Effects of nutrition and gestational alcohol consumption on fetal growth and development

Abstract

Fetal alcohol exposure can lead to a range of developmental disorders, including impaired fetal growth and development of multiple organ systems. These disorders are grouped under the term fetal alcohol spectrum disorders (FASDs). Adequate nutrition and a conducive intrauterine environment are essential for healthy fetal development. Nutrient deficiencies resulting from inadequate maternal nutrient ingestion may be compounded by alcohol-induced altered nutrient metabolism, placental clearance, and malabsorption. Alcohol-induced alteration of the intrauterine environment is the main source of developmental deficits and nutritional insufficiencies can worsen the effects on fetal development. In this review, we discuss studies examining the collective and interactive effects of nutrition (specifically iron, selenium, vitamin A, thiamine, zinc, folate, vitamin B12, choline, and amino acids) relative to gestational alcohol consumption and its effects on fetal growth and development. We also summarize scientific reports that tested potential benefits of micronutrient supplementation in animal models of fetal alcohol spectrum disorders and in humans. In summary, the deleterious effects of alcohol exposure in relation to nutrient homeostasis further validate that avoidance of alcohol consumption during pregnancy is the most effective way to mitigate the teratogenic effects of alcohol.

Síndrome alcoólica fetal no contexto de pós-pandemia da COVID-19

“…Insegurança alimentar pode ser definida como a falta de acesso a uma alimentação e nutrição adequadas por razões físicas e sociais, sendo, também, diretamente influenciada pelas condições econômicas do país (NILES MT, et al, 2020). Em relação a saúde materna e ao desenvolvimento fetal, uma boa nutrição é essencial e desempenha um papel crítico no crescimento fetal, no controle da expressão do genoma e na neuroproteção do feto (NAIK VD, et al, 2022). A nutrição adequada é importante em todos os períodos gestacionais, e nesse caso depende do metabolismo da mãe, da integridade de seu estado nutricional e do mecanismo de transporte placentário (SEBASTIANI G, et al, 2018).…”

“…O álcool interfere diretamente ao inibir a ingestão adequada de nutrientes ao substitui-los na dieta, ou indiretamente ao interferir no metabolismo, inibindo a absorção intestinal e aumentando a excreção urinária. Também, altera o fornecimento fetal de nutriente, ao diminuir a disponibilidade deste e interferir no transporte placentário, pois prejudica a circulação sanguínea para a placenta ao gerar estresse oxidativo e diminuir a disponibilidade de óxido nítrico (SEBASTIANI G, et al, 2018;NAIK VD, et al, 2022).…”

Alcohol blunts pregnancy‐mediated insulin resistance and reduces fetal brain glucose despite elevated fetal gluconeogenesis, and these changes associate with fetal weight outcomes

“…Maternal nutrition is an important modifier of these fetal outcomes, along with dose, timing, and frequency of alcohol consumption 4–6 . Alcohol interferes with the absorption and/or utilization of nutrients required for fetal growth and development, including choline, folate, iron, and various amino acids 7 . Although excessive alcohol intake is well known to enhance hepatic insulin sensitivity 8–10 and inhibit gluconeogenesis 11,12 in nonpregnant people, very little is known about alcohol's impact on these processes during pregnancy and the potential contribution of such disruptions to the subsequent deficits in fetal growth and brain development 13 …”

“…[4][5][6] Alcohol interferes with the absorption and/or utilization of nutrients required for fetal growth and development, including choline, folate, iron, and various amino acids. 7 Although excessive alcohol intake is well known to enhance hepatic insulin sensitivity [8][9][10] and inhibit gluconeogenesis 11,12 in nonpregnant people, very little is known about alcohol's impact on these processes during pregnancy and the potential contribution of such disruptions to the subsequent deficits in fetal growth and brain development. 13 Healthy pregnancy is characterized by adaptive changes in maternal energetics and metabolism that support the growing fetus.…”

Fetal Alcohol Spectrum Disorder and Iron Homeostasis

“…The list of nutrients that alcohol interferes with includes the essential mineral iron [ 15 ]. Iron plays a critical role in oxygen transport, organ formation, and brain development [ 16 ].…”