Alcohol can have a range of negative consequences for the unborn child.
It is widely known that drinking during pregnancy carries a health risk for the child.
Despite this common knowledge, and because around 50 percent of American pregnancies are unplanned, alcohol consumption during early pregnancy still occurs.
Fetal alcohol spectrum disorders (FASD) are a range of physical and mental disabilities that can affect a child’s development and have long-lasting consequences.
Symptoms of FASD vary from individual to individual but can include physical changes, such as slightly different facial characteristics and smaller heads. Children may also weigh less and be shorter in stature than average.
FASD often includes cognitive difficulties and behavioral issues – for instance, impaired attention, memory, and speech development.
In the United States and Western Europe, around 2-5 percent of school-aged children are affected by FASD; other parts of the world have even higher figures.
Searching for alcohol damage
One of the major issues facing clinicians is that the extent of the alcohol damage is difficult to gauge until later in the child’s life.
“It’s a huge problem, but we might not realize the full scope because infants born with normal-looking physical features may be missed, making many cases difficult to diagnose early,” says co-senior author Prof. Rajesh Miranda, of the Texas A&M College of Medicine.
Teams of scientists from the University of California-San Diego School of Medicine, Texas A&M College of Medicine, and the Omni-Net Birth Defects Prevention Program in Ukraine recently combined their efforts to design a solution. Their findings are published today in PLOS One.
The group of researchers set out to develop a test that would be able to measure the extent of alcohol damage at an earlier stage.
The investigators looked at birth outcomes for 68 pregnant women from prenatal care clinics in western Ukraine. Blood samples were taken along with information about the women’s health history and alcohol consumption in the second and third trimesters.
Alcohol exposure in early pregnancy alters microRNA circulation
Once the data were analyzed, the researchers found significant differences in certain markers in the maternal blood samples. Alcohol exposure during early pregnancy changed the amount of circulating small RNA molecules, called microRNAs (miRNAs).
These changes in miRNAs were particularly marked in the mothers whose child showed neurobehavioral or physical signs due to alcohol within the first 12 months of life. Prof. Miranda says: “Collectively, our data indicate that maternal plasma miRNAs may help predict infant outcomes and may be useful to classify difficult-to-diagnose FASD subpopulations.”
One of the factors that make FASD so difficult to predict is that similar amounts of infant exposure to alcohol can result in vastly different outcomes for the child.
“Although it is generally true that binge drinking during pregnancy presents the greatest risk, not all women who consume substantial amounts of alcohol in pregnancy will have a child who is clearly affected.”
Co-senior author Prof. Christina Chambers
Having a specific biomarker that can be measured in the second and third trimester could help determine if the unborn child would benefit from early interventions.
Early intervention may prevent further damage
FASD cannot be cured, but in some cases, children can benefit from early interventions, where exposure to alcohol could potentially be reduced. As Dr. Wladimir Wertelecki, leader of the team in Ukraine, says: “Good nutrition, better perinatal healthcare, lowering stress levels, and infant care interventions can all improve the outcome of alcohol-affected pregnancies.”
The results of the current investigation are encouraging; the team will continue their research and look at a larger sample of women. They also plan to see if these early-stage markers are useful predictors of longer term developmental issues in the children.
Prof. Miranda says: “If we can reset developmental trajectories earlier in life, it is a lot easier than trying to treat disabilities later in life.” Identifying mothers and infants who are most at risk will enable healthcare providers to ensure they receive extra care and support.