A review on consequences on foetal development during alcohol induced mother

Jyothirlatha Ravuru; Sowjanya M; Prapurna Chandra Y; Venugopalaiah Penabaka; Afroz Patan

doi:10.37022/jcscr.v4i2.755

Ravuru Jyothirlatha B. Pharmacy, IV Year, Ratnam Institute of Pharmacy, Pidathapolur (V & P), Muthukur (M), SPSR Nellore District-524 346, Andhra Pradesh.
M. Sowjanya Assistant professor, Department of Pharmacy practice , Ratnam Institute of Pharmacy, Pidathapolur (V & P), Muthukur (M), SPSR Nellore District-524 346, Andhra Pradesh.
Y Prapurna Chandra Principal and Professor, Department of Pharmacology, Ratnam Institute of Pharmacy, Pidathapolur (V & P), Muthukur (M), SPSR Nellore District-524 346, Andhra Pradesh.
Venugopalaiah Penabaka Professor, Department of Pharmaceutics, Ratnam Institute of Pharmacy, Pidathapolur (V & P), Muthukur (M), SPSR Nellore District-524 346, Andhra Pradesh.
Afroz Patan Professor & HOD, Department of Pharmacy practice, Ratnam Institute of Pharmacy, Pidathapolur (V & P), Muthukur (M), SPSR Nellore District-524 346, Andhra Pradesh.

DOI https://doi.org/10.37022/jcscr.v4i2.755

Abstract

Maternal alcohol consumption during pregnancy remains a significant global public health concern, with severe and lasting consequences on foetal development. This review explores the broad spectrum of physical, neurological, cognitive, and behavioural abnormalities associated with prenatal alcohol exposure, collectively known as Foetal Alcohol Spectrum Disorders (FASDs). Among these, Foetal Alcohol Syndrome (FAS) represents the most severe end of the spectrum, characterized by distinct craniofacial abnormalities, growth retardation, and central nervous system dysfunction. Alcohol acts as a teratogen that interferes with cellular differentiation and proliferation during critical stages of embryonic development. It can cross the placental barrier and accumulate in the amniotic fluid, directly impacting the foetus, whose metabolic system is underdeveloped and thus unable to eliminate alcohol efficiently. The timing, frequency, and amount of alcohol consumed play a crucial role in determining the severity of developmental outcomes. First-trimester exposure often affects organogenesis and facial morphology, while third-trimester exposure more commonly impacts brain growth and synaptogenesis. This review also highlights emerging research linking prenatal alcohol exposure to epigenetic modifications and alterations in neurodevelopmental gene expression. Children born to alcohol-consuming mothers often show deficits in learning, memory, attention, language, and executive functions, which can persist into adolescence and adulthood. Behavioural disorders such as ADHD, conduct disorders, and emotional dysregulation are also frequently reported.

Keywords: Foetal Alcohol Spectrum Disorders (FASDs), Foetal Alcohol Syndrome (FAS), prenatal alcohol exposure, neurodevelopment, teratogen, epigenetics, cognitive impairment, behavioural disorders, maternal health, pregnancy

References

1. Tette EMA, Intiful FD, Asare AA, Enos JY. Pregnancy as a Fundamental Determinant of Child Health: a Review. Curr Nutr Rep. 2022 Sep;11(3):457-485. doi: 10.1007/s13668-022-00416-1. Epub 2022 Jul 5. PMID: 35789475.
2. Addila AE, Bisetegn TA, Gete YK, Mengistu MY, Beyene GM. Alcohol consumption and its associated factors among pregnant women in Sub-Saharan Africa: a systematic review and meta-analysis' as given in the submission system. Subst Abuse Treat Prev Policy. 2020 Apr 15;15(1):29. doi: 10.1186/s13011-020-00269-3. Erratum in: Subst Abuse Treat Prev Policy. 2020 Oct 26;15(1):82. doi: 10.1186/s13011-020-00325-y. PMID: 32293479; PMCID: PMC7158038.
3. Ghosh A, Verma A, Choudhury S, Dhawan P. Regional disparities and correlates of alcohol use during pregnancy in India: Insights from the National Family Health Survey-5. Drug Alcohol Rev. 2025 Feb;44(2):576-587. doi: 10.1111/dar.13995. Epub 2024 Dec 22. PMID: 39711048.
4. Popova, S., Dozet, D., & Rehm, J. (2023). Global prevalence of alcohol use during pregnancy and fetal alcohol spectrum disorders. Drug and Alcohol Dependence, 248, 109991.
5. May, P. A., Chambers, C. D., Kalberg, W. O., Zellner, J., Feldman, H., & Hoyme, H. E. (2018). Prevalence of fetal alcohol spectrum disorders in 4 US communities. JAMA, 319(5), 474–482.
6. Popova S, Dozet D, Shield K, Rehm J, Burd L. Alcohol's Impact on the Fetus. Nutrients. 2021 Sep 29;13(10):3452. doi: 10.3390/nu13103452. PMID: 34684453; PMCID: PMC8541151.
7. Burd L, Roberts D, Olson M, Odendaal H. Ethanol and the placenta: A review. J Matern Fetal Neonatal Med. 2007 May;20(5):361-75. doi: 10.1080/14767050701298365. PMID: 17674239.
8. Popova, S., Dozet, D., Shield, K., Rehm, J., & Burd, L. (2021). Alcohol’s Impact on the Fetus. Nutrients, 13(10), 3452.
9. Popova S, Dozet D, Shield K, Rehm J, Burd L. Alcohol’s Impact on the Fetus. Nutrients. 2021; 13(10):3452.
10. Wallén, E.; Auvinen, P.; Kaminen-Ahola, N. The Effects of Early Prenatal Alcohol Exposure on Epigenome and Embryonic Development. Genes 2021, 12, 1095.
11. Guerri,C.,&Renau-Piqueras,J.(1997).Ethanol, acetaldehyde, and brain development: Mechanisms of damage. Neurotoxicology and Teratology, 19(4), 403–414.
12. Dong,J.,&Sulik,K.K.(2001).The role of nitric oxide in ethanol-induced cell death in the developing mouse brain. Neurotoxicology and Teratology, 23(4), 377–385.
13. Shankar,K.,etal.(2006).Maternal nutrition and fetal development: Interplay of alcohol and nutrient interactions. The Journal of Nutrition, 136(11), 2743–2747.
14. Gundogan,F.,etal.(2008).Fetal alcohol-induced oxidative stress in the placenta:Relevancetopregnancylossandfetalinjury.Alcohol, 42(6), 479–487.

15. Mattson,S.N.,etal.(2019).Diagnosis of fetal alcohol spectrum disorders: A guideline from the Canadian FASDResearchNetwork.Canadian Medical AssociationJournal,191(19),E520E528.
16. May,P.A.,etal.(2018).Prevalence of Fetal Alcohol Spectrum Disorders AmongUSChildren.JAMA,319(5),474
17. Mattson,S.N.,etal.(2019).Toward a neurobehavioral profile of fetal alcohol spectrum disorders.Alcoholism: Clinical and Experimental Research, 43(3), 529–544.
18. Abel,E.L.(1995).An update on incidence of FAS: FAS is not an equal opportunitybirthdefect.Neurotoxicology and Teratology, 17(4), 437–443.

19. Chen, W. J. A., et al. Alcohol and the Developing Brain: Neuroanatomical Studies. 2003. (Review of human and animal neuroanatomy).
20. Fryer, S. L., et al. (2007). Attention and working memory abilities in children with prenatal alcohol exposure: A meta-analysis. Neuropsychology, 21(2), 140–149.
21. Jones, K. L., & Smith, D. W. (1973). Recognition of the fetal alcohol syndrome in early infancy. The Lancet, 302(7836), 999–1001.
22. Riley, E. P., Infante, M. A., & Warren, K. R. (2011). Fetal alcohol spectrum disorders: An overview. Neuropsychology Review, 21(2), 73–80.
23. Chang, G. (2001). Alcohol-screening instruments for pregnant women. Alcohol Research & Health, 25(3), 204–209.
24. Carson, G., et al. (2017). Alcohol use and pregnancy consensus clinical guidelines. J Obstet Gynaecol Can, 39(9), e220–e231.