Monday, 31 August 2015

HEALTH RISKS OF ALCOHOL IN PREGNANCY

No safety had been documented in modern literature regarding use of alcohol in pregnancy.  Irrespective of how small in amount a pregnant woman consumes alcohol, it carries a potential threat to the growing fetus in utero in diverse ways.
The first three months or first trimester is period marked with exponential fetal growth and most of fetal anomalies cognates from this period when there is interruption in normal growth pattern of the embryo and fetus.[] Alcohol corrupts brain cells migration and organization which imposes a threat to the brain structural integrity.[3]

A child born by alcoholic mother may exhibit neurological deficits in hearing, vision, learning and intelligence as a result of alcohol damaging effect to the hippocampus of the brain which is prevalent during the third trimester of pregnancy. [3]

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It is recommended that any woman who is pregnant or intending to become pregnant should abstain from alcohol use.[1]. If one wasn't aware that she was pregnant should stop taking alcohol as soon as she realizes. [2] Alcohol use during pregnancy can have a whole lot of effects ranging from gross to subtle impairment in function which is variable to the dose of alcohol ingested, gestation and the frequency of fetal alcohol exposure during pregnancy.[3] 

Alcohol exposure even at low repetitive doses may result in intellectual deficits, behavioral problems and growth impairment. [4] 

NOTE: Pregnant women are given folic acid supplements to enable healthy growth and development of the brain and spinal cord. [5] Alcohol deactivated folate in blood and further blocks its absorption from the gastrointestinal tract. [6] 

Alcohol crosses the 'placental barrier' to the fetus easily. Alcohol is mostly metabolized and detoxified in the liver. During intra-uterine growth, the fetal liver is immature and lacking in enzyme alcohol dehydrogenase to detoxify alcohol. Extrapolating from this point, this translates to prolonged intoxication and exposure of the fetus to alcohol putting the fetus at triple risk. [3]

There is a whole spectrum of complications that comes along with drinking a lot of alcohol during pregnancy. These complications are life long and may be mild or severe such as:-
  • Miscarriage and still births. [2]
  • Cerebral palsy. [2]
  • Premature births. [2]
  • Low birth weight babies.[4]
READ: ALCOHOL BLACKOUTS- 10 avoidable risk factors

Other significant feature which may be noted in children born by mother who drink a lot are:-
  • Behavioral deficits. [2] like unlawfulness.
  • Attention problems [2]
  • Heart defects [2] e.g abnormal heart sound, [3] ventricular and aortic septal defects. [4]
  • Oral- facial cleft to include cleft lip and cleft palate which requires surgical interventions. [4]
  • Abnormal position and function of bones and joints[3]
  • Abnormal palmar creases pattern.[3]
  • Eye involvement may cause light sensitivity, eye movements which are involuntary, small eyes and decreased visual acuity.[3]
  • Abnormal facial shape.[2] This may be characteristic of brain damage though brain damage may exist as an entity in the absence of facial anomalies. These includes:-
1. A decreased eye width (Small palpebral fissures)
2. Thin upper lip (thin vermilion)
3. Flattened groove between the nose and upper lip (smooth philtrum)[3]
  • Problems with movement, coordination and balance making these children have delayed milestones. [2]
  • Learning and speech problems.[2]
  • Significant growth deficit which is below the average height and weight for age. [3]
  • Structural brain malformation like microcephally (small head size reflecting a problem with corpus collosum or cerebellar hypoplasia) This may be diagnosed immediately after birth as the midwife takes the head circumference or before birth through medical imaging. [3]. 
  • Neurological development disorder which may be symbolized by seizure disorder, hearing loss due to the problem with nerves, poor gait, clumsiness, impaired hand-eye coordination and deficit in fine motor skills like writing. [3]
1. Alcohol, Medicines and Drugs -Pregnancy and Baby Guide -NHS Choices. Last reviewed 06/07/2015. Address:http://www.nhs.uk/Conditions/pregnancy-and-baby/pages/alcohol-medicines-drugs-pregnant.aspx. Viewed on: 17/07/2015.
2.Alcohol and Pregnancy -Medlineplus Medical Encyclopedia. Last update: 03/11/2014. Address:http://www.nlm.nih.gov/medlineplus/ency/article/007454.htm. Viewed on 17/07/2015.
3. Fetal Alcohol Spectrum Disorder -Wikipedia, the free encyclopedia. Last edited: 9th July, 2015 by Doc James. Address:https://en.m.wikipedia.org/wiki/Fetal_alcohol_spectrum_disorder. Viewed on: 17/07/2015.
4. Alcohol Abuse in Pregnant Women: Effects on Fetus and Newborn, Mode of Action and Maternal Treatment. By Asher Arnoy and Zivanit Ergaz. Published online: 2010 Jan 27. Address: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2872283/. Viewed on 17/07/2015.
5. Folic Acid and Pregnancy (Folic acid benefits in pregnancy): WebMD. Reviewed by Nivin Todd, MD, August 22, 2014. Address:http://www.m.webmd.com/baby/folic-acid-and-pregnancy. Viewed on 16/07/2015.
6. Alcohol: Balancing Risks and Benefits|The Nutrition Source|Harvard T.H Chan School of Public Health. Address:http://www.hsph.harvard.edu/nutritionsource/alcohol-full-story/. Viewed on: 16/07/2015.