Alcohol consumption during pregnancy and its effects on neurodevelopment: what is known and what remains uncertain

Abstract

It has been claimed that mothers' drinking during pregnancy may affect the neurodevelopment of around 1% of all children. If this is true, then prenatal alcohol exposure represents an important risk factor for neurodevelopmental problems, giving rise to a large burden of disability which could be potentially preventable. Evidence to support this idea has come from animal experiments and human observational studies. However, such findings need to be supported by more robust research designs. Because randomized controlled trials in this area are neither feasible nor ethical, suggestions are made for further research making more use of natural experiments.

Alcohol consumption during pregnancy : Prevalence, predictors and prevention

“…It has been suggested that alcohol exposure during pregnancy, apart from FAS, is a major cause of neurodisability, affecting up to 1% of all children. However, as evidence of harm caused by exposure to small amounts is currently insufficient, it is not possible to determine whether or not this is accurate (Gray et al, 2009). In light of this uncertainty, authorities in Sweden advocate the precautionary principle and recommend total abstinence to pregnant women.…”

A Bio-Social and Ethical Framework for Understanding Fetal Alcohol Spectrum Disorders

“…Animal models are limited by alcohol's variable effect on different laboratory species compared to humans and by important differences in the cognitive and behavioural functioning of humans and commonly studied non-human species. For these reasons, observational studies of relationships between alcohol consumption by women during pregnancy and birth outcomes have been the most important way of studying FASD [2]. Most recently, longitudinal cohort studies have tested possible cause and effect relationships between low to moderate alcohol consumption and reduced IQ using novel statistical approaches that use genetic variations to control for the effects of confounding (via Mendelian randomization [22]).…”

“…Fetal Alcohol Spectrum Disorders (FASD) comprise a constellation of physical abnormalities and neurodevelopmental disorders that are caused by prenatal alcohol exposure [1,2]. At the most severe end of the spectrum is Fetal Alcohol Syndrome (FAS), diagnosed when a child exhibits specific facial dysmorphia, malformed organs, arrested mental development and growth, and when the mother is known to have consumed alcohol during pregnancy [3][4][5].…”

“…At the most severe end of the spectrum is Fetal Alcohol Syndrome (FAS), diagnosed when a child exhibits specific facial dysmorphia, malformed organs, arrested mental development and growth, and when the mother is known to have consumed alcohol during pregnancy [3][4][5]. Subsequent to the characterisation of FAS in the early 1970s, a range of other conditions, such as alcohol-related birth defects (ARBD) and alcohol-related neurodevelopmental disorders (ARND), have been included under the umbrella of FASD [1,2]. In these latter conditions, the facial deformities that characterise FAS may be absent.…”

“…In these latter conditions, the facial deformities that characterise FAS may be absent. Advances in epidemiology, biogenetics and neurobiology are changing how FASD is understood [2,[6][7][8][9] but there are as yet no biomarkers or definitive diagnostic tests for FASD. A diagnosis of FASD is conferred on the basis of clinical judgement according to a number of different diagnostic criteria, and there is some debate as to the validity of different approaches to its diagnosis [10].…”