Ethanol: Toxicity and Dangers in Women of Child-Bearing Age

The World Health Organisation estimates that alcohol abuse by adults accounts for about 5% of global disease burden. Additionally, prenatal alcohol exposure (PAE) causes ‘fetal alcohol spectrum disorder’ (FASD). Depending on severity, FASD is characterised by low birth weight, small head size at birth and growth retardation. There are also facial features of narrow eyes, flat upper lip and midface and impaired fine motor skills, hearing loss, poor hand-eye coordination and cognitive impairment. World-wide, up to 10% of children may be affected by PAE. It is unclear what dose or pattern of drinking results in these damaging effects, but animal models suggest that high, acute doses of ethanol (‘binge drinking’) in early pregnancy can result in the facial changes of FASD, whilst sustained, lower dose intake in later pregnancy produces anxiety and depression-like symptoms and deficits of learning and memory. The mechanisms underlying the deleterious effects of PAE are also unresolved, but evidence exists of long-lasting damage due to oxidative stress, increases in inflammatory mediators and changes to the brain renin-angiotensin system. There is also evidence of epigenetic changes. There is a need to prevent or limit the potential adverse effects of ethanol on the unborn child. It is highly unlikely, however, that all sexually-active women of child-bearing age not using reliable contraception will abstain from alcohol. There is therefore a need to research methods of reducing ethanol toxicity for the unborn child and / or develop therapeutic strategies to reverse the deleterious effects of ethanol on the unborn child.