I: Reviews
Citation: Chaudhuri, J.D. (2000) Alcohol and the developing fetus – A review. Medical Science Monitor, 6(5), 1031-1041.
Article Type: Review
Conclusion: FAS continues to present a challenge to all of those involved. Enhanced efforts to promote education, to identify the specific mechanism through which alcohol affects the fetus, and to view prenatal alcohol consumption as a form of abuse are required in order to lessen its impact on society.
Summary: This paper provides an overview of FAS, discussing: its history; clinical features of FAS; evidence of the impact of prenatal exposure to alcohol on the fetus; possible mechanisms for its action; and the need for prevention. With respect to the clinical features, the author points out that there is great variation, with the most common features being growth retardation and cranial (head) malformations. The impact on the brain is discussed, as well as to the vertebrae and organs such as the liver, eye, kidney, and hearing system. In presenting the effect of alcohol on the fetus, the author highlights both human as well as animal studies. Several possible mechanisms are reviewed, all of which focus on the means by which alcohol and its metabolized byproducts affect the growth and development of cells. Finally, with respect to prevention, the author points out that a lack of awareness is a primary contributor to its prevalence, particularly among members of the medical community. Further research on the mechanisms of alcohol’s damage on the fetus is required in order to develop protocols that would prevent its occurrence.
Implications: Central to the prevention of FAS are increased efforts in research and education, as well as legislative mandates that categorize maternal alcohol during pregnancy as a form of abuse. It is the author’s contention that in the absence of such legislation, FAS will continue to present a significant challenge.
Email Address: joydeep@medicine.med.um.edu.my
I: Reviews
Citation: Randall, C.L. (2001). Alcohol and pregnancy: Highlights from three decades of research. Journal of Studies on Alcohol, 62, 554-561.
Article Type: Review
Conclusion: Although much progress has been made in the area of fetal alcohol research, there is still much to be learned. The field is both subject to and a contributor towards the evolution of molecular and genetic research. It is important that researchers, both experimental and clinical, identify the most pressing questions and apply innovative and multi-disciplinary methods in pursuing their answers.
Summary: This article traces the history of research and evidence regarding prenatal alcohol exposure, showing how advances in knowledge have progressed hand-in-hand with the status of research pertaining to pregnancy and fetal development as a whole. It points to: the significance of Jones and Smith’s 1973 article that coined the term “fetal alcohol syndrome;” the use of animal models in research in order to identify specific effects; the advent and growth of the field of “behavioral teratology;” and the promises that imagining technology offers. Research on the possible mechanisms of actions is reviewed, as well as opportunities that exist for future work. These include studies that: lead to possible pretreatment interventions; use advances in molecular and genetic technology to identify protective and risk factors; result in the development of effective screening tools for pregnant women; and provide evidence-based interventions for children with FAS. The author points to several challenges in the field, namely: the need for the FAS research community to identify what questions need to be answered; the need to identify effective means through which pregnant women are encouraged to protect their unborn children; and the need to tackle fetal alcohol research using a multi-disciplinary approach.
Implications: The field of fetal alcohol research has made much progress, but it is clearly in its infancy. New technology and approaches afford much opportunity in the search for identifying systemic mechanisms of prenatal alcohol exposure. These, in turn, can be utilized in developing effective prevention and intervention strategies (behavioral, pharmacological and physical) for children with FAS. Approaches that are innovative and multi-disciplinary have much to offer.
Email Address: randallc@musc.edu