Despite a growing focus on the hazards of prescription painkillers for newborns, drinking during pregnancy remains the nation’s leading preventable cause of birth defects and developmental disorders in children. Fetal Alcohol Spectrum Disorders (FASD) encompass a wide variety of neurobehavioral and central nervous system disabilities related to alcohol use during pregnancy, including, but not limited to, developmental delays, growth retardation speech disabilities, and poor social skills. The classic physical characteristics of FASD, such as small head size, wide-set eyes and a thin upper lip, are not always present.
September 9th is International Fetal Alcohol Spectrum Disorders Awareness Day. Kenneth Warren, acting director of the National Institute on Alcohol Abuse and Alcoholism, said in a prepared statement that “Almost 40 years have passed since we recognized that drinking during pregnancy can result in a wide range of disabilities for children, of which fetal alcohol syndrome (FAS) is the most severe. Yet up to 30 percent of women report drinking alcohol during pregnancy.”
NIAAA, in a brief history of the disorder, calls fetal alcohol syndrome the “most common known cause of mental retardation.” Tragically, the knowledge of alcohol as a teratogen responsible for birth defects was not widely recognized by the medical community in American until the 1970s, when a group of crusading physicians began reporting observations of clustered birth defects among alcoholic mothers. (French doctors were on to FAS in the 1960s). In short order, the Surgeon General issued an FAS advisory, the U.S. Congress passed laws requiring pregnancy warning labels on alcoholic beverages, and doctors began warning their pregnant patients about the hazards of heavy drinking while pregnant. Nonetheless, CDC studies have shown that 0.2 to 1.5 cases of fetal alcohol syndrome (FAS) occur for every 1,000 live births.
Not surprisingly, the NIAAA finds that the risk for teratogenic injury and the severity of injury “appear to increase with greater levels of alcohol consumption.” Facial features associated with FAS are linked to early fetal exposure, so it is possible that “an embryo may escape the injury necessary to develop the characteristic FAS face but receive sufficient injury later in development to exhibit all the FAS-associated CNS and neurobehavioral deficits.”
Organ abnormalities are also characteristic of early exposure, while growth deficits are more likely the result of alcohol exposure later in pregnancy. Binge drinking—high peak dose drinking—is especially troublesome, as it has a great negative impact than low-dose steady drinking. But no period is risk-free. Genetic and environmental factors are plausibly invoked as contributors, but nobody knows what they are at present.
The disabilities caused by FASD often linger throughout adulthood, burdening families with anguish and heavy medical costs. “The message is simple, not just on Sept. 9, but every day,” says Warren. “There is no known safe level of drinking while pregnant. Women who are, who may be, or who are trying to become pregnant, should not drink alcohol.”
Graphics Credit: http://edmontonfetalalcoholnetwork.org/
