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Alcohol, Drug Use and Pregnancy Outcome
Alan Challoner MA(Phil) MChSCurrent concerns about the effects of alcohol consumption on the unborn child may beassessed from this summary of some of the research that has been carried out since the1970s.The suggestion that alcohol has an adverse effect on pregnancy and child developmenthas a long history. Modernconcern about the influenceof alcohol on pregnancyoutcome was revived in theearly 1970s when a series ofarticles by researchers waspublished.
. These reportsculminated in thedescription, by Jones andSmith
, of a
fetal alcohol syndrome
(the FAS) amongthe offspring of severely andchronically alcoholicmothers, who continued todrink throughout pregnancy.A study in USA has shown thatthere is a seven point deficitin a child’s IQ where itsmother has taken just oneunit of alcohol daily duringpregnancy.
The principal characteristicsthat have been associatedwith the FAS are:
pre-natal and post-natalgrowth retardation;
central nervous systemdysfunction includingmental deficiency,neurological problemsand behaviouraldysfunction;
a characteristic pattern of facial anomalies including the nose, mouth, ears and jaw;
and various other malformations mainly of the skeletal, urogenital and cardiac systems.The effects are dose-related and therefore every woman must realise the potential hazardfor her child-to-be.
Research from the late 1990s
indicates that pregnant women maydrink a small amount of alcohol without harming the foetus. The acceptable level that wasconsidered reasonable was one unit per day (i.e. small glass of wine; half a pint of ordinarybeer, or a single measure of spirits. More than this may hinder the growth of the foetus,leading to a smaller baby. Consumption of over 15 units a week may be associated withintellectual impairment.
FETAL ALCOHOL SYNDROME
: A combination of birthdefects, including organ deformities and mental, motor,and/or growth retardation, that results from maternalalcohol abuse as well as some additional, but lessimportant, factors.However where the syndrome is diagnosed, the alcoholabuse is most often accompanied by adverseenvironmental circumstances. Foetuses conceived byheavy drinkers are more likely to miscarry, are smaller atbirth, do not thrive so well initially and are poor suckers,whether from the bottle or breast. It is not uncommon tofind that as the child reaches primary school-age, he willbe less intelligent and be less integrated with his peers.Alcoholic mothers are likely to have infants suffering fromfetal alcohol syndrome, which is characterized bydeformities of the heart and joints, face (short eyelid slitsand abnormal jaw protrusion), and hand (altered palmar crease patterns), lags in motor development and motor dysfunction, and severe mental handicap. Even moderatedrinking
less than one drink per day
has been found tobe related to attentional deficits in children at four years ofage, Streissguth
, decreased fetal growth, andincreased risk of miscarriage, Mills
. Results of animalstudies by Furey also show serious problems resulting fromsingle episodes of heavy alcohol consumption around thetime of conception.
In view of these research findings, the USA Surgeon Generalhas warned that all pregnant women should avoid alcoholentirely. Some areas, such as New York City, have passedordinances that require all bars, restaurants, and liquor stores to post notices such as; “
Warning: Drinking alcoholicbeverages during pregnancy can cause birth defects.”