Abstract
Alcohol has always been present in human life, and currently it is estimated that 50% of women of childbearing age consume alcohol. It has become increasingly clear over the last years that alcohol exposure during fetal development can have detrimental effects on various organ systems, and these effects are exerted by alcohol through multiple means, including effects on free radical formation, cellular apoptosis, as well as gene expression. Fetal alcohol exposure can lead to a spectrum of short term as well as long-term problems, with Fetal Alcohol Syndrome being on the more severe end of that spectrum. This syndrome is morbid, yet preventable, and is characterized by midfacial hypoplasia, thin upper lip, widely spaced small eyes, long smooth philtrum and inner epicanthal folds. Other findings include growth restriction as well as various neurodevelopmental abnormalities. This article is the first comprehensive review combining the molecular as well as the gross physiological and anatomical effects of alcohol exposure during pregnancy on various organ systems in the body. Our knowledge of these various mechanisms is crucial for our understanding of how alcohol exposure during fetal development can lead to its detrimental effects.
Highlights
For thousands of years, alcohol has played a major part of human life
All evidence shows that alcohol plays a detrimental effect on fetal development
It is clear that the harmful effects of alcohol vary in relation to the pattern of drinking, with more harm done with binge drinking than with chronic alcohol use, as well as to the level of alcohol exposure during pregnancy
Summary
Alcohol has played a major part of human life. Since ancient times, various civilizations have used alcohol for leisure, trade, and religious rites. It is believed that as much as 40% of the world’s adult population consumes alcohol, with an average yearly alcohol consumption of 17.1 L per drinker [1]. The current medical term for this syndrome is Fetal Alcohol Syndrome (FAS) It includes findings such as midfacial hypoplasia, thin upper lip, widely spaced small eyes, long smooth philtrum and inner epicanthal folds. Multiple factors are involved in determining the severity of FAS in an afflicted individual These include: quantity of alcohol consumed during pregnancy, frequency of alcohol use, timing of maternal drinking in terms of gestational age, as well as multiple other maternal risk factors such as age, gravidity, nutrition, socioeconomic status, and metabolic and genetic influence [6,7]. Given the detrimental effects of alcohol on fetal development, the American Academy of Pediatrics, as well as the American College of Obstetricians and Gynecologists both recommends abstinence during pregnancy for pre-conceptional and pregnant women [2]
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