Alcohol use in pregnancy

The use of alcohol during pregnancy can bring many problems for the child, including hyperactivity, attention deficits, learning and memory. Several factors may contribute to the emergence of problems in the fetus: pattern of alcohol consumption, maternal metabolism, genetic susceptibility, the gestation period in which alcohol was consumed and vulnerability of different brain regions of the child. It is now known that the risks to the fetus increases with the level of consumption and frequency of use ^1.2

The most serious consequences related to alcohol consumption during pregnancy is Fetal Alcohol Syndrome (SFA) that was first described by Jones and Smith in 1973. The child with FAS has some facial abnormalities and display intellectual deficit, cognitive problems and behavioral problems . Despite presenting a number of intellectual limitations, children with FAS has good performance on tests of language, but still presents difficulties in tests of arithmetic and their social-emotional development.

For the diagnosis of fetal alcohol syndrome is made it is necessary that the patient is assessed by a pediatrician. This is because other diseases that promote developmental delays in the child may be present or be confused with the SFA. There is a therapeutic approach developed directly for SFA. Clinical complications such as seizures or heart disease, require specific treatments. The same applies to the presence of associated psychiatric disorders. Some protective factors against social and psychological complications have been identified as:

- Stable family relationships 
- Diagnosis of the syndrome before the age of 6 
- Lack of physical violence 
- Routine stable and immune to periodic changes of residence or city 
- Lack of social deprivation 
- Presence of specialized monitoring 

Mental retardation, severity once established, should receive the necessary attention in specialized services. Motor problems, such as incoordination and deficits seem to have responded well to physiotherapy treatments. One should not, however, address the problem in a restricted manner. Medicate a psychiatric disorder, ophthalmologic care for, look for a special school or child care provide psychological or physical therapy are essential, but only effective if associated and concurrent. There should be a treatment plan and constant communication between all professionals and families involved.

Alcohol use is, in fact, the leading cause of preventable birth defects and mental retardation in North America and in the Western world as a whole.

Exactly how alcohol causes these defects is not known. One line of research suggests that al­cohol, or products produced by the metabolism of alcohol (acetaldehyde), cause faulty migration of cells in the brain during early stages of development or block the action of certain neuro-transmitters in the brain. In addition, inadequate nutrient intake, reduced nutrient and oxygen transfer across the placenta, cigarette smoking commonly linked to alcohol intake, drug use, and possibly other factors contribute to the overall result. Furthermore, it is not known how much al­cohol it takes to produce these adverse effects. Again, for this reason, many authorities includ­ing the U.S. Surgeon General and the American Medical Association believe it is best that mothers-to-be avoid alcohol altogether. In other words, there is no safe drinking.

Abstinence is especially important during the first trimester, when key growth and develop­ment occur. Alcohol reaches the fetal blood at the same concentration as the mother's blood within 15 minutes of her drinking. However, the effect on the fetus may be up to 10 times greater. For example, just one bout of binge drinking can arrest and alter cell division during crit­ical phases of fetal development. The fetus then may develop an irreversible defect.

Physical damage to the embryo (and later the fetus) results more from first-trimester drinking because the basic structures of tissues and organs develop during this period. Emotional and learning problems stem more from third-trimester drinking because this is when critical further development of the brain occurs. And, throughout the pregnancy, alcohol interferes with growth. Overall, mothers who drink at least one to two drinks a day throughout pregnancy are much more likely to have growth-retarded infants, and mothers who drink only in late pregnancy are more likely to give birth to preterm infants.

Because alcohol has the capacity to adversely affect each stage of fetal development, the ear­lier in pregnancy that drinking ceases, the greater the potential for improved outcome. The best course is to consider alcohol an indulgence that must be eliminated from the time of conception until after pregnancy. Currently about half of all women in North America are drinking at the time of conception (i.e., before learning they are pregnant). One step in the right direction is the mandated warnings about drinking during pregnancy that appear on all alcoholic beverage con­tainers in the United States.

Pregnancy lasts only 9 months. In contrast, parents may spend a lifetime caring, often at great expense (estimated at $1.4 million in the United States), for their offspring needlessly handicapped by FAS or FAE. Keep in mind that fetal alcohol syndrome is a completely pre­ventable disease.