Something most college students aren’t thinking about when they’re out partying with their friends is the potential long-term effect alcohol can have on a baby. And unfortunately, as is the case with so many things involving reproduction, the onus for responsibility regarding alcohol and babies rests with women because everything that goes into a woman’s body also affects her baby.
Fetal Alcohol Syndrome is characterized by permanent birth defects that result from maternal consumption of alcohol during pregnancy. It consists of a group of symptoms that include severe birth defects, vision and hearing deficiencies, mental retardation and behavioral problems, such as attention-deficit hyperactivity disorder. FAS also results in a characteristic facial appearance including a smooth philtrum (the groove between the nose and upper lip), a thin vermillion (upper lip) and small palpebral fissures (the space between upper and lower eye lids). The severity of the facial abnormalities correlates with the degree of neurological impairment, which, roughly translated, means that the more abnormal the child’s facial features are, the more likely that child also suffers from severe mental and neurologic deficiencies. There is no definitive data to show that increased alcohol intake by a mother leads to more severe symptoms in her child, but more severe symptoms seem to be related to the amount of alcohol the child received in the uterus. In other words, a mother who drinks two to three drinks a week might have a child who is severely affected with the problems of FAS, while a mother who drinks 20 drinks a week might have a child who is less affected, simply because the former child absorbed more of the alcohol than the latter.
There are also physical deformities of the brain that are regarded as manifestations of prenatal alcohol exposure. These include microcephaly, agenesis of the corpus callosum and cerebellar hypoplasia. Microcephaly is small head size as determined bay comparing the child’s head circumference to standard growth charts to assess how many standard deviations below normal the child’s head size is; more than two standard deviations below normal is considered microcephaly.
Agenesis, which refers to an organ’s or physical body’s failure to develop, similarly can cause severe problems and can affect communication and coordination skills. The corpus callosum is the tract of axons from neurons that connects the two hemispheres of the brain. Without a corpus callosum, children develop low muscle tone and experience motor problems, including delays in meeting motor milestones. They also might experience speech and language difficulties as well as difficulty processing facial cues — leading to social disabilities and difficulties chewing and swallowing. Agenesis of the corpus callosum can cause seizures and low pain perception, which may lead to children suffering injuries without being aware that they are in pain. Cerebellar hypoplasia means that the cerebellum — the part of the brain that coordinates motor control, sensory perception and coordination — does not fully develop and reach its normal size. Children with underdeveloped cerebellums suffer from similar problems as those without corpus callosums.
But FAS is not the only condition that can result from prenatal alcohol exposure. There are many other conditions, collectively known as Alcohol-Related Birth Defects, that can occur with FAS or independently from it. ARBD include heart problems like temporary murmurs, septal defects or even severe heart conditions that often require surgery. There are also skeletal and joint anomalies that can be minor or severe, kidney problems ranging from lack of kidneys to small or malformed kidneys and spina bifida. Eye problems can include strabismus or improper alignment and optic nerve hypoplasia — an incompletely developed nerve to the eye — that can lead to sensitivity to light and decreased visual acuity. Unfortunately, despite the afflictions of FAS and ARBD on children, little data has been collected about the exact physiological effects because conducting a live human study about this topic is considered unethical. Thus, the only data available is incidental: mothers who happen to drink while pregnant and the condition of their babies.
While there is no cure for FAS, it can be completely prevented by not drinking during pregnancy. Even this, though, can be problematic. It might seem simple enough to tell pregnant women not to drink, but it is not nearly as simple to tell “not-pregnant” women not to drink. The problem becomes apparent when one considers that most women do not even know they are pregnant until they are at least four to eight weeks into the pregnancy, which means they might still be drinking during that time period. Those first few weeks are often the most critical for fetal development, and so the alcohol intake has the greatest impact during that time period. Thus, the most conservative recommendation many health professionals make is that women of reproductive age — including college students, of course — should not drink because they might become pregnant and not know they are pregnant until damage has already been done to the baby.
This recommendation extends to women who are on birth control — because no method is 100-percent effective — but does not include women who are abstinent from sexual activity. As mentioned earlier, this is another case of women having to take the majority of responsibility for reproductive health, but being able to give birth to new life is a pretty cool thing.
Katie is a University Medical student. She can be reached at k.mcbeth@cavalierdaily.com.
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