Fetal alcohol exposure: Consequences, diagnosis, and treatment

Obstetrical and Gynecological Survey

Volumn 68, Issue 1, 2013, Pages 62-69

  Pruett, Dawn ^a   Waterman, Emily Hubbard ^b   Caughey, Aaron B ^b  

^a OREGON HEALTH AND SCIENCE UNIVERSITY   (United States)

^b OREGON HEALTH AND SCIENCE UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ACETALDEHYDE; ALCOHOL DEHYDROGENASE; ALCOHOL DEHYDROGENASE TYPE 2; ANTIOXIDANT; CASPASE 3; CELL ADHESION MOLECULE; CELL DNA; CYTOCHROME C; CYTOCHROME P450 17; GAMMA GLUTAMYLTRANSFERASE; HEMOGLOBIN ASSOCIATED ACETALDEHYDE; MITOCHONDRIAL DNA; REACTIVE OXYGEN METABOLITE; UNCLASSIFIED DRUG;

ACADEMIC ACHIEVEMENT; ADVERSE OUTCOME; ALCOHOL ABUSE; ALCOHOL CONSUMPTION; ALCOHOL METABOLISM; AMNION FLUID; APOPTOSIS; ATTENTION DEFICIT DISORDER; ATTENTION DISTURBANCE; BASAL GANGLION; BRAIN ATROPHY; CELL ADHESION; CELL DAMAGE; CELL INTERACTION; CHILDHOOD MORTALITY; DIETARY INTAKE; DISEASE PREDISPOSITION; DIZYGOTIC TWINS; DNA DAMAGE; DRUG ABUSE; EARLY DIAGNOSIS; FETAL ALCOHOL SYNDROME; FETUS CIRCULATION; FETUS DEATH; FETUS ECHOGRAPHY; GENETIC POLYMORPHISM; GENETIC SUSCEPTIBILITY; GROWTH RETARDATION; HEARING IMPAIRMENT; HUMAN; INHIBITION (PSYCHOLOGY); INTELLECTUAL IMPAIRMENT; LEARNING; LIP MALFORMATION; MATERNAL BEHAVIOR; MEAN CORPUSCULAR VOLUME; MENTAL DEFICIENCY; MICROCEPHALY; MONOZYGOTIC TWINS; NERVE CELL NECROSIS; NEURAL CREST; NONHUMAN; OPTIC NERVE HYPOPLASIA; OXIDATIVE STRESS; PALPEBRAL FISSURE ANOMALY; PARIETAL LOBE; PHILTRUM; PLACENTA CIRCULATION; PREGNANCY OUTCOME; PRENATAL DIAGNOSIS; RETINA MALFORMATION; RETINAL VESSEL TORTUOSITY; REVIEW; SECOND TRIMESTER PREGNANCY; SEXUAL BEHAVIOR; SOCIAL STATUS; SPATIAL MEMORY; TERATOGENESIS; VASOCONSTRICTION; VERBAL MEMORY; VESTIBULAR DISORDER; VISUAL IMPAIRMENT; WHITE MATTER LESION; WORKING MEMORY;

ALCOHOL DRINKING; ANTIOXIDANTS; BIOLOGICAL MARKERS; ETHANOL; FEMALE; FETAL ALCOHOL SYNDROME; FETAL DEATH; FETAL GROWTH RETARDATION; FETUS; HUMANS; INFANT, NEWBORN; PERINATAL CARE; PREGNANCY; PREGNANCY OUTCOME; PRENATAL DIAGNOSIS; PRENATAL EXPOSURE DELAYED EFFECTS; PROGNOSIS; SEROTONIN RECEPTOR AGONISTS;

EID: 84872851198     PISSN: 00297828     EISSN: 15339866     Source Type: Journal    
DOI: 10.1097/OGX.0b013e31827f238f     Document Type: Review

References (91)

1. Centers for Disease Control and Prevention (CDC). Alcohol use among pregnant and nonpregnant women of childbearing ageVUnited States, 1991-2005. MMWR Morb Mortal Wkly Rep. 2009;58:529-532.
2. Jones KL, Smith DW. Recognition of the fetal alcohol syndrome in early infancy. Lancet. 1973;302:999-1001.
3. Committee to Study Fetal Alcohol Syndrome and Institute of Medicine. Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment. Washington, DC: The National Academies Press; 1996.
4. Shankar K, Ronis MJ, Badger TM. Effects of pregnancy and nutritional status on alcohol metabolism. Alcohol Res Health. 2007;30:55-59.
5. Nava-Ocampo AA, Velazquez-Armenta Y, Brien JF, et al. Elimination kinetics of ethanol in pregnant women. Reprod Toxicol. 2004;18:613-617.
6. Greenberg DA. Linking acquired neurodevelopmental disorders to defects in cell adhesion. Proc Natl Acad Sci USA. 2003;100:8043-8044.
7. Charness ME, Safran RM, Perides G. Ethanol inhibits neural cell-cell adhesion. J Biol Chem. 1994;269:9304-9309.
8. Wilkemeyer MF, Pajerski M, Charness ME. Alcohol inhibition of cell adhesion in BMP-treated NG108-15 cells. Alcohol Clin Exp Res. 1999;23:1711-1720.
9. Minana R, Climent E, Barettino D, et al. Alcohol exposure alters the expression pattern of neural cell adhesion molecules during brain development. J Neurochem. 2000;75:954-964.
10. Ramachandran V, Watts LT, Maffi SK, et al. Ethanol-induced oxidative stress precedes mitochondrially mediated apoptotic death of cultured fetal cortical neurons. J Neurosci Res. 2003; 74:577-588.
11. Ramachandran V, Perez A, Chen J, et al. In utero ethanol exposure causes mitochondrial dysfunction, which can result in apoptotic cell death in fetal brain: a potential role for 4-hydroxynonenal. Alcohol Clin Exp Res. 2001;25:862-871.
12. de La Monte SM, Wands JR. Mitochondrial DNA damage and impaired mitochondrial function contribute to apoptosis of insulin-stimulated ethanol-exposed neuronal cells. Alcohol Clin Exp Res. 2001;25:898-906.
13. Devi BG, Schenker S, Mazloum B, et al. Ethanol-induced oxidative stress and enzymatic defenses in cultured fetal rat hepatocytes. Alcohol. 1996;13:327-332.
14. Seiler AE, Ross BN, Green JS, et al. Differential effects of ethanol on insulin-like growth factor-I receptor signaling. Alcohol Clin Exp Res. 2000;24:140-148.
15. Cartwright MM, Smith SM. Stage-dependent effects of ethanol on cranial neural crest cell development: partial basis for the phenotypic variations observed in fetal alcohol syndrome. Alcohol Clin Exp Res. 1995;19:1454-1462.
16. Cartwright MM, Smith SM. Increased cell death and reduced neural crest cell numbers in ethanol-exposed embryos: partial basis for the fetal alcohol syndrome phenotype. Alcohol Clin Exp Res. 1995;19:378-386.
17. Sari Y, Zhou FC. Prenatal alcohol exposure causes long-term serotonin neuron deficit in mice. Alcohol Clin Exp Res. 2004; 28:941-948.
18. Riikonen RS, Nokelainen P, Valkonen K, et al. Deep serotonergic and dopaminergic structures in fetal alcoholic syndrome: a study with nor-beta-CIT-single-photon emission computed tomography and magnetic resonance imaging volumetry. Biol Psychiatry. 2005;57:1565-1572.
19. Schenker S, Hu ZQ, Johnson RF, et al. Human placental biotin transport: normal characteristics and effect of ethanol. Alcohol Clin Exp Res. 1993;17:566-575.
20. Schenker S, Johnson RF, Mahuren JD, et al. Human placental vitamin B6 (pyridoxal) transport: normal characteristics and effects of ethanol. Am J Physiol. 1992;262:R966-R974.
21. Kay HH, Grindle KM, Magness RR. Ethanol exposure induces oxidative stress and impairs nitric oxide availability in the human placental villi: a possible mechanism of toxicity. Am J Obstet Gynecol. 2000;182:682-688.
22. Taylor SM, Heron AE, Cannell GR, et al. Pressor effect of ethanol in the isolated perfused human placental lobule. Eur J Pharmacol. 1994;270:371-374.
23. Altura BM, Altura BT, Carella A, et al. Alcohol produces spasms of human umbilical blood vessels: relationship to fetal alcohol syndrome (FAS). Eur J Pharmacol. 1982;86:311-312.
24. Erskine RL, Ritchie JW. The effect of maternal consumption of alcohol on human umbilical artery blood flow. Am J Obstet Gynecol. 1986;154:318-321.
25. Abel EL, Hannigan JH. Maternal risk factors in fetal alcohol syndrome: provocative and permissive influences. Neurotoxicol Teratol. 1995;17:445-462.
26. Streissguth AP, Dehaene P. Fetal alcohol syndrome in twins of alcoholic mothers: concordance of diagnosis and IQ. Am J Med Genet. 1993;47:857-861.
27. Russo D, Purohit V, Foudin L, et al.Workshop on alcohol use and health disparities 2002: a call to arms. Alcohol. 2004;32:37-43.
28. Delpisheh A, Topping J, Reyad M, et al. Prenatal alcohol exposure, CYP17 gene polymorphisms and fetal growth restriction. Eur J Obstet Gynecol Reprod Biol. 2008;138:49-53.
29. Clarren SK, Alvord EC Jr, Sumi SM, et al. Brain malformations related to prenatal exposure to ethanol. J Pediatr. 1978;92:64-67.
30. Archibald SL, Fennema-Notestine C, Gamst A, et al. Brain dysmorphology in individuals with severe prenatal alcohol exposure. Dev Med Child Neurol. 2001;43:148-154.
31. Lebel C, Roussotte F, Sowell ER. Imaging the impact of prenatal alcohol exposure on the structure of the developing human brain. Neuropsychol Rev. 2011;21:102-118.
32. Riley EP, Mattson SN, Sowell ER, et al. Abnormalities of the corpus callosum in children prenatally exposed to alcohol. Alcohol Clin Exp Res. 1995;19:1198-1202.
33. Sowell ER, Thompson PM, Mattson SN, et al. Regional brain shape abnormalities persist into adolescence after heavy prenatal alcohol exposure. Cereb Cortex. 2002;12:856-865.
34. Clarren SK, Smith DW. The fetal alcohol syndrome. N Engl J Med. 1978;298:1063-1067.
35. Stromland K, Pinazo-Duran MD. Ophthalmic involvement in the fetal alcohol syndrome: clinical and animal model studies. Alcohol Alcohol. 2002;37:2-8.
36. Church MW, Kaltenbach JA. Hearing, speech, language, and vestibular disorders in the fetal alcohol syndrome: a literature review. Alcohol Clin Exp Res. 1997;21:495-512.
37. Hofer R, Burd L. Review of published studies of kidney, liver, and gastrointestinal birth defects in fetal alcohol spectrum disorders. Birth Defects Res A Clin Mol Teratol. 2009;85:179-183.
38. Streissguth AP, Bookstein FL, Barr HM, et al. Risk factors for adverse life outcomes in fetal alcohol syndrome and fetal alcohol effects. J Dev Behav Pediatr. 2004;25:228-238.
39. Ervalahti N, Korkman M, Fagerlund A, et al. Relationship between dysmorphic features and general cognitive function in children with fetal alcohol spectrum disorders. Am J Med Genet A. 2007;143A:2916-2923.
40. Norman AL, Crocker N, Mattson SN, et al. Neuroimaging and fetal alcohol spectrum disorders. Dev Disabil Res Rev. 2009; 15:209-217.
41. Mattson SN, Riley EP, Gramling L, et al. Neuropsychological comparison of alcohol-exposed children with or without physical features of fetal alcohol syndrome. Neuropsychology. 1998;12:146-153.
42. Mattson SN, Riley EP, Gramling L, et al. Heavy prenatal alcohol exposure with or without physical features of fetal alcohol syndrome leads to IQ deficits. J Pediatr. 1997;131:718-721.
43. Howell KK, Lynch ME, Platzman KA, et al. Prenatal alcohol exposure and ability, academic achievement, and school functioning in adolescence: a longitudinal follow-up. J Pediatr Psychol. 2006;31:116-126.
44. Lebel C, Rasmussen C, Wyper K, et al. Brain microstructure is related to math ability in children with fetal alcohol spectrum disorder. Alcohol Clin Exp Res. 2010;34:354-363.
45. Mattson SN, Riley EP. A review of the neurobehavioral deficits in children with fetal alcohol syndrome or prenatal exposure to alcohol. Alcohol Clin Exp Res. 1998;22:279-294.
46. O'Connor MJ, Shah B, Whaley S, et al. Psychiatric illness in a clinical sample of children with prenatal alcohol exposure.AmJ Drug Alcohol Abuse. 2002;28:743-754.
47. Coles CD, Platzman KA, Raskind-Hood CL, et al. A comparison of children affected by prenatal alcohol exposure and attention deficit, hyperactivity disorder. Alcohol Clin Exp Res. 1997; 21:150-161.
48. Fryer SL, McGee CL, Matt GE, et al. Evaluation of psychopathological conditions in children with heavy prenatal alcohol exposure. Pediatrics. 2007;119:e733-e741.
49. Burd L, Klug MG, Bueling R, et al. Mortality rates in subjects with fetal alcohol spectrum disorders and their siblings. Birth Defects Res A Clin Mol Teratol. 2008;82:217-223.
50. Marbury MC, Linn S, Monson R, et al. The association of alcohol consumption with outcome of pregnancy. Am J Public Health. 1983;73:1165-1168.
51. Okah FA, Cai J, Hoff GL. Term-gestation low birth weight and health-compromising behaviors during pregnancy. Obstet Gynecol. 2005;105:543-550.
52. Harlap S, Shiono PH. Alcohol, smoking, and incidence of spontaneous abortions in the first and second trimester. Lancet. 1980;2:173-176.
53. Windham GC, Von Behren J, Fenster L, et al. Moderate maternal alcohol consumption and risk of spontaneous abortion. Epidemiology. 1997;8:509-514.
54. Strandberg-Larsen K, Nielsen NR, Gronbaek M, et al. Binge drinking in pregnancy and risk of fetal death. Obstet Gynecol. 2008;111:602-609.
55. Aliyu MH, Wilson RE, Zoorob R, et al. Alcohol consumption during pregnancy and the risk of early stillbirth among singletons. Alcohol. 2008;42:369-374.
56. Bakker R, Pluimgraaff LE, Steegers EA, et al. Associations of light and moderate maternal alcohol consumption with fetal growth characteristics in different periods of pregnancy: the Generation R Study. Int J Epidemiol. 2010;39:777-789.
57. Kesmodel U, Bertrand J, Stovring H, et al. The effect of different alcohol drinking patterns in early to mid pregnancy on the child's intelligence, attention, and executive function. BJOG. 2012; 119(10):1180-90.
58. Henderson J, Gray R, Brocklehurst P. Systematic review of effects of low-moderate prenatal alcohol exposure on pregnancy outcome. BJOG. 2007;114:243-252.
59. Ernhart CB, Sokol RJ, Martier S, et al. Alcohol teratogenicity in the human: a detailed assessment of specificity, critical period, and threshold. Am J Obstet Gynecol. 1987;156:33-39.
60. Sood B, Delaney-Black V, Covington C, et al. Prenatal alcohol exposure and childhood behavior at age 6 to 7 years: I. doseresponse effect. Pediatrics. 2001;108:E34.
61. Henderson J, Kesmodel U, Gray R. Systematic review of the fetal effects of prenatal binge-drinking. J Epidemiol Community Health. 2007;61:1069-1073.
62. Pierce DR, West JR. Blood alcohol concentration: a critical factor for producing fetal alcohol effects. Alcohol. 1986;3:269-272.
63. Maier SE, Chen WJ, West JR. Prenatal binge-like alcohol exposure alters neurochemical profiles in fetal rat brain. Pharmacol Biochem Behav. 1996;55:521-529.
64. Kochunov P, Castro C, Davis DM, et al. Fetal brain during a binge drinking episode: a dynamic susceptibility contrast MRI fetal brain perfusion study. Neuroreport. 2010;21:716-721.
65. Polygenis D,Wharton S, Malmberg C, et al.Moderate alcohol consumption during pregnancy and the incidence of fetal malformations: a meta-analysis. Neurotoxicol Teratol. 1998;20:61-67.
66. Svinarich DM, DiCerbo JA, Zaher FM, et al. Ethanol-induced expression of cytokines in a first-trimester trophoblast cell line. Am J Obstet Gynecol. 1998;179:470-475.
67. McLeod W, Brien J, Loomis C, et al. Effect of maternal ethanol ingestion on fetal breathing movements, gross body movements, and heart rate at 37 to 40 weeks' gestational age. Am J Obstet Gynecol. 1983;145:251-257.
68. Tough S, Tofflemire K, Clarke M, et al. Do women change their drinking behaviors while trying to conceive? An opportunity for preconception counseling. Clin Med Res. 2006;4:97-105.
69. Russell M, Martier SS, Sokol RJ, et al. Detecting risk drinking during pregnancy: a comparison of four screening questionnaires. Am J Public Health. 1996;86:1435-1439.
70. Ernhart CB, Morrow-Tlucak M, Sokol RJ, et al. Underreporting of alcohol use in pregnancy. Alcohol Clin Exp Res. 1988;12:506-511.
71. Cook JD. Biochemical markers of alcohol use in pregnant women. Clin Biochem. 2003;36:9-19.
72. Soderberg BL, Salem RO, Best CA, et al. Fatty acid ethyl esters. ethanol metabolites that reflect ethanol intake. Am J Clin Pathol. 2003;119(suppl):S94- S99.
73. Kulaga V, Pragst F, Fulga N, et al. Hair analysis of fatty acid ethyl esters in the detection of excessive drinking in the context of fetal alcohol spectrum disorders. Ther Drug Monit. 2009;31:261-266.
74. Ostrea EM Jr. Testing for exposure to illicit drugs and other agents in the neonate: a review of laboratory methods and the role of meconium analysis. Curr Probl Pediatr. 1999;29:37-56.
75. Bearer CF, Jacobson JL, Jacobson SW, et al. Validation of a new biomarker of fetal exposure to alcohol. J Pediatr. 2003; 143:463-469.
76. Marcellus L. Is meconium screening appropriate for universal use? Science and ethics say no. Adv Neonatal Care. 2007; 7:207-214.
77. Wilkemeyer MF, Sebastian AB, Smith SA, et al. Antagonists of alcohol inhibition of cell adhesion. Proc Natl Acad Sci USA. 2000;97:3690-3695.
78. Wilkemeyer MF, Chen SY, Menkari CE, et al. Ethanol antagonist peptides: structural specificity without stereospecificity. J Pharmacol Exp Ther. 2004;309:1183-1189.
79. Kotch LE, Chen SY, Sulik KK. Ethanol-induced teratogenesis: free radical damage as a possible mechanism. Teratology. 1995;52:128-136.
80. Peng Y, Kwok KH, Yang PH, et al. Ascorbic acid inhibits ROS production, NF-kappa B activation and prevents ethanolinduced growth retardation and microencephaly. Neuropharmacology. 2005;48:426-434.
81. Heaton MB, Mitchell JJ, Paiva M. Amelioration of ethanol-induced neurotoxicity in the neonatal rat central nervous system by antioxidant therapy. Alcohol Clin Exp Res. 2000;24:512-518.
82. Long L, Li Y, Wang YD, et al. The preventive effect of oral EGCG in a fetal alcohol spectrum disorder mouse model. Alcohol Clin Exp Res. 2010;34:1929-1936.
83. Kim JA, Druse MJ. Protective effects of maternal buspirone treatment on serotonin reuptake sites in ethanol-exposed offspring. Brain Res Dev Brain Res. 1996;92:190-198.
84. Tajuddin NF, Druse MJ. In utero ethanol exposure decreased the density of serotonin neurons. maternal ipsapirone treatment exerted a protective effect. Brain Res Dev Brain Res. 1999;117:91-97.
85. Burd L, Cotsonas-Hassler TM, Martsolf JT, et al. Recognition and management of fetal alcohol syndrome. Neurotoxicol Teratol. 2003;25:681-688.
86. Olson HC, Oti R, Gelo J, et al. "Family matters": fetal alcohol spectrum disorders and the family. Dev Disabil Res Rev. 2009; 15:235-249.
87. Abel EL. Fetal alcohol syndrome in families. Neurotoxicol Teratol. 1988;10:1-2.
88. Kooistra L, Crawford S, Gibbard B, et al. Differentiating attention deficits in children with fetal alcohol spectrum disorder or attention-deficit-hyperactivity disorder. Dev Med Child Neurol. 2010;52:205-211.
89. Doig J, McLennan JD, Gibbard WB. Medication effects on symptoms of attention-deficit/hyperactivity disorder in children with fetal alcohol spectrum disorder. J Child Adolesc Psychopharmacol. 2008;18:365-371.
90. Marche K, Danel T, Bordet R. Fetal alcohol-induced hyperactivity is reversed by treatment with the PPARalpha agonist fenofibrate in a rat model. Psychopharmacology (Berl). 2011;214:285-296.
91. Peadon E, Rhys-Jones B, Bower C, et al. Systematic review of interventions for children with fetal alcohol spectrum disorders. BMC Pediatr. 2009;9:35.