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June 7, 2000
News this month A single drinking binge by a pregnant woman can be enough to cause irreversible damage to the baby's brain, according to research published in the February 11 issue of Science. Doctors have long known that alcohol harms the fetal brain, but this study reports for the first time how alcohol damages brain cells–and how little exposure it takes to do so. Children born to drinking mothers can suffer learning
disabilities and other brain disorders.
Although experiments in the study were conducted on laboratory rats, experts said the findings offer an explanation of why children born to drinking mothers can suffer learning disabilities and other brain disorders. The researchers led by Dr. John Olney, a professor of psychiatry and neuropathology at Washington University of Medicine in St. Louis, studied newborn rats, whose brain development is similar to a human's except for the timing of a key growth spurt, which is called synaptogenesis. Rats, and presumably humans, are most susceptible
to alcohol-related damage during a growth spurt when developing brain
cells are building the connections needed for memory, learning and
thought.
The study indicates that rats, and presumably humans, are most susceptible to alcohol-related neurological damage during this growth spurt when developing brain cells are furiously building the connections needed for memory, learning and thought. In humans, this brain growth spurt starts in the sixth month of gestation. In rats, it comes in the two weeks after birth. Alcohol may block chemical in fetal brain They discovered that exposure to alcohol blocks a key neurochemical called glutamate, whose job it is to regulate the activity of cells in the central nervous system. When this so-called "excitatory" brain chemical is stopped from doing its job, the cells no longer get the chemical signal they need to grow and divide. When cells don't receive this signal, they send out a warning that something is wrong and trip a biochemical switch that sends cells into suicide mode. This is the body's way of eliminating surplus cells. A single prolonged episode of alcohol exposure
that lasts four hours or more is enough to kill millions of brain
cells.
A single prolonged episode of alcohol exposure that lasts four hours or more is enough to kill millions of brain cells during this growth spurt, according to Olney. Link to fetal alcohol syndrome Problems include mental retardation, learning disorders, facial abnormalities and stunted growth. The facial defects have been traced to use of alcohol early in pregnancy, but Olney said the brain damage comes if a pregnant woman drinks later in pregnancy, during the brain growth spurt. "It's very important to stress that damage requires only a one-time intoxication," Dr. Olney said in an interview. "Our study showed that it only requires one round of intoxication of about four hours for this to occur." The "binge" researchers imposed on the rats gave the rodents a blood alcohol level of .20, or 200 milligrams of alcohol per deciliter of blood. Such a level in people is twice the legal standard of drunkenness in many states. Dr. Olney’s research did not address how much alcohol a woman
would have to drink to trigger such damage in her baby. "To
be safe, the best advice is for mothers to avoid alcohol altogether
during pregnancy," he said. While there's no evidence to suggest
an occasional glass of wine earlier in the pregnancy can harm the
baby, Olney suggests women should err on the side of caution and
avoid all alcohol during the last few months of pregnancy.
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 Not drinking is best for your baby There is an increasing amount of evidence that alcohol consumption during pregnancy can be very harmful to the developing fetus. This study was conducted on mice, but data from other research support its findings. Drinking during the formative stages of fetal development, as well as later in the pregnancy while organs are maturing, can be very dangerous. We know from this study and others that drinking is associated with four adverse pregnancy outcomes:
"I advise my patients not to drink any alcoholic beverages while pregnant."
Whether a woman is a chronic drinker or experiences one drinking binge at a critical point in her baby’s development, serious, irreparable damage may occur. For this reason, I advise my patients not to drink any alcoholic beverages while pregnant. Occasionally a newly pregnant woman will worry about what she might have done before she learned she was pregnant. She may have been to a party or had several drinks without realizing she might be putting a newly conceived baby in danger. My response is to counsel the patient not to worry about what cannot be changed, but to make sure she stops drinking for the duration of the pregnancy. Physician survey Most surprising to me was that 4 percent of physicians reported telling patients consumption of eight or more drinks a week does not present a risk. Clearly, physicians need to be aware of the danger since their advice to patients is an important factor in women’s decision to stop drinking while pregnant. "Even moderate drinking has been associated with…symptoms [of fetal alcohol syndrome]."
Statistics indicate about 760,000 of the four million women in the U.S. who give birth each year drink during pregnancy. Consequences include fetal alcohol syndrome, which affects one in 750 babies born each year. There is no cure for this syndrome, which can result in mild to moderate mental retardation; a small head and defects or malformations of the eyes, nose or mouth; restless, hyperactive behavior; slow growth and poor coordination. Even moderate drinking has been associated with some of these symptoms. Avoid all toxic substances Smoking cessation is actually more of an issue in our community than drinking, and our nurse educators as well as our physicians caution women about the primary risks of smoking while pregnant, which include premature birth and underweight babies. We strongly suggest women stop or cut down on tobacco use while pregnant. Passive smoke is also a hazard for pregnant women. The components of tobacco smoke have a toxic effect on blood vessels that can result in a reduction of blood to the placenta, so women should not only stop smoking, they should avoid areas where other people are smoking. We are constantly learning more about the negative effects alcohol,
tobacco and other toxic substances can have on the health of a developing
baby. Women need to understand these risks and seek help if they are
not able to stop consuming these substances during their pregnancies. Dr. Berman is an attending obstetrician/gynecologist at Yale-New Haven Hospital and a clinical professor of obstetrics and gynecology at the Yale School of Medicine. He is president of the County Obstetrics and Gynecology Group with offices in New Haven, Branford, Clinton and Wallingford and founder of the Hygeia ® > Foundation for Perinatal Loss and Bereavement. |
