It represents the biggest single cause of developmental disabilities among newborns in Canada and the United States – exceeding $14 billion in health-care costs annually. And while the prevention of fetal alcohol spectrum disorders (FASD) remains a high priority, Western researchers are convinced an alcohol culture will make it tougher to get the message out – no matter how much proof scientists provide.
“The scientists have bought into it; our problem now is convincing the public,” Biology professor Shiva Singh said. “It’s the tip of the iceberg when you look at FASD – there are a lot of problems underneath. The more you look the more you’re going to find.”
Fetal alcohol spectrum disorder is a continuum of various permanent birth defects caused by the mother’s consumption of alcohol during pregnancy. The umbrella term was developed to include fetal alcohol syndrome as well as other conditions.
Hard as it is to believe, no scientific consensus exists on whether there is a safe limit for alcohol consumption during pregnancy.
Recent findings, led by Biology PhD student Ben Laufer, however, have proven exposure of human embryonic stem cells to low alcohol can alter gene expression, leading to the abnormal development of prefrontal cortex in the newborn. These findings build on – and confirm – his previous work on mice models, which also showed continuous exposure of low-to-moderate doses of alcohol during pregnancy impacted behavioural and cognitive outcomes for the newborn.
In addition to issues at birth, the lingering effects continue later in life, Laufer said. Fetal alcohol-exposed school children show a small, but potentially important, detrimental effect on educational outcomes.
“Even a single binge dose of alcohol, at any time during pregnancy, results in alterations in gene expression and associated FASD-related (characteristics),” Laufer said.
For the study, Laufer teamed up with Dr. Joachuim Kapalanga, head of paediatrics for Grey Bruce Health Services, for a pilot experiment using non-invasive diagnostics on fetal alcohol exposed children ages 3-6.
“We’ve come across a strong replication and expansion of the pattern that we’ve seen in the mouse models,” said Laufer, who works under Singh’s supervision.
These latest results deserve serious consideration as the Royal College of Obstetrics and Gynecologists continue to state, “There is considerable doubt as to whether infrequent and low level of alcohol consumption during pregnancy convey any long-term harm.”
“The rational question is, ‘Does no evidence of harm from low levels of alcohol consumption mean 100 per cent exclusion of the possibility of any harm to the fetus?’ To the best of our understanding, the answer is ‘no,’” Laufer continued. “The business-as-usual model is not helpful. It continues to result in births with alcohol effects. Any harm caused by prenatal alcohol is currently not reversible and will affect the child for life.
“Any adult has the right to drink if they so wish. But also, every child has the right to be born healthy.”
Through a simple saliva test, Laufer saw identical signatures in humans as in mice.
“The brain’s whole epigenome really seems to be deregulated. A lot of that seems to be an indicator of a past developmental event being altered, as opposed to a current one,” he said. “That was our ‘eureka moment.’ We see it in the child’s spit, so we were wondering, ‘Why is this exact same signature occurring in the (mouse) brain?’”
When Singh began studying FASD, it was the most common disorder in the population of those with mental defects – at times up to 30 per cent of children. With no clear causation for any other diseases, it all went back to maternal drinking.
“Looking at gene expression, we found it doesn’t matter if we treated them (mice) in the first, second or third trimester. The affect was still there. Their brain gene expression was altered,” he said. “This kind of observation has never been made – that you do something way back and it maintains.”
While questions always remain for scientists, the continuing problem is convincing the general public of the dangers of prenatal drinking.
“The idea is to make use of what’s under the iceberg to enable you to predict whether or not someone is actually going to show it,” he said. “It is amenable to treatment, not necessary with a drug, but with proper education.”