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Government Publication on "Fetal Alcohol Syndrome"

Here's a passage from "Fetal Alcohol Syndrome" in the National Institute on Alcohol Abuse and Alcoholism publication, Alcohol Alert No.13, July 1991...part of the US Dept of Health & Human Services, Public Health Service, National Institutes of Health. The article has 28 references.

Apart from epidemiology, the key questions in FAS research include, How much alcohol is too much? and, When is the fetus at greatest risk? The major problem in addressing these questions is the lack of a specific physiological marker currently available to measure alcohol intake, and self-reports of alcohol consumption may be unreliable, perhaps especially so during pregnancy. Morrow-Tlucak and colleagues found that women with more-serious alcohol-related problems are those more likely to underreport their alcohol consumption when interviewed during pregnancy.

While it is apparent that children who meet the criteria for FAS are born only to those mothers who consume large amounts of alcohol during pregnancy, studies have reported neurobehavioral deficits and intrauterine growth retardation in infants born to mothers who reported themselves to be moderate alcohol consumers during pregnancy. In a prospective study of 359 newborns, Ernhart and colleagues found a trend toward increasing head and facial abnormalities with increasing embryonic alcohol exposure. An effect occurred even at the lowest reported levels of alcohol intake, so that a clear threshold (minimum amount of alcohol to produce an effect) could not be defined.

Given the range of defects that result from prenatal alcohol exposure, the search for an overall threshold for fetal risk may be unreasonable. Instead, each abnormal outcome in brain structure and function and growth might have its own dose-response relationship. Animal research had shown that different profiles of alcohol-related birth defects are related to critical periods for specific aspects of fetal development. Thus, heavy alcohol consumption throughout pregnancy results in a wide variety of effects characteristic of FAS, while episodic binge drinking at high levels results in partial expression of the syndrome, with the abnormalities being unique to the period of exposure. Vulnerability of individual organ systems may be greatest at the time of their most rapid cell division.