Alcohol exposure even in low amounts during pregnancy can change the baby’s brain structure and delay brain development, according to a new MRI study. These results have been presented at the annual meeting of the Radiological Society of North America (RSNA).
Fetal MRI is a highly specialized and safe examination method that allows us to make accurate statements about brain maturation prenatally,” said Gregor Kasprian, M.D., senior study author, as per Sci Tech Daily reporting.
Gregor Kasprian, M.D, associate professor of radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
Fetal alcohol spectrum disorders (FASD) are a range of conditions that can affect the fetus if it is exposed to alcohol. Babies born with fetal alcohol spectrum disorders may develop behavioral problems, speech and language delays, and learning disabilities.
FASD is a serious, under-recognized problem
Globally, nearly eight out of every 1,000 children in the general population is estimated to have FASD, according to a landmark 2017 study by the Centre for Addiction and Mental Health (CAMH).
Movendi International developed an Alcohol Issues Special Feature to help improve understanding of the burden of and solutions for FASD.
Another landmark study showed that alcohol use during pregnancy is common in many countries and as such, FAS is a relatively prevalent alcohol-related birth defect. More effective prevention strategies targeting alcohol use during pregnancy and surveillance of FAS are urgently needed, according to the researchers.
Multiple countries are facing serious crises. For instance, the United States is facing a crisis of fetal alcohol syndrome (FAS) with the rising level of alcohol use disorder and addiction in the country. Nevertheless, policy action to prevent FAS and other alcohol harms has been lacking across governments in the country. For example, the main fetal alcohol program at the federal mental health agency was discontinued in 2015. Since then there has been no constituency organized enough to get fetal alcohol syndrome back on the national agenda. The harm from FAS is however grave for the country causing billions of dollars in costs, straining the criminal justice system, tearing apart families — and causing disabilities that are largely preventable.
Alcohol use during pregnancy and its effects on the fetus is a grave example of alcohol’s second-hand harms and an overlooked problem around the world.
In a thorough overview article, Movendi International provides a summary of how prenatal alcohol exposure affects the brain, fetal alcohol spectrum disorder, and the challenges with diagnosis.
The article also includes three examples of the way forward from Sweden, Australia, and the U.S.
Unfortunately, many pregnant women are unaware of the influence of alcohol on the fetus during pregnancy,” said Patric Kienast, M.D., lead author on the study, according to Sci Tech Daily.
Therefore, it is our responsibility not only to do the research but also to actively educate the public about the effects of alcohol on the fetus.”
Patric Kienast, Ph.D. student, Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Austria
For the study, researchers analyzed MRI exams of 24 fetuses with prenatal alcohol exposure. At the time of MRI, the fetuses were between 22 and 36 weeks of gestation. Alcohol exposure was determined via anonymous surveys of the mothers. The questionnaires used were the Pregnancy Risk Assessment Monitoring System (PRAMS), a surveillance project of the Centers for Disease Control and Prevention and health departments, and the T-ACE Screening Tool, a measurement tool of four questions that identify high-risk alcohol use.
Already low doses of alcohol exposure harm brain development in the fetus
In fetuses with alcohol exposure, the fetal total maturation score (fTMS) was significantly lower than in the age-matched controls, and the right superior temporal sulcus (STS) was shallower. The STS is involved in social cognition, audiovisual integration and language perception.
We know that this region, and specifically the formation of the STS, has a great influence on language development during childhood,” said Dr. Kasprian, according to Sci Tech Daily.
Gregor Kasprian, M.D, associate professor of radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
Brain changes were seen in the fetuses even at low levels of alcohol exposure.
Seventeen of 24 mothers consumed alcohol relatively infrequently, with average alcohol consumption of less than one alcoholic drink per week,” Dr. Kienast said, according to Sci Tech Daily.
Nevertheless, we were able to detect significant changes in these fetuses based on prenatal MRI.”
Patric Kienast, Ph.D. student, Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Austria
According to the researchers, delayed fetal brain development could be specifically related to a delayed stage of myelination and less distinct gyrification in the frontal and occipital lobes.
The myelination process is critical to brain and nervous system function. Myelin protects nerve cells, allowing them to transmit information faster. Important developmental milestones in infants, such as language processing, rolling over, and crawling are directly linked to myelination.
Gyrification is the process by which the brain undergoes changes in surface morphology to create sulcal and gyral regions. The period of greatest development of brain gyrification is during the third trimester of pregnancy, a period of time in which the brain undergoes considerable growth. This folding enlarges the surface area of the cortex with limited space in the skull, enabling an increase in cognitive performance. When gyrification is diminished, functionality is reduced.
In a seminal blog post for Movendi International, FASD prevention experts Nadja Frederiksen and Niina-Maria Nissinen wrote that alcohol consumption during pregnancy is a risk behaviour and can cause severe damage to a foetus, even at low doses. But the problem of FASD remains underestimated despite the magnitude of harm. In their report, the experts reveal blind spots in prevention and detection, existing barriers in care and support, and the lack of political attention. Their guest expert opinion is a compelling analysis and charts a promising way forward for tackling FASD effectively and holistically.
Zero alcohol during pregnancy for the child’s (brain) health
Pregnant women should strictly avoid alcohol consumption,” Dr. Kienast said, as per Sci Tech Daily reporting.
As we show in our study, even low levels of alcohol consumption can lead to structural changes in brain development and delayed brain maturation.”
Patric Kienast, Ph.D. student, Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Austria
It remains unclear how these structural changes will affect brain development in these babies after birth.
To assess this accurately, we need to wait for the children who were examined as fetuses at that time to get a little older, so that we can invite them back for further examinations,” said Dr. Kienast, according to Sci Tech Daily.
However, we can strongly assume that the changes we discovered contribute to the cognitive and behavioral difficulties that may occur during childhood.”
Patric Kienast, Ph.D. student, Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Austria
But the alcohol industry has been working to keep people in the dark about the harm caused by their products to the unborn child.
A recent, groundbreaking independent assessment exposed alcohol industry misinformation, with direct comparisons across a range of industries which affect public health. The study also revealed the effects of alcohol industry misinformation on uncertainty.
Father’s alcohol use can also harm baby
According to research, dad’s alcohol use can harm the baby too. It has been found that dad’s sperm could be responsible for fetal alcohol spectrum disorder (FASD), which affects one in every 100 infants. Children with FASD are affected by mental disability, developmental disorders and abnormal facial features…
The impact of alcohol on fetal health and social outcomes later in life is enormous, placing a huge economic burden on countries. Prevention of prenatal alcohol exposure and early identification of affected individuals should be a global public health priority.
A 2022 study found that by adolescence children with fetal alcohol spectrum disorders (FASD) had greater odds of impairments to bone and body composition. These findings highlight the importance of early FASD diagnosis and appropriate post-diagnostic medical follow-up to enable timely, effective interventions to optimize bone and body composition during pediatric growth.
