Academic journal article Alcohol Research

Prenatal Exposure to Alcohol

Academic journal article Alcohol Research

Prenatal Exposure to Alcohol

Article excerpt

Maternal alcohol consumption during pregnancy can cause serious birth defects, of which fetal alcohol syndrome (FAS) is the most devastating. Recognizable by characteristic craniofacial abnormalities and growth deficiency, this condition includes severe alcohol-induced damage to the developing brain. FAS children experience deficits in intellectual functioning; difficulties in learning, memory, problem-solving, and attention; and difficulties with mental health and social interactions. An FAS diagnosis, however, fails to identify prenatal-alcohol-exposed children who lack the characteristic facial defects and growth deficiency of FAS. Nonetheless, these often undiagnosed children may still experience serious fetal alcohol effects (FAE), including alcohol-induced mental impairments (i.e., alcohol-related neurodevelopment disorder) or alcohol-related abnormalities of the skeleton and certain organ systems (i.e., alcohol-related birth defects). Neuroimaging techniques can assist researchers in identifying FAE th rough precise pictures of brain abnormalities in persons prenatally exposed to alcohol. By understanding the mechanisms underlying FAE and the behavioral manifestations of the resulting structural brain damage, researchers can ultimately develop effective FAS prevention strategies that identify and assist high-risk women at varying levels of pregnancy. KEY WORDS: fetal alcohol syndrome; prenatal alcohol exposure; neurodevelopmental anomaly; cranio facial anomaly; diagnostic criteria; brain damage; cognitive and memory disorder; central nervous system; neurotransmission; neuroimaging

Fetal Alcohol Syndrome (FAS) is a set of specific birth defects caused by maternal alcohol consumption during pregnancy. Scientists first identified the syndrome in France in 1968 (Lemoine et al. 1968) and in the United States in 1973 (Jones et al. 1973). Today, FAS is considered the most common nonhereditary cause of mental retardation. Estimates of FAS prevalence vary from 0.5 to 3.0 per 1,000 live births in most populations, with much higher rates occurring in some communities (Stratton et al. 1996).

At birth, children with FAS are recognizable by their apparent growth deficiency and characteristic minor facial anomalies (i.e., craniofacial abnormalities) that tend to become less noticeable and adopt a more normal appearance as the child matures. Less evident at birth-- but far more devastating to FAS children and their families--are the lifelong effects of alcohol-induced damage to the developing brain. In addition to deficits in general intellectual functioning, persons with FAS often demon-state difficulties with learning, memory problem-solving, and attention as well as difficulties with mental health and social interactions.

However, the diagnosis of FAS identifies only a relatively small proportion of children affected by alcohol exposure before birth. Many children with significant prenatal alcohol exposure lack the characteristic facial defects and growth deficiency of FAS but still have serious alcohol-induced mental impairments. This condition is referred to as "alcohol-related neurodevelopmental disorder" (ARND). In addition, some prenatally exposed children without FAS facial features exhibit other alcohol-related physical abnormalities of the skeleton and certain organ systems; these anomalies are referred to as alcohol-related birth defects (ARBD).

DIAGNOSING THE EFFECTS OF PRENATAL ALCOHOL EXPOSURE

Researchers first outlined the diagnostic criteria for FAS in 1973 (Jones et al. 1973). Although the terms used to describe the condition have changed over the years, the diagnostic criteria-- growth deficiency, dysflmction of the central nervous system, and characteristic facial defects-have remained essentially the same. Perhaps the most immediately obvious effects of alcohol on the fetus is a pattern of abnormal facial features-small head circumference, skin folds at the corner of the eyes, small eye openings, low nasal bridge, short nose, small midface, thin upper lip, and flat philtrum [1] (see figure, p. …

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