Alcohol in Pregnancy

QUICK FACTS:

 

POSSIBLE RISKS:

The following risks are POSSIBLE risks. They are not guaranteed and this list is not comprehensive. Alcohol in pregnancy may affect 2 major areas: structural growth and brain development.

 

Structural Growth Impairment:

 

Brain Development Impairment:

 

Fetal Alcohol Spectrum Disorder (FASD):

Broad term used to describe the effects of alcohol exposure in an infant and includes the following4:

 

Possible Risks by Trimesters:

 

Alcohol exposure is dangerous to a fetus in all stages of gestation, but may have different effects at different times.

 

 

WHAT TO LOOK FOR:

Signs of Brain Development Impairment8-13:


WHAT TO DO:

Early Detection and Intervention is very important for improving outcomes.

The initial workup to diagnose Fetal Alcohol Spectrum Disorder is performed by a multispecialty team.

 
References:
  1. Henderson J, Gray R, Brocklehurst P. Systematic review of effects of low-moderate prenatal alcohol exposure on pregnancy outcome. BJOG. 2007 Mar;114(3):243-52. doi: 10.1111/j.1471-0528.2006.01163.x. Epub 2007 Jan 12. Erratum in: BJOG. 2007 Jul;114(7):914-5. PMID: 17233797.
  2. Heller M, Burd L. Review of ethanol dispersion, distribution, and elimination from the fetal compartment. Birth Defects Res A Clin Mol Teratol. 2014 Apr;100(4):277-83. doi: 10.1002/bdra.23232. Epub 2014 Mar 10. PMID: 24616297.
  3. Williams JF, Smith VC; COMMITTEE ON SUBSTANCE ABUSE. Fetal Alcohol Spectrum Disorders. Pediatrics. 2015 Nov;136(5):e1395-406. doi: 10.1542/peds.2015-3113. Epub 2015 Oct 19. PMID: 26482673.
  4. Fetal Alcohol Exposure. National Institutes of Health. (2015). https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/fetal-alcohol-exposure. (Accessed on 07/22/2021).
  5. Feldman HS, Jones KL, Lindsay S, Slymen D, Klonoff-Cohen H, Kao K, Rao S, Chambers C. Prenatal alcohol exposure patterns and alcohol-related birth defects and growth deficiencies: a prospective study. Alcohol Clin Exp Res. 2012 Apr;36(4):670-6. doi: 10.1111/j.1530-0277.2011.01664.x. Epub 2012 Jan 17. PMID: 22250768.
  6. O'Leary CM, Nassar N, Kurinczuk JJ, de Klerk N, Geelhoed E, Elliott EJ, Bower C. Prenatal alcohol exposure and risk of birth defects. Pediatrics. 2010 Oct;126(4):e843-50. doi: 10.1542/peds.2010-0256. Epub 2010 Sep 27. PMID: 20876169.
  7. The Interagency Coordinating Committee on FASDs. Consensus statement on recognizing Alcohol-Related Neurodevelopmental Disorder (ARND) in primary health care of children. 2011. www.niaaa.nih.gov/sites/default/files/ARNDConferenceConsensusStatementBooklet_Complete.pdf (Accessed on 07/22/2021).
  8. Hoyme HE, Kalberg WO, Elliott AJ, Blankenship J, Buckley D, Marais AS, Manning MA, Robinson LK, Adam MP, Abdul-Rahman O, Jewett T, Coles CD, Chambers C, Jones KL, Adnams CM, Shah PE, Riley EP, Charness ME, Warren KR, May PA. Updated Clinical Guidelines for Diagnosing Fetal Alcohol Spectrum Disorders. Pediatrics. 2016 Aug;138(2):e20154256. doi: 10.1542/peds.2015-4256. Epub 2016 Jul 27. PMID: 27464676; PMCID: PMC4960726.
  9. Paintner A, Williams AD, Burd L. Fetal alcohol spectrum disorders--implications for child neurology, part 2: diagnosis and management. J Child Neurol. 2012 Mar;27(3):355-62. doi: 10.1177/0883073811428377. Epub 2012 Jan 12. PMID: 22241713.
  10. Streissguth AP, Aase JM, Clarren SK, Randels SP, LaDue RA, Smith DF. Fetal alcohol syndrome in adolescents and adults. JAMA. 1991 Apr 17;265(15):1961-7. PMID: 2008025.
  11. Clarren SK, Smith DW. The fetal alcohol syndrome. N Engl J Med. 1978 May 11;298(19):1063-7. doi: 10.1056/NEJM197805112981906. PMID: 347295.
  12. Spohr HL, Willms J, Steinhausen HC. Fetal alcohol spectrum disorders in young adulthood. J Pediatr. 2007 Feb;150(2):175-9, 179.e1. doi: 10.1016/j.jpeds.2006.11.044. PMID: 17236896.
  13. O'Connor MJ, Paley B. Psychiatric conditions associated with prenatal alcohol exposure. Dev Disabil Res Rev. 2009;15(3):225-34. doi: 10.1002/ddrr.74. PMID: 19731386.