Wednesday, November 29, 2006

Pregnancy and Alcohol

I was disappointed at the rather unscientific and irresponsible article in the NYtimes about alcohol and pregnancy that seems to give a view that moderate drinking while pregnant is safe. The author appears to have missed the relevance of a lot of recent research - most of which is found in New Scientist 6/29/06 (pay article) titled "Sobering news for pregnant women" where they catalog the research showing that even light drinking has the potential to alter the development of the fetus.

If you insist on drinking then take choline during pregnancy which seems to offer some protection against the neuronal apoptosis that alcohol can induce in the fetal brain during the 2nd trimester.

"Peter Hepper at Queen's University, Belfast, UK, examined the movements of fetuses scanned on ultrasound in response to a noise stimulus. Having asked women about their drinking habits, they compared the responses of fetuses exposed to low levels of alcohol - between 1 and 6 British units per week, each containing 10 millilitres of alcohol - and those exposed to none. When tested between 20 and 35 weeks, the fetuses exposed to alcohol tended to show a "startle response" usually found only in the earlier stages of pregnancy, when the nervous system is less developed"

"When Ed Riley and colleagues at San Diego State University in California looked at children's brains using magnetic resonance imaging, they found obvious changes in the brain structure of children whose mothers drank very heavily, but also some changes in children born to moderate drinkers. For example, there were abnormalities in the corpus callosum, the tract of fibres connecting the right and left hemispheres of the brain. The greater the abnormality, the worse the children performed on a verbal learning task."

"John Olney, a neuroscientist at Washington University in St Louis, Missouri, has examined the impact of alcohol on developing rodent brains as a model for what happens in humans. Six years ago Olney and others showed that alcohol causes neurons in the developing rat brain to undergo programmed cell death, or apoptosis"

The research by Olney shows that the timing of alcohol has an effect. The first trimester affects facial development and other physical features and gestures, the second trimester affects different levels of brain function depending again when the alcohol hits and what part of the brain is forming. Olney believes that even small amounts of alcohol (50mg per 100 ml of blood) can potentially kill 20 million neurons in the fetus. In the third trimester alcohol can throw off circadian rhythms in the offspring. So as children they sleep poorly and are prone to a host of other psychiatric conditions like depression. Based on what Olney has seen in his research he thinks it would be safest to abstain.

It's possible that for some women a small amount of alcohol over an extended time on a full stomach might have little or no impact on a fetus. But how would you know if you metabolize alcohol in the right way, or that you ate enough to blunt the effect of the alcohol, or that you drank slowly enough for it not to effect the fetus, or that you didn't go over the level at which neurons die in the fetus? Is it worth the risk if only to partake in a brief cultural ritual, or to momentarily feel more social?

The BBC has covered this 9/18/02 "Professor Peter Hepper, of Queen's University, Belfast, said that there was a growing body of evidence linking even moderate alcohol use in pregnancy to deficits in children.
He said: "If it was proven that drinking any amount of alcohol in pregnancy caused you to be born with the tip of your finger missing - something that would hardly affect your life at all - then it would be banned instantly."

Of course brain damage is much harder to measure... and so likely goes unnoticed except for dramatic cases.

More here, here, here and here

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