Alcohol, Pregnancy and Fetal Alcohol Spectrum Disorders
The consumption of alcohol during any gestation of pregnancy equates into alcohol fetal consumption, which can cause detrimental physical and neurological defects. Infants born with the varying degrees of detrimental effects of prenatal alcohol ingestion can have an array of disorders which are described as Fetal Alcohol Spectrum Disorders [FASD] (May & Gossage, 2011a). The most profound effects of prenatal alcohol exposure are on the fetus’s brain development, which includes cognitive and behavioral effects that follow (Riley, Infante, & Warren, 2011). The incidence of FASD is believed to range from 0.2 to 2 per 1000 live births (Douzgou et al., 2012). Alcohol yields teratogentic effects in all the gestations, with peculiar features in relationship to the trimester of pregnancy in which the alcohol is consumed (Paoletti et al., 2013). Due to the fact that there is no exact dose-response relationship between the amount of alcohol ingested during the prenatal period and the extent of damage caused by alcohol in the fetus, abstinence from alcohol at conception and during pregnancy is strongly recommended (Paoletti et al., 2013).
Pathophysiology
When alcohol is consumed by a pregnant woman, it crosses the placenta and rapidly reaches the fetus. There have been many studies, which have shown equivalent fetal and maternal alcohol concentrations, suggesting an unrestrained bidirectional movement of alcohol between the 2 compartments (Vaux, 2012). The fetus appears to depend on maternal hepatic detoxification because the activity of alcohol dehydrogenase (ADH) in the fetal liver is less than 10% of that seen in the adult liver (Vaux, 2012). In addition, the amniotic fluid acts as...
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...euronal plasticity, which is the ability of brain to be changed in relationship to previous experiences (Paoletti et al., 2013). During development, neuronal plasticity plays a key role in the processes of learning and memory (Medina, 2011). The proposed oxidative stress alcohol induced can explain the mechanism through which alcohol can exert harmful teratogenic effects on the brain during the third trimester (Brocardo, Gil-Mohapel, & Christie, 2011).
Clinical Manifestations
The leading cause of intellectual disability is maternal alcohol abuse (Sadler, & Langman, 2012).
Diagnosis
There are three major factors that must be addressed in the diagnosis of FASD in an individual: (1) physical growth, development, and structural defects (for example, dysmorphology); (2) cognitive function and neurobehavior; and (3) maternal exposure and risk (May & Gossage, 2011a).
The Centers for Disease Control and Prevention suggestion that a pregnant woman should not drink alcohol during pregnancy (Advisory on alcohol use in pregnancy 2005) has been widely criticized as being unnecessarily paternalistic, but the CDC goes further into explaining that, “Alcohol consumed during pregnancy increases the risk of alcohol related birth defects, including growth deficiencies, facial abnormalities, central nervous system impairment, behavioral disorders, and impaired intellectual development” (Advisory on alcohol use in pregnancy
(Malformations resulting from exposure to one of the most common teratogens—alcohol—can be observed notoriously in Fetal Alcohol Syndrome, or FAS, where patterns of mental and physical defects develop in association with high levels of alcohol consumption during pregnancy.) Though the toxicity of these teratogens is particularly damaging during the fourth through tenth weeks of gestation, teratogens can harm throughout the span of development in the womb. The manner in which a teratogen impacts the developing human may vary, though nicotine, caffeine and medication consumption are all directly related to physical development. These are examples of habitual teratogens, each contributing to low birth weight and behavioral problems in adolescents. The level of influence of any given teratogen depends on many factors; the first, called the “threshold effect,” occurs when a relatively harmless teratogen in small quantities becomes toxic at a specific exposure threshold....
LaPlante, Charil A., DP, C. Vaillancourt, and S. King. "Prenatal Stress and Brain Development." NCBI. U.S. National Library of Medicine, 05 Oct. 2010. Web. 03 Nov. 2013.
There are multiple criteria that come into play when determining a psychological disorder. One reason is because, it is hard to know for sure if an action is abnormal or not. Something could be abnormal in our country, but a custom in another. According to Psychology in Action, “[r]ather than being fixed categories, both “abnormal” and “normal” behaviors exist along a continuum, and no single criterion is adequate for [i]dentifying all forms of abnormal behavior” (Huffman). There are four criteria used to determine whether a behavior is abnormal.
Many studies have established that a developing organism is susceptible to exogenous and endogenous factors during certain stage of the organism’s development. The effects of ethyl alcohol or ethanol on the developing fetus, which manifest a variety of characteristic abnormalities, are collectively called Fetal alcohol Syndrome. Ethanol exposure to the fetus causes various malformation ranging from the cellular to the organismic levels with the eventual results frequently being different levels of mental retardation (3).
According to Hassold and Sherman (2002), the probability of giving birth to a child with DS is not linked to any race, ethnicity, socioeconomic status or geographic location. Maternal age seems to be the only etiological factor that may cause DS. Some characteristics of DS include: deep folds at the corners of the eyes, hypotonia, short stature, flexible joints, small oral cavity and heart defects (Taylor, Richards, & Brady, 2005). Most individuals with DS have a moderate intellectual disability, although there is a range of disability, from severe to high functioning (IQ above 70). Since DS is a birth defect and not a disease, there are no treatment options.
When it comes to pregnancy, expectant mothers usually have a lot of questions and concerns. One such concern is alcohol consumption. Some people feel that it is okay while others are against the consumption. However those who drink take a huge risk that can result in what is referred to as Fetal Alcohol Spectrum Disorders (FASD). This umbrella term is used to describe the range of damage from alcohol exposure to a fetus. The characteristics, diagnosis, and the mother are all important factors to look at when trying to understand these birth defects.
A mother who drinks while she is pregnant stands a high risk of harming their unborn child because the alcohol passes through her blood to her baby, and that can harm the development of the baby’s cells. This is most likely to harm the baby’s brain and spinal cord. Many of the common effects of a child suffering from fetal alcohol spectrum disorder (FASD) is: distinctive facial features, growth problems making them smaller than the average child, and learning and behavior problems.
In 2004, the term “Fetal Alcohol Spectrum Disorders” was agreed upon by a group of national experts to be used as an umbrella term to encompass all the disorders caused by prenatal alcohol exposure. When signs of brain damage appear following fetal alcohol exposure in the absence of other indications of FAS, the conditio...
Alcohol (wine, beer, or liquor) is the leading known preventable cause of developmental and physical birth defects in the United States. When a woman drinks alcohol during pregnancy, she risks giving birth to a child who will pay the price, in mental and physical deficiencies, for his or her entire life. One study (Phyllis Trujillo Lewis, MA, Philip A. May, PhD, and Virginia C. Shipman, PhD, 2007) asserted that “Numerous studies on alcohol-related birth defects have concluded that maternal drinking, compounded by other risk factors, leads to fetal alcohol syndrome (FAS). FAS is a serious birth defect and the most common non-genetic cause of mental retardation” as said by (Hankin, 2002; Abel & Sokol,1986; O’Connor, Kogan, & Findlay, 2002; May & Gossage, in press). It is unknown how much maternal alcohol consumption results in FAS or other related disorders, or why some women who drink are at substantially higher risk of giving birth to a child with alcohol-related disabilities than others (Stratton, Howe, & Battaglia, 1996). However, researchers have identified several maternal risk factors differentially associated with FAS. These include advanced maternal age, number of pregnancies, previous births of a child with FAS, cohabitation with a male partner who drinks heavily, and low socioeconomic status (SES; May et al. 2004; 2008a; Viljoen et al., 2002). FAS is 100% preventable, which makes awareness and education the core preventative method for FAS. It is seen through Lewis, May & Shipman’s research that women who are less educated are less aware of the risks involved with drinking while pregnant.
In 2006, 49% of all pregnancies in the United States were reported unintended on a national survey.1 The highest rate of preventable birth defects and mental retardation is due to alcohol use.2 In this paper, I will further discuss FAS, the potential effects of binge drinking during the embryonic stage of gestation, and what actions need to be taken in order to reduce the incidences of alcohol-related birth defects. Alcohol Consumption During Pregnancy Alcohol is an ethanol containing substance that is a common beverage in many social and private settings. Alcohol is also a teratogen, therefore alcohol consumption and binge drinking potentially pose a substantial risk to the embryo or fetus. In 2013, the Centers for Disease Control conducted a telephone survey of women in the age range of 18-44 years regarding alcohol use.3
For many years it was believed that alcohol can affect an unborn child only after placenta and umbilical cord are fully developed. Ten to fourteen days after fertilization the egg arrives into the uterus, and nests there. In that phase there is no connection between a mother’s bloodstream and a child via umbilical cord, but while placenta is developing embryo is getting its nutrients from mother’s blood through yolk sac. The minute alcohol enters mother’s bloodstream trough her stomach and the small intestine, it will also get to the embryo by cellular processes and it will disturb the cell division.
Identification of any psychosocial or contextual factors to be considered, as outlined in the DSM-5
As the human body goes through different experiences, the brain grows, develops, and changes according to the environmental situations it has been exposed to. Some of these factors include drugs, stress, hormones, diets, and sensory stimuli. [1] Neuroplasticity can be defined as the ability of the nervous system to respond to natural and abnormal stimuli experienced by the human body. The nervous system then reorganizes the brain’s structure and changes some of its function to theoretically repair itself by forming new neurons. [2] Neuroplasticity can occur during and in response to many different situations that occur throughout life. Some examples of these situations are learning, diseases, and going through therapy after an injury.
The problem of alcohol use is very relevant nowadays. Today alcohol consumption characterized by vast numbers in the world. All of society is suffering from this, but primarily jeopardized the younger generation: children, teenagers, young people, and the health of future mothers. Because alcohol is particularly active effect on the body that are not formed, gradually destroying it. The harm of alcohol abuse is evident. It is proved that when alcohol is ingested inside the body, it is carried by blood to all organs and has harmful effect on them until destruction. Systematic use of alcohol develops a dangerous disease such as alcoholism. Alcoholism is dangerous to human health, but it is curable as other diseases. The big problem is that most of the alcohol products which are made in private places contain many toxic substances, defective products often leads to poisoning and even death. All this has negative impact on society and its cultural values.