Ethanol and the placenta: A review

Burd, Larry; Roberts, Drucilla J.; Olson, Meredith; Odendaal, Hein J.

doi:10.1080/14767050701298365

Cited by 133 publications

(102 citation statements)

References 97 publications

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“…3,4 Siblings of children with FASD have an increased rate for FASD. 5,6 Fetal alcohol syndrome (FAS) is the most readily identifiable category of FASD. In 2010, the prevalence of FAS in the United States was reported to be 0.2-1.5 cases per 1000 live births, 7 a review paper of more recent studies reports rates of FAS of 2 to 7 per 1000 live births.…”

Section: Introductionmentioning

confidence: 99%

Prenatal alcohol exposure, blood alcohol concentrations and alcohol elimination rates for the mother, fetus and newborn

2012

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Fetal alcohol spectrum disorders (FASDs) are a common cause of intellectual impairment and birth defects. More recently, prenatal alcohol exposure (PAE) has been found to be a risk factor for fetal mortality, stillbirth and infant and child mortality. This has led to increased concern about detection and management of PAE. One to 2 h after maternal ingestion, fetal blood alcohol concentrations (BACs) reach levels nearly equivalent to maternal levels. Ethanol elimination by the fetus is impaired because of reduced metabolic capacity. Fetal exposure time is prolonged owing to the reuptake of amniotic-fluid containing ethanol by the fetus. Alcohol elimination from the fetus relies on the mother's metabolic capacity. Metabolic capacity among pregnant women varies eightfold (from 0.0025 to 0.02 g dl À1 h À1 ), which may help explain how similar amounts of ethanol consumption during pregnancy results in widely varying phenotypic presentations of FASD. At birth physiological changes alter the neonate's metabolic capacity and it rapidly rises to a mean value of 83.5% of the mother's capacity. FASDs are highly recurrent and younger siblings have increased risk. Detection of prenatal alcohol use offers an important opportunity for office-based interventions to decrease exposure for the remainder of pregnancy and identification of women who need substance abuse treatment. Mothers of children with FAS have been found to drink faster, get drunk quicker and to have higher BACs. A modest increase in the prevalence of a polymorphism of alcohol dehydrogenase, which increases susceptibility to adverse outcomes from PAE has been reported. Lastly, detection of alcohol use and appropriate management would decrease risk from PAE for subsequent pregnancies.

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Section: Introductionmentioning

confidence: 99%

Prenatal alcohol exposure, blood alcohol concentrations and alcohol elimination rates for the mother, fetus and newborn

2012

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“…Alcohol consumption 15 In addition, poor placental function, reflected by low levels of pregnancy-associated plasma protein A in the first trimester, was associated with more stillbirths, some of which were unexplained and others caused by placental abruption. 16 Furthermore, many stillbirths, including unexplained ones, are related to poor placental function.…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately no autopsies were done and no placentas sent for histological examination, as little is known about the effects of heavy drinking on the human placenta. 15 Financial constraints at hospitals in developing countries limit the use of non-essential special investigations.…”

Section: Discussionmentioning

confidence: 99%

The role of prenatal alcohol exposure in abruptio placentae

2010

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“…Together, these insults place infants at risk for microcephaly, epilepsy, cerebral palsy, cognitive deficits and attention deficit disorders (179,181,(189)(190)(191)(192). Although the severity of these deficits associated with PAE are time, dose and exposure dependent (190) including opioids (190).…”

Section: Prenatal Alcohol Exposurementioning

confidence: 99%

The Unifying Effects of Maternal-Placental-Fetal Axis Dysregulation on Neurodevelopment Following Infectious and Toxic In Utero Insults

Yellowhair¹,

Oppong²,

Maxwell³

et al. 2017

MRAJ

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Homeostasis during pregnancy and in the in utero environment is essential for prenatal development. Prenatal maturation is hallmarked by an orchestrated and rigorous developmental program characterized by critical cascades in multiple organ systems. During these critical periods of development, however, potential vulnerability to injury exists throughout pregnancy. Indeed, the developing central nervous system (CNS) is extremely vulnerable to environmental insults throughout the entirety of gestation. These insults can adversely affect the developing brain and spinal cord, and permanently alter the neurodevelopmental trajectory. Specifically, in utero insults and dysregulation of the maternal-placentalfetal axis can change molecular, cellular, structural, and functional development of the CNS, culminating in adverse outcomes and neurological disorders throughout postnatal life. In this review, we will discuss common infectious and toxin-induced in utero insults that have recently garnered attention, including Zika virus, prenatal opioid and alcohol exposure, and chorioamnionitis. The goals are to identify common pathophysiological mechanisms, to emphasize the urgent need for new diagnostic tools, and to promote a broader understanding of the diverse array of neurological outcomes presenting in these children throughout their lifespan. With an increasing number of infants exposed to in utero infections and toxins, and the expanding public health awareness of the consequences of Zika infection, the opioid crisis, alcohol consumption during pregnancy, and the frequency of preterm birth in the United States, familiarity with the underlying mechanisms of each of these insults is paramount to improve the diagnosis and treatment for this exceedingly vulnerable patient population.

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Ethanol and the placenta: A review

Cited by 133 publications

References 97 publications

Prenatal alcohol exposure, blood alcohol concentrations and alcohol elimination rates for the mother, fetus and newborn

Prenatal alcohol exposure, blood alcohol concentrations and alcohol elimination rates for the mother, fetus and newborn

The role of prenatal alcohol exposure in abruptio placentae

The Unifying Effects of Maternal-Placental-Fetal Axis Dysregulation on Neurodevelopment Following Infectious and Toxic In Utero Insults

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