) in 1995-1997. Methods The impact of alcohol consumption in pregnancy on fetal growth (small-for-gestational-age [SGA] and large-forgestational-age infants [LGA]) and preterm birth (<37 weeks of gestation) was assessed using multivariate logistic regression analysis and adjusting for confounding factors. Main outcome measures Odds ratios and 95% CI, attributable risk, and population attributable risk were calculated. Results The percentage of SGA infants and preterm birth increased with higher levels of prenatal alcohol exposure; however, the association between alcohol intake and SGA infants was attenuated after adjustment for maternal smoking. Low levels of prenatal alcohol were not associated with preterm birth; however, binge drinking resulted in a nonsignificant increase in odds. Preterm birth was associated with moderate and higher levels of prenatal alcohol consumption for the group of women who ceased drinking before the second trimester. This group of women was significantly more likely to deliver a preterm infant than women who abstained from alcohol (adjusted OR 1.73 [95% CI 1.01-3.14]). Conclusions Alcohol intake at higher levels, particularly heavy and binge drinking patterns, is associated with increased risk of preterm birth even when drinking is ceased before the second trimester. This finding, however, is based on small numbers and needs further investigation. Dose and timing of prenatal alcohol exposure appears to affect preterm delivery and should be considered in future research and health education.