Maternal Alcoholism and Fetal Alcohol Syndrome

The fetal alcohol syndrome is the third most common recognizable cause of mental retardation in the United States. Many of the features of the fetal alcohol syndrome are secondary to the effect of alcohol on brain development. These include microcephaly, short palpebral fissures, the long smooth philtrum and thin vermilion of the upper lip, joint anomalies, altered palmar crease pattern, and mental retardation. Approximately 40% of babies born to alcoholic women and 11% of babies born to nonalcoholic moderately drinking women have evidence of the prenatal effect of alcohol. Alcohol, like other teratogens, causes a spectrum of defects. Thus, affected children may show great variability from the fullblown fetal alcohol syndrome to much milder effects of alcohol, some of which may not be obvious until school age. A "safe" amount of alcohol probably does not exist for the pregnant woman. Depending on unknown factors, what may be a "safe" amount for some women, may be devastating to the unborn baby of another. Two factors, the severity of the maternal alcoholism and the extent and severity of the pattern of malformation, seem to be most predictive of the ultimate prognosis for children with the fetal alcohol syndrome. Any decision to file child abuse changes against a mother whose baby was prenatally exposed to alcohol should be based on the parents ability to provide a stable home environment and not on whether the baby has features of the fetal alcohol syndrome. The fetal alcohol syndrome, the third most common recognizable cause of mental retardation, is completely preventable. All attempts must be made to educate people regarding the deleterious effect of alcohol.

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Ignored Papers, Invented Quotations: A History of Fetal Alcohol Syndrome

Neonatology ◽

10.1159/000518534 ◽

2021 ◽

pp. 1-7

Author(s):

Michael Obladen

Keyword(s):

Fetal Alcohol Syndrome ◽

High Rate ◽

Fetal Alcohol ◽

Parental Alcoholism ◽

Maternal Alcohol Consumption ◽

Citation Practice ◽

History Of ◽

Maternal Alcoholism ◽

The 19Th Century ◽

Severe Growth

Given the high rate of alcoholism throughout history, its effects on the fetus may have existed for millennia. But, the claim that Greeks and Romans were aware of fetal alcohol syndrome rests on incorrect citations. From 1725, maternal alcohol consumption was associated with retarded fetal growth and neurological anomalies. From 1809, scientists followed Lamarck’s theory that the disorders parents acquire during their lifetime are passed on to their offspring. Fetal effects were thought to be inherited mainly from the father. During the 19th century, parental alcoholism became associated with malformations. In 1915, Ballantyne distinguished genetic influence via germ cells from toxin’s effect on the embryo. Fetal alcohol syndrome was characterized by Rouquette [Influence de la toxicomanie alcoolique parentale sur le développement physique et psychique des jeunes enfants] in 1957 and Lemoine et al. [Ouest Medical. 1968;21:476–482] in 1968 as consisting of 4 features: (A) facial anomalies (narrow forehead, retracted upper lip, and cupped ears), (B) severe growth retardation (prenatal and postnatal), (C) malformations (limbs, cardiac, and visceral), and (D) central nervous system anomalies (hyperexcitability and mental retardation). But, their studies, written in French, remained disregarded. In 1973, Jones et al. [Lancet. 1973;302:999–1001] reported “the first association between maternal alcoholism and aberrant morphogenesis in the offspring.” The history of fetal alcohol syndrome reveals shortcomings in citation practice. Alleged quotations remained unverified, non-English publications neglected, and short quotations taken out of context. Prejudiced by religious and abstinence groups, reports on alcohol damage to the unborn were fraught with emotions, moralizing, social implications, and presentism, the interpretation of past events with present knowledge.

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