Study of children whose mothers drank at least 4 alcoholic drinks per day during pregnancy

According to recent research funded and conducted in the USA and Chile (respectively), cognitive changes may be the only sign of fetal alcohol exposure.

The term fetal alcohol syndrome is used to refer to a pattern of birth abnormalities found in children of mothers who consumed considerable amounts of alcohol during pregnancy.

The abnormalities associated with fetal alcohol syndrome typically involve a characteristic pattern of facial abnormalities, growth retardation, and brain damage. Neurological and physical differences seen in children exposed to alcohol prenatally - but who do not have the full pattern of birth defects seen in fetal alcohol syndrome - are classified as fetal alcohol spectrum disorders.

About the study: The research was part of an on-going study of heavy drinking in pregnancy called the NICHD-University of Chile Alcohol in Pregnancy Study. Researchers asked over 9000 women at a community health clinic in Santiago, Chile about their alcohol use during pregnancy. They found 101 pregnant women (approx 1%), who said that they had consumed 4 or more drinks per day during their pregnancies and matched them with 101 women with similar characteristics but who had not consumed any alcohol during their pregnancy. After these women gave birth, the researchers evaluated the infants' health and conducted regular assessments of their physical, intellectual and emotional development through age 8.

Dr Devon Kuehn of the Epidemiology Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and colleagues reported the latest results of the study into the effects of consumption of alcohol during pregnancy. They found that most of the children they studied who had been exposed to high levels of alcohol in the womb did not develop the distinct facial features associated with fetal alcohol syndrome. However, many did display signs of abnormal intellectual or behavioral development.

The abnormalities of the nervous system believed to be due to - or at least that were associated with - fetal alcohol syndrome involved language delays, hyperactivity, attention deficits or intellectual delays. The researchers used the term a "functional neurologic impairment" to describe these abnormalities. The authors of the recent study recorded an abnormality of one of these types in approx 44% of children whose mothers drank at least 4 alcoholic drinks per day during pregnancy (note that this research concerned high levels of alcohol intake, not an occasional beer or glass of wine with a meal). By comparison, abnormal facial features were observed in approx. 17% of fetal alcohol exposed children.

" Our concern is that in the absence of the distinctive facial features, health care providers evaluating children with any of these functional neurological impairments might miss their history of fetal alcohol exposure," said Devon Kuehn, M.D..

" As a result, children might not be referred for appropriate treatment and services."

Research Results Summary:

The researchers documented differences in the rate of children affected in the following areas:

It has been reported that some of the women who had heavy drinking habits also engaged in binge drinking (5 or more drinks at a time). Even though these women already had high levels of alcohol consumption, the researchers stated that "binge drinking" increased the likelihood of adverse outcomes for their children.

Dr. Kuehn conducted the study with NICHD colleagues Tonia C. Carter, Ph.D., Mary R. Conley and Jim Mills, M.D, as well as researchers at the National Heart, Lung and Blood Institute, the National Capital Consortium, in Bethesda, M.D., and the University of Chile in Santiago. Their report is available online in Alcoholism: Clinical and Experimental Research.

About NIH:
The National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov - statement understood to be correct as of publication date.

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