Effects of Light Ethanol Consumption During Pregnancy: Increased Frequency of Minor Anomalies in the Newborn and Altered Contractility of Umbilical Cord Artery

Iveli, María Florencia; Morales, Silvina; Rebolledo, Alejandro; Savietto, Valeria; Salemme, Silvia; Apezteguía, María; Cecotti, Norma; Drut, Ricardo; Milesi, Verónica

doi:10.1203/pdr.0b013e3180332c59

Cited by 20 publications

(20 citation statements)

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“…We, like Iveli et al [5] , found no evidence that low maternal intake of alcohol was associated with offspring birth weight. Further, we found little evidence of association between birth weight and blood pressure, or either measure of PWV.…”

Section: Discussioncontrasting

confidence: 48%

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Maternal Alcohol Intake and Offspring Pulse Wave Velocity

et al. 2009

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Background: Intrauterine exposure to alcohol may affect cardiovascular development, increasing risk of cardiovascular malformations. Intrauterine exposure to light maternal alcohol intake has been reported to affect human umbilical arterial contractility, and adult sheep exposed in utero have had altered cerebrovascular reactivity. In human adults, alcohol intake affects arterial stiffness. Objectives: We investigated whether intrauterine exposure to alcohol was associated with childhood pulse wave velocity (PWV), a measure of arterial stiffness. Methods: On postnatal day 4, mothers of 147 twin pairs born in Tasmania from 1991 to 1993 reported alcohol intake during each trimester of pregnancy. At 9 years, child PWV was assessed over carotid-femoral and femoral-dorsalis pedis arterial segments by applanation tonometry. Results: Carotid-femoral PWV was 0.2 m/s (95% CI 0.06, 0.4) higher (indicating stiffer vessels) in children whose mothers drank alcohol in the 2nd trimester rather than abstained, after adjusting for potential confounding factors. A similar effect was not seen for femoral-dorsalis pedis PWV. Findings were independent of child blood pressure which correlated strongly with PWV. Alcohol intake varied little between trimesters, so it was not possible to assess the effect of timing of exposure. Conclusions: Carotid-femoral PWV in adults is predictive of cardiovascular morbidity and mortality. The degree of continuity between childhood and adulthood PWV is unknown, but as we found an association between prenatal alcohol exposure and carotid-femoral PWV at 9 years, a permanent change in vessel wall structure or function is possible. These findings need to be confirmed in other and larger cohorts, and mechanistic animal studies are needed.

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Section: Discussioncontrasting

confidence: 48%

“…A recent study found that umbilical arteries from babies exposed to low doses of alcohol in utero had reduced contractile responses compared with control arteries, independently of endothelial release of the vasodilators nitric oxide or prostacyclin [5] .…”

Section: Introductionmentioning

confidence: 99%

Maternal Alcohol Intake and Offspring Pulse Wave Velocity

et al. 2009

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“…The only previous study to examine low levels of PAE found that 66% of 79 newborns in the exposure group had some facial abnormality. 25 However, observed abnormalities were not objectively defined and assessed by unblinded observers. Moreover, the weekly mean intake of alcohol per trimester was reported retrospectively, and it is not possible to know if there were spikes in consumption at particular time points, including the first trimester and the period before recognition of pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Association Between Prenatal Alcohol Exposure and Craniofacial Shape of Children at 12 Months of Age

et al. 2017

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IMPORTANCEChildren who receive a diagnosis of fetal alcohol spectrum disorder may have a characteristic facial appearance in addition to neurodevelopmental impairment. It is not well understood whether there is a gradient of facial characteristics of children who did not receive a diagnosis of fetal alcohol spectrum disorder but who were exposed to a range of common drinking patterns during pregnancy.OBJECTIVE To examine the association between dose, frequency, and timing of prenatal alcohol exposure and craniofacial phenotype in 12-month-old children. DESIGN, SETTING, AND PARTICIPANTSA prospective cohort study was performed from January 1, 2011, to December 30, 2014, among mothers recruited in the first trimester of pregnancy from low-risk, public maternity clinics in metropolitan Melbourne, Australia. A total of 415 white children were included in this analysis of 3-dimensional craniofacial images taken at 12 months of age. Analysis was performed with objective, holistic craniofacial phenotyping using dense surface models of the face and head. Partial least square regression models included covariates known to affect craniofacial shape.EXPOSURES Low, moderate to high, or binge-level alcohol exposure in the first trimester or throughout pregnancy.MAIN OUTCOMES AND MEASURES Anatomical differences in global and regional craniofacial shape between children of women who abstained from alcohol during pregnancy and children with varying levels of prenatal alcohol exposure. RESULTSOf the 415 children in the study (195 girls and 220 boys; mean [SD] age, 363.0 [8.3] days), a consistent association between craniofacial shape and prenatal alcohol exposure was observed at almost any level regardless of whether exposure occurred only in the first trimester or throughout pregnancy. Regions of difference were concentrated around the midface, nose, lips, and eyes. Directional visualization showed that these differences corresponded to general recession of the midface and superior displacement of the nose, especially the tip of the nose, indicating shortening of the nose and upturning of the nose tip. Differences were most pronounced between groups with no exposure and groups with low exposure in the first trimester (forehead), moderate to high exposure in the first trimester (eyes, midface, chin, and parietal region), and binge-level exposure in the first trimester (chin).CONCLUSIONS AND RELEVANCE Prenatal alcohol exposure, even at low levels, can influence craniofacial development. Although the clinical significance of these findings is yet to be determined, they support the conclusion that for women who are or may become pregnant, avoiding alcohol is the safest option.

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“…Previous research found a difference in minor facial anomalies between infants born to women who abstained from alcohol and women with low alcohol intake [24]. We are using 3D imaging to analyse detailed facial morphometrics amongst the major PAE groups to identify subtle manifestations of PAE not evident clinically.…”

Section: Methodsmentioning

confidence: 99%

Study protocol: Asking QUestions about Alcohol in pregnancy (AQUA): a longitudinal cohort study of fetal effects of low to moderate alcohol exposure

Muggli

O’Leary

Forster

et al. 2014

BMC Pregnancy Childbirth

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BackgroundDespite extensive research, a direct correlation between low to moderate prenatal alcohol exposure (PAE) and Fetal Alcohol Spectrum Disorders has been elusive. Conflicting results are attributed to a lack of accurate and detailed data on PAE and incomplete information on contributing factors. The public health effectiveness of policies recommending complete abstinence from alcohol during pregnancy is challenged by the high frequency of unplanned pregnancies, where many women consumed some alcohol prior to pregnancy recognition. There is a need for research evidence emphasizing timing and dosage of PAE and its effects on child development.Methods/DesignAsking QUestions about Alcohol (AQUA) is a longitudinal cohort aiming to clarify the complex effects of low to moderate PAE using specifically developed and tested questions incorporating dose, pattern and timing of exposure. From 2011, 2146 pregnant women completed a questionnaire at 8-18 weeks of pregnancy. Further prenatal data collection took place via a questionnaire at 26-28 weeks and 35 weeks gestation. Extensive information was obtained on a large number of risk factors to assist in understanding the heterogeneous nature of PAE effects. 1571 women (73%) completed all three pregnancy questionnaires. A biobank of DNA from maternal and infant buccal cells, placental biopsies and cord blood mononuclear cells will be used to examine epigenetic state at birth as well as genetic factors in the mother and child. Participants will be followed up at 12 and 24 months after birth to assess child health and measure infant behavioural and sensory difficulties, as well as family environment and parenting styles. A subgroup of the cohort will have 3D facial photography of their child at 12 months and a comprehensive developmental assessment (Bayley Scales of Infant & Toddler Development, Bayley-III) at two years of age.DiscussionUsing detailed, prospective methods of data collection, the AQUA study will comprehensively examine the effects of low to moderate alcohol consumption throughout pregnancy on child health and development, including the role of key mediators and confounders. These data will ultimately contribute to policy review and development, health professional education and information about alcohol consumption for pregnant women in the future.

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Effects of Light Ethanol Consumption During Pregnancy: Increased Frequency of Minor Anomalies in the Newborn and Altered Contractility of Umbilical Cord Artery

Cited by 20 publications

References 35 publications

Maternal Alcohol Intake and Offspring Pulse Wave Velocity

Maternal Alcohol Intake and Offspring Pulse Wave Velocity

Association Between Prenatal Alcohol Exposure and Craniofacial Shape of Children at 12 Months of Age

Study protocol: Asking QUestions about Alcohol in pregnancy (AQUA): a longitudinal cohort study of fetal effects of low to moderate alcohol exposure

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