Alcohol & Pregnancy


Alcohol + Babies = Problems 


"No amount of alcohol in any trimester is considered safe," said Julia Robertson, the Utah Department of Health's Pregnancy Risk Line's Mother to Baby program manager.’

No amount of alcohol a pregnant woman drinks is safe for a developing baby.  In addition, maternal alcohol consumption may not just impact the baby a woman is carrying, but also that baby’s future children and even grandchildren!  (Centers for Disease Control and Prevention) 

Alcohol can spark epigenetic changes that persist across generations.
  “We have evidence today that the effects of prenatal alcohol exposure could pass through to other generations, negatively impacting offspring who didn’t have direct alcohol exposure. (Kelly Huffman, psychology professor and lead researcher, University of California Riverside, published in the journal Cerebral Cortex)

Three-fourths of women actively wanting to get pregnant say they drink alcohol. 
More than 3 million American women are at risk of exposing a developing baby to alcohol, due in part to a lag time very early in the pregnancy before a woman knows that she's pregnant. That may create a window where even women who would never drink if they knew they were pregnant place their developing baby at risk. And some pregnant women mistakenly believe it's possible to drink moderately without risk to the babies they are carrying.  (CDC) 

Babies born to women who drink during pregnancy
may suffer fetal alcohol spectrum disorder (FASD), which the CDC describes as "physical, behavioral and intellectual disabilities that last a lifetime."  Fetal exposure to alcohol can create issues from behavioral problems to developmental disabilities, problems with key organs like the heart and kidneys, low birth weight, learning disabilities and reasoning challenges. It has been linked to poor mental health, substance abuse and even criminal involvement, among other things.

Babies exposed to alcohol prenatally can grow up with significant lifelong challenges, Robertson said. They may make bad decisions, struggle in school and find it difficult to keep both friends and jobs. Their families are also impacted. If those babies grow up to have children of their own, they may not have picked up the skills they need to be good parents.

Many physical problems are also associated with fetal alcohol exposure.

"We know alcohol increases the chance for birth defects. We see heart defects. We see facial changes. And we see, most importantly, effects to the child's brain. These effects to the brain are with that child for their lifetime. Alcohol is a bad actor,” Robertson said.

While no amount of alcohol is considered safe, Robertson said the risk line tries to reassure women who find they've been using mouthwash that contains alcohol, or who had a glass of wine a couple of times before learning they were pregnant.  "With alcohol, we want to know the amount and when, so we can give a proper risk assessment to the woman contacting us," Robertson said. "But if you are sexually active, not using birth control and are binge drinking, we'd definitely like to talk about that with you.”

"People have known about fetal alcohol syndrome for a long time, but it was always discussed as 'if a mother drinks a lot of alcohol when she's pregnant, her baby is affected," Huffman said. But it was considered a one-generation issue that would not impact future generations — "a one and done. We are now finding out that's incorrect."

Huffman's lab at the UC Riverside previously showed that prenatal ethanol exposure (PrEE) changes the anatomy of the neocortex, which is the part of the brain that's responsible for the complex behavior and cognition that are hallmarks of being a human.  Using mice, they showed that alcohol exposure disrupted the wiring in that part of the brain, messing up connections and altering gene expression.  Subsequently, using imaging, the findings were replicated in humans. The prenatal alcohol exposure disrupted how brain connections were organized through a mechanism known as epigenetic change, said Huffman.

She said that because DNA isn't altered by experience,
Huffman said it was believed that the effects of one's experiences would not be passed on to subsequent generations. But experiences and exposures can make epigenetic changes to chromosomes that affect how genes are expressed, and it's becoming clear those can be passed to offspring across generations, Huffman said.

Epigenetic changes may occur with age, or they may be due to environmental factors like toxins or lifestyle factors like alcohol consumption or disease. While those factors don't change DNA coding, they can change its details, disrupting gene expression, perhaps making it happen at the wrong point in development, for example. And those differences can be passed on to the next generation.

Huffman and her colleagues used a transgenerational mouse model with male mice offspring. The first generation was directly exposed to alcohol during development. The second generation had indirect exposure through the sperm that came from the germ cells in the first-generation mice who had been exposed.

The third-generation mice had not been exposed, either directly or through germ cells. "But when we did tests and looked at the modifications, they were still happening. … We could demonstrate a heritable condition that can be passed on," Huffman said.

Prenatal exposure changes motor behavior and increases anxiety in offspring, among other things. The new findings show that negative changes can pass to future generations that were not even directly exposed to ethanol. Using mouse models, they showed that second and third generations had similar effects to those with direct exposure.

"We found that body weight and brain size were significantly reduced in all generations of PrEE animals when compared to controls; all generations of PrEE mice showed increased anxiety-like, depressive-like behaviors and sensory-motor deficits," Huffman said in background material accompanying the study.

The strong transgenerational effects indicate fetal alcohol spectrum disorders may be heritable in humans.

Early epigenetic research looked at starvation and followed the impact of a short but extremely severe famine on pregnant women. Those women had severe nutritional deficiency during pregnancy, Huffman said. And though their children and grandchildren and great-grandchildren had not suffered in the famine, they still showed markers of nutritional deficits.

"I hope people understand the danger,"
she said. "When you have a child, it's pretty much your whole life. You have to give up some things, make sacrifices. It's really not that big a deal to do that — to stop drinking for nine months. Just go without."    (Source:  Drinking alcohol while pregnant could harm not just your children, but grandchildren,” by Lois M. Collins, Deseret News, July 16, 2017) 


This topic is covered more fully under
"Alcohol and Pregnancy"

Statistics
  • Up to 1 in 20 U.S. school children may have FASD’s.

    Drinking while pregnant costs the U.S. $5.5 billion (2010) 
Physical Issues:
  • Low birth weight and growth
  • Problems with heart, kidneys and other organs
  • Damage to parts of the brain
    Which leads to…
Behavioral and Intellectual Disabilities
  • Learning disabilities and low IQ
  • Hyperactivity
  • Difficulty with attention
  • Poor ability to communicate in social situations
  • Poor reasoning and judgment skills
    These can lead to…

Lifelong Issues with
  • School and social skills
  • Living independently
  • Mental health
  • Substance use
  • Keeping a job
  • Trouble with the law
(Source:  CDC Vital Signs, February 2016, American Journal of Preventive Medicine, Nov. 2015)

What You Can Do

  • There are 4 ways a man's health affects his offspring.  A fathers lifestyle may have far more effect on a child's health than doctors originally believed. Researchers at Georgetown University Medical Center found, that there are 4 ways a man's health affects his offspring:
1)  Kids of older fathers (40 and older) have higher rates of schizophrenia, autism, and birth defects.
2)  Your dad's diet impacts how you react to food.
3)  A dad who smokes may cause DNA damage.
4)  An alcoholic father raises the risk of fetal alcohol syndrome and developmental difficulties, as three quarters of babies with fetal alcohol problems had fathers who were alcoholics.  Researchers found there are four ways a man's health affects his offspring:

Fertility specialists say men are not immune to reproductive aging.  A man's lifestyle, age, and genetics can play just as significant a role in the health of a baby as the mother's health.  Dads lifestyle linked to kids' health issues,  ("Influence of paternal preconception exposures on their offspring: through epigenetics to phenotype," American Journal of Stem Cells, April 2016)
  • A warning for women of childbearing age.  The CDC states that women ages 15-44 should avoid alcohol unless they are using birth control. Alcohol can harm a developing baby before a woman knows she is pregnant.  The CDC estimates more than 3 million women are at risk of exposing a developing fetus to alcohol. This warning is to reduce the cases of fetal alcohol syndrome.    (CBS Morning News, USA Today, February 3, 2016)

  • "No Alcohol during Pregnancy -- Ever -- Plead U.S. Pediatricians."  In an effort to once and for all put a rest to any debate about drinking during pregnancy, the American Academy of Pediatrics has put out a clear message: Don't do it. Ever. At all. Not even a tiny bit.

    "No amount of alcohol should be considered safe to drink during any trimester of pregnancy," the group wrote.  Prenatal exposure to alcohol is the leading preventable cause of birth defects, as well as cognitive problems later in life.  The risk of having a baby with growth retardation goes up even when a woman has just one alcoholic drink a day.

    Drinking alcohol during pregnancy increases the risk the baby could have myriad problems, including trouble with hearing and vision, and with the heart, bones and kidneys. Children of mothers who drank while pregnant were also more likely to have neurodevelopment issues such as troubles with abstract reasoning, information processing, and attention-deficit/hyperactivity disorder.

    Women who drank in their first trimester were 12 times more likely to have a child with these issues, compared to women who didn't drink at all. First- and second-trimester drinking increased the risk 61 times, and women who drank during all trimesters increased the risk by a factor of 65.

    "There is no safe amount, no safe time, and no safe type of alcohol to drink during pregnancy. It's just not worth the risk," said Dr. Cheryl Tan, an epidemiologist at the CDC. an conducted a study showing that during 2011-2013, one in 10 pregnant women reported consuming alcohol in the past 30 days and one in 33 reported binge drinking.

    "The research suggests that the smartest choice for women who are pregnant is to just abstain from alcohol completely," said Dr. Janet F. Williams, one of the leading authors of the report from the American Academy of Pediatrics.  (Source: "No alcohol during pregnancy - ever - plead U.S. pediatricians," by Elizabeth Cohen, CNN Senior Medical Correspondent, CNN, October 21, 2015; American College of Obstetricians and Gynecologists; Centers for Disease Control and Prevention)

  • Women who drink just 3 alcoholic beverages a week face a higher chance for developing breast cancer compared with nondrinkers.  A compelling study followed more than 100,000 nurses almost 30 years showing an association between alcohol and breast cancer.  The researchers took into account other cancer risk factors, including age of menstruation and menopause, family history, weight and smoking—and still found evidence of a link with alcohol.  It made no difference whether the women drank liquor, beer or wine.  Increased risks were also seen in binge drinkers—women who consumed at least 3 drinks daily in a typical month.  The study does not prove that drinking causes the disease—but validates a link.    (Journal of the American Medical Association, Dr. Wendy Chen, a researcher at Brigham and Women’s Hospital and Dana-Farber Cancer Institute and associate professor at Harvard Medical School, November 2011)

  • Alcohol is Unsafe.  From the standpoint of cancer risk…there is no level of alcohol consumption that can be considered safe for women.  Even low-to-moderate amounts of alcohol increase the risk of cancer, which outweighs any potential cardiovascular benefit for having a single drink every day.    

    No level of alcohol use during pregnancy has been proven safe.  Each year, more than 50,000 babies are born with some degree of alcohol-related damage.  Alcohol passes swiftly through the placenta to the fetus.  In the unborn baby’s immature body, alcohol is broken down much more slowly than in an adult’s body.  As a result, the alcohol level of the fetus’s blood can be even higher and can remain elevated longer than in the mother’s blood.  This sometimes causes the baby to suffer lifelong damage.  (Dr. Michael S. Lauer and Paul Sorlie, National Heart, Lung and Blood Institute, and Epidemiologist Naomi E. Allen, University of Oxford, Journal of the National Cancer Institute)

  • Fetal Alcohol Syndrome (FAS) is entirely preventable.  Babies with classic FAS are abnormally small at birth and usually do not catch up as they get older.  FAS can affect their physical features, internal organs, and result in a lifetime of behavior problems.

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