According to the National Institute on Alcohol Use and Alcoholism (NIAAA) and the Center for Disease Control and Prevention (CDC):
- Fetal alcohol syndrome (FAS) estimates range from two to seven births per 1,000 births.
- Fetal alcohol spectrum disorder (FASD) means that the infant displays some symptoms of FAS but doesn’t have enough symptoms to be diagnosed with the disorder. FASD is probably much more common and may range from 20 to 50 births per 1,000.
- Despite these estimates, it is impossible to accurately estimate the prevalence of FASD due to numerous unreported cases.
- The assessments of children at school age suggest an even higher estimate of FASD symptoms that may range from 2 percent to 5 percent of school-aged children.
Alcohol Use During Pregnancy
Researchers and clinicians describe a teratogen as a substance that interrupts the process of normal development in the fetus during pregnancy. The developing fetus is sensitive to numerous teratogens, and varying exposures at specific levels of development can often affect different aspects of development. The development of the central nervous system in the fetus is extremely vulnerable to teratogens early in development.
Alcohol is an identified teratogen because it is readily passed from the mother to the child if the mother drinks alcohol when she is pregnant. Although there are numerous conflicting reports regarding when a pregnant woman can or cannot use alcohol, the CDC recommends that pregnant women do not drink alcohol at all.
Through numerous public statements, major health organizations, such as the National Institute of Health (NIH), the World Health Organization (WHO), and the CDC, advise that there is no known safe level of alcohol use for a pregnant woman. The specific type of alcoholic beverages does not provide any safeguard against this warning, despite some beliefs that a single glass of wine or beer is safe. These organizations advise that a woman who discovers she is pregnant should immediately refrain from any alcohol use, and any woman planning to get pregnant should immediately discontinue any use of alcoholic beverages. Any woman who discovers that she is pregnant and has used alcohol should immediately stop drinking and consult with her physician.
Research findings from the above organizations have described numerous effects that can be associated with alcohol use in pregnant women. The alcohol that a pregnant woman consumes is directly transmitted to her baby through the umbilical cord, and this can result in significant issues, including miscarriage, stillbirth, and numerous potential birth defects if the child survives. These effects include:
- Neural tube issues: The area of the embryo that eventually develops into the brain and spinal cord (the central nervous system) is referred to as the neural tube. Alcohol use early in pregnancy (most often within the first month but anytime within the first trimester) may lead to defects associated with the neural tube’s development.
- Anencephaly describes the incomplete development of the brain and spinal cord in infants that results in high mortality rates. Alcohol increases the risk for this defect.
- Chiari malformations result when the brain and spinal cord are undifferentiated and brain matter extends into the spinal cord, leading to significant developmental problems and issues with the ability to learn and develop cognitively.
- Spina bifida occurs when the spinal column in the fetus does not completely close and can lead to numerous issues, including paralysis of the legs.
- Fetal alcohol spectrum disorders: FASDs represent a large collection of potential issues that occur as a result of alcohol exposure to the fetus. There can be numerous issues involved, such as:
- Low birth weight, which is associated with various health conditions in infants
- Decreased growth in the fetus and later in childhood
- Lower than expected head circumference in children compared to children without FASD, which can result in significant cognitive issues
- Delays in developmental milestones, such as when the child begins to walk, talk, etc.
- Symptoms that are often seen in children with attention deficit hyperactivity disorder (ADHD) or learning disabilities
- Decreased IQ scores compared to normal children
- Issues with movement, including problems with motor coordination
- Problems with vision or decreased hearing abilities
- Abnormal development of the face, particularly in the area that is described as the philtrum (the ridge that is just above the upper lip), the eyes, and the ears
- Cardiac issues, as up to one-third of children with symptoms of FASD also have malformations of the heart that can result in permanent cardiac issues
- Poor skeletal development
- Hypoplasia, which are development problems with the kidneys that can lead to chronic renal failure or other issues.
- Renal agenesis, a condition that can occur where the child is born without kidneys
The symptoms of FASD are not reversible. In addition, it is virtually impossible to predict what child will develop one of the symptoms and what child will not. Thus, the notion that it is not safe to use any form of alcohol in any amount while pregnant remains the most common sense notion.
In addition to the above symptoms, other issues include:
- Fetal alcohol syndrome: FAS is a specific nonreversible disorder that is a result of alcohol use during pregnancy. The disorder consists of significant developmental delay (formally known as mental retardation), significant brain involvement, heart malformations, poor growth rate, skeletal malformations, poor motor skills, and significant learning disabilities. The facial features associated with FAS include a short or upturned nose, lack of the philtrum, flat cheeks, and small eyes. These may resolve to some extent as a child develops, but the cognitive and other issues that occur remain. FAS is thought to be the number one preventable cause of mental development issues in children.
- Fetal alcohol effects: This term describes children with combinations of FASD symptoms that result from alcohol use and abuse by a pregnant mother.
It is important to remember what the CDC and other organizations continue to remind people concerning the effects of alcohol use by pregnant women. There are probably numerous symptoms in children that may not formally qualify for a diagnosis of FAS or that go undetected that result from alcohol use during pregnancy. The symptoms are easily preventable. Again, there is no safe level of alcohol use for a woman who is pregnant. This means that even drinking so-called nonalcoholic beer may present a significant risk because even these beverages have some level of alcohol in them.
The Child Is Not the Only One at Risk
While there is quite a bit of publicity regarding the effects on the developing child as a result of alcohol use by a pregnant woman, there are research studies that indicate potential issues for the mother; as a result of endangering the mother, the child is also at risk.
- The potential for accidents that can result in injuries are increased with alcohol use in anyone.
- Alcohol use is associated with numerous problems, such as being at increased risk to be a victim of a crime, a victim of abuse, and even a potential increase in suicidality.
- Alcohol poisoning is a serious issue that occurs in habitual drinkers.
- Alcohol use results in a decrease in rational behavior that can lead to the person engaging in risky behaviors, such as unprotected sex, drug use, etc.
- Chronic use of alcohol is associated with numerous health conditions that will also affect the fetus, such as cardiac problems, high blood pressure, ulcers, liver damage, etc.
- Chronic use of alcohol is associated with the use of other potentially dangerous substances that can affect the mother and the fetus, including tobacco, abuse of prescription drugs, use of illicit drugs, etc.
- Alcohol use is associated with cognitive problems, such as issues with memory and attention as well as an increased potential to be diagnosed with some other mental health disorder, such as depression, trauma- and stressor-related disorders, anxiety disorders, etc.
- Chronic alcohol use is associated with various social problems, including divorce, estrangement from family members, financial issues, a lower quality of life, etc.
In other words, any woman who is pregnant should not drink alcohol at all. It should be noted that it is certainly possible that someone who is unknowingly pregnant may continue to drink until they discover they are pregnant. If this happens, the woman should not panic but should immediately stop drinking and then consult with their physician to monitor the development of the child. If the individual is unable to stop their use of alcohol on their own, they should seek professional help.