Less than a week after Cosmopolitan published a nearly viral editorial in which one mom explained her reasons for drinking during her pregnancy, research about the frequency of Fetal Alcohol Spectrum Disorder (FASD) was published in the medical journal Pediatrics. FASD is the term for a spectrum of conditions that have no cure and are caused by the consumption of beer, wine, and other spirits by pregnant women. The newly published research, led by Professor Philip May with the University of North Carolina, found that a much higher number of children may actually suffer from health or behavioral problems caused by women drinking during pregnancy than previously expected.
The study found that in one Midwest town, somewhere between 2.4 and 4.8 percent of children have FASD when they expected much lower rates of children damaged by alcohol, according to U.S. News & World Report.
"Knowing not to drink during pregnancy and not doing so are two different things," May explained.
Most women are aware that the official U.S. Surgeon General's position on drinking during pregnancy is there is no known safe amount of alcohol. Older and statistically more educated women are choosing to drink moderately during pregnancy in greater numbers, according to reports. It has become more socially acceptable to drink moderately while pregnant, especially since associate professor of economics Emily Oster released her book that supported light to moderate drinking during pregnancy.
Previous studies that supported light to moderate drinking during pregnancy failed to examine many of the specific cognitive and behavioral issues that caregivers and specialists find people with FASD actually suffer from, but they are used to excuse and even promote drinking during pregnancy, according to the FASD caregiver community.
For example, the Danish study published in BJOG, is often cited as evidence that moderate drinking is harmless to children. Interestingly, some kids were excluded from that study. Children with impaired hearing or vision that made taking the test difficult were excluded, for example. These two physical health issues can be caused by maternal drinking during pregnancy. Children with Trisomy 21 were also excluded, even though there is believed to be an increased incidence of Trisomy 21 in children born of second-generation alcoholic mothers. Additionally, while the researchers in the Danish study examined the young children's sustained attention, the test didn't assess their actual working memory, which is one of the most common issues children with FASD struggle with. In addition, in the Danish study, the authors indicated that limitation, such as information and selection bias, may have occurred, and that the research should not be used to promote or justify drinking during pregnancy.
The new research published in Pediatrics asserts far more children than expected may have physical and behavioral issues that would be defined as FASD. Researchers examined multiple FASD-specific difficulties in addition to physical screenings and maternal surveying. The research also focused on children at an age when issues start to become more obvious because school expectations rise.
There are some characteristics of FASD that, when combined with other characteristics, are indicative that a FASD-related diagnosis should be made, regardless of whether or not a woman will admit to a researcher that she drank during pregnancy. Lara Crutchfield, FASD trainer with FASD Today, has a detailed explanation of the specific physical and neurological damage that can be caused when a woman drinks during pregnancy. Some damage is unique to alcohol exposure.
Children on the less severe end of the FASD spectrum may initially appear unaffected, but may exhibit impairments that can cause difficulties in school, such as working memory problems, impulse control, or other behavioral issues. May and his team of researchers chose a town in the Midwest that had a higher annual alcohol consumption rate than many other areas in the United States. The town had 32 schools. Of the more than 2,000 first graders in the town, about 70 percent of them were given permission to participate in the study by a parent.
First, the team identified first-graders who had developmental problems or were below the 25th percentile for weight, head circumference, or height. The team gave these children comprehensive behavior, memory, and thinking assessments. The researchers also examined the children for clear physical attributes of FASD, including a smooth upper lip, a thin red border to the upper lip, a small head, and small eye openings. Between six to nine out of every 1,000 children had clear Fetal Alcohol Syndrome. Between 11 and 17 children had partial FAS. The researchers expected a higher incidence in the Midwest town in order to have better odds of attaining more data to assess. Still, the number of children that were diagnosed with FAS or a FASD-related diagnosis by the research team were far higher than expected, according to MedLine Plus. Between 2.4 and 4.8 percent of children there have FASD.
"FASD is an umbrella term covering the full spectrum of permanent lifelong conditions, ranging from mild to severe, and encompassing a broad variety of physical defects and cognitive, behavioral, emotional and adaptive functioning deficits," Dr. Janet Williams, professor of pediatrics at the University of Texas Health Science Center in San Antonio, said. "As we have better methodology, we're getting closer to the real prevalence, the real problem, and we need to stop the root cause of the problem."
"First and foremost, women are receiving mixed messages about alcohol use during pregnancy through their family or friends, health care providers and public health campaigns," Lana Popova, assistant professor of epidemiology and of social work at the University of Toronto and senior scientist at the Centre for Addiction and Mental Health, told U.S. News & World Reports.
"It's very sad that in some countries of Eastern Europe, for example, some doctors are still not aware of the harmful effects of alcohol during pregnancy. 'Drink one glass of red wine per day and it's good for your blood,' they say to pregnant women. That is complete nonsense. It's a very harmful message," Popova told Vancouver Sun, which claimed that in Barcelona, a 2008 study assessed over 300 babies in that area of Spain and found a staggering 45 percent showed signs of maternal drinking during pregnancy.
In order to avoid FASD and alcohol related damage, Popova says we need to be clear that "there is no amount of alcohol that has been proven to be safe during pregnancy. There is no safe time to drink during a pregnancy, and there is no safe type of alcohol."
[Photo adapted from stock photos on Pixabay]