According to the Center for Disease Control and Prevention, half of all pregnant women say they use alcohol and half of all pregnancies are unplanned. These are troubling statistics because birth defects associated with alcohol exposure can occur at any point during pregnancy, even before a woman knows she is pregnant.

Daniel Bonthius, MD, PhD, pediatrician with University of Iowa Children's Hospital and president of the National Fetal Alcohol Syndrome Study Group, says fetal alcohol syndrome is the constellation of developmental defects that results from maternal abuse of alcohol during pregnancy, including:

• Prenatal and postnatal growth deficiencies
• Set of midfacial abnormalities
• Central nervous system dysfunction

Approximately one in every 100 children born nation-wide is adversely affected by prenatal alcohol exposure, says Bonthius. "This includes children with the full fetal alcohol syndrome, as well as children who may not have all of the external features of the syndrome, but whose brains have been injured. We refer to this problem as "alcohol-related neuro-developmental disorder."

There is no known "safe" dose of alcohol during pregnancy. "We recommend that all women who are pregnant or who may become pregnant refrain from drinking any alcohol," he says.

"Brain dysfunction is the most important aspect of fetal alcohol syndrome. Children with fetal alcohol syndrome often have learning difficulties and attention deficit disorder. They may also have epilepsy, clumsiness, mental retardation, and behavior problems"

Alcohol disrupts many aspects of brain development. Bonthius says that during brain development, young neurons need to establish specific connections with other neighboring neurons. Alcohol disrupts the ability of developing neurons to form these specific connections. "In addition, one of the most damaging effects of alcohol on the developing brain is neuronal death. Developing neurons are exquisitely vulnerable to alcohol-induced cell death. Once those neurons are killed by alcohol, the brain is largely incapable of generating replacements."

Presently, there is no specific treatment for fetal alcohol syndrome. "Once alcohol damages the developing brain, that damage cannot be reversed, he says. "For this reason, the emphasis is on prevention. All cases of fetal alcohol syndrome are potentially preventable. This means that should women not abuse alcohol during pregnancy. Fetal alcohol syndrome is the most common preventable cause of mental retardation in the western world.

University of Iowa Children's Hospital is currently doing research regarding fetal alcohol syndrome. Bonthius lab has a very active program investigating the mechanisms by which alcohol kills developing neurons and identifying molecules that can protect neurons against alcohol's toxic effects. Bonthius and his collaborator, Bahri Karacay, PhD, have found that a molecule called nitric oxide can substantially reduce alcohol-induced neuronal death. "We are now exploring the molecular signaling pathway by which nitric oxide exerts this protective effect and we are working on gene therapy approaches through which fetal alcohol syndrome might someday be prevented or reversed," says Bonthius.

For more information:

University of Iowa Children's Hospital