Alcohol use in pregnancy and its impact on the mother and child

Abstract

Aims To review the impact of prenatal alcohol exposure on the outcomes of the mother and child. Design Narrative review. Setting Review of literature. Participants Mothers and infants affected by prenatal alcohol use. Measurements Outcomes of mothers and children. Findings Prenatal alcohol exposure is one of the most important causes of preventable cognitive impairment in the world. The developing neurological system is exquisitely sensitive to harm from alcohol and there is now also substantial evidence that alcohol-related harm can extend beyond the individual person, leading to epigenetic changes and intergenerational vulnerability and disadvantage. There is no known safe level or timing of drinking for pregnant or lactating women and binge drinking (> four drinks within 2 hours for women) is the most harmful. Alcohol-exposure increases the risk of congenital problems, including Fetal Alcohol Spectrum Disorder (FASD) and its most severe form, Fetal Alcohol Syndrome (FAS). Conclusion The impact of FASD and FAS is enduring and lifelong with no current treatment or cure. Emerging therapeutic options may mitigate the worst impact of alcohol exposure but significant knowledge gaps remain. This review discusses the history, epidemiology and clinical presentations of prenatal alcohol exposure, focusing on FASD and FAS, and the impact of evidence on future research, practice and policy directions.

Social predictors of alcohol use and cessation during pregnancy among Japanese women: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study

“…It is possible that highly educated women are more receptive to messages offered during the above opportunities than less educated women, because education conveys factual health-related knowledge and raises cognitive skills that affect healthpromoting decisions [33,37]. However, early pregnancy is the time of greatest neurological vulnerability for the fetus [2,38]. The message that alcohol can damage a fetus even during the earliest weeks of pregnancy should be spread more widely.…”

Reproductive Health and Liver Disease: Practice Guidance by the American Association for the Study of Liver Diseases

“…Effects of the fetus are well recognized, and the complications of fetal alcohol spectrum disorder are longlasting. (232,233) These statistics highlight the importance of inquiring about alcohol use in all women, especially as a component of preconception and pregnancy management. For women with alcoholassociated liver disease (ALD), the achievement of alcohol abstinence is the most important aspect of preconception management.…”

Addiction Teaching and Training in the General Psychiatry Setting

“…For example, adolescents, perinatal women, and geriatric patients may be less likely to be screened for substance use due to assumptions that these groups are less likely to use substances. In the geriatric population, SUDs may be challenging to identify because symptoms of alcohol and drug use can resemble illnesses common in later life, and this population many have difficulty identifying their risky substance-related behaviors [11,14].…”