Welcome back, Cellfie readers! We hope you are enjoying the wide range of topics that our talented monthly writers are covering: we have had everything from the chemicals in skincare to genetic editing! Today, we bring you a fascinating but worrying article on the effects that alcohol can have on foetuses. Thank you to Ielaf for this article.
Weekly visits to the local pub to drink alcohol and socialise was the norm prior to the Covid-19 pandemic but lockdown has also seen an increase in alcohol consumption. With its ever-growing appearance on social media, TV and advertisements fuelling this varied but huge drink culture, clearly, you can see that alcohol has become an integral part of British culture.
However, it comes at no real surprise that alcohol does have its shortcomings and consequences. These include an increased risk of developing serious long-term physical health conditions such as gastritis, due to increase production of stomach acid caused by alcohol, digestion problems, compromised fertility and liver, mouth and other cancers as well as mental health issues such as depression and migraines. It is, therefore, vital to be aware of the facts and the science behind alcohol consumption in order to make informed and sensible lifestyle decisions.
This article will focus on Foetal Alcohol Syndrome (FAS) which is the consequence of maternal consumption of alcohol during pregnancy. About 1 in 10 women consume alcohol during pregnancy and 20% of those binge drink, consuming more than what is recommended and significantly increasing the likelihood of their child being born with the syndrome. FAS is a condition encompassing characteristic congenital physical abnormalities and intellectual disability due to impeded development of foetal tissue. In the Western world, this occurs in approximately 1 in 500 live births. The NHS, and low-risk drinking guidelines, have recommended that circumventing alcohol consumption during this critical period of time of foetal development is the safest option to reduce the risk of harm to the foetus.
How does this happen?
The foetus is connected to the placenta through the umbilical cord which facilitates the transport of oxygen and nutrients from the mother to the foetus via blood. Similarly, ethanol and other alcohol metabolites such as acetaldehydes can also pass through the placenta to the foetus. However, this presents as a problem for the foetus as it doesn’t have the enzymes to metabolise them. These substances intervene with cellular activities such as cell division, proliferation, cell growth and differentiation, influencing adverse effects on the development of foetus tissue including brain tissue. Both acetaldehyde and ethanol are teratogens, agents that cause embryo malformation, that impair placental transport function and can explain the mechanism behind FAS. Studies have also revealed reductions in the concentration of a crucial amino acid for foetal protein synthesis, foetal plasma histidine, due to maternal ethanol consumption, further explaining what may contribute to FAS.
Parts of the foetal brain tissue affected due to incomplete formation:
· Agenesis (incomplete development) of the corpus callosum which links the two left and right cerebral hemispheres for communication and signal transmission.
Ø Can cause learning disabilities
Ø Seizures
· Impaired frontal cortex and hippocampus development
Ø Poor memory retention and attention deficiency
Ø Affects communication
· Cerebellar hypoplasia (improper development of the cerebellum)
Ø Poor coordination and balance
Ø Difficulty with movement
What are the symptoms?
Symptoms may vary among individuals affected by FAS. However common symptoms and signs associated with the syndrome include low weight and height stemming from hindered growth, a smaller undeveloped head in a condition known as microcephaly and exhibition of certain facial characteristics such as a thin upper lip, short eye openings known as short palpebral fissures, a flat philtrum and a thin vermillion boarder. Other signs include limb dislocation, irritability and heart defects which may increase likelihood of developing cardiovascular complications later on.
Detection and diagnosis
A combination of recognising characteristic symptoms, using brain imaging and assessing maternal history of alcohol consumption during pregnancy can help confirm FAS as there is no specific or standard blood test for the syndrome. Unfortunately, alcohol consumption during pregnancy stigmatises and denounces pregnant women and may consequently make the woman disinclined to disclose drinking or indicate accurately the quantity of alcohol consumed. This can complicate and reduce accuracy of diagnosis and hence is the reason why physiological and behavioural examination are more depended on.
Treatment
There are no current treatments for FAS as the organ damage and defects are irreversible. Nevertheless, surgical procedures may be undertaken to fix heart and other defects that are a consequence of FAS to improve health and appearance. To improve the quality of life of persons with FAS, focus has been shifted more towards management of symptoms. Bespoke education programmes, to support those with learning difficulties, and behavioural interventions and therapy, to improve communication and coordination, are both examples of early interventions that deal with the physical and mental problems constituting FAS to improve child development and confidence with interaction in society.
Continually, findings regarding FAS undergo evaluation to further understand the syndrome. Ultimately, more needs to be done to increase drinking awareness, particularly the consequences of drinking during pregnancy, and to encourage access to alcohol support services in order to improve overall wellbeing. I would encourage you to look at other alcohol related issues pertaining to pregnancy such as miscarriages and premature births.
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