Fetal Alcohol Spectrum Disorders: An Overview from the Glia Perspective

If you drink during pregnancy, you place your baby at risk of fetal alcohol syndrome. Exposure of primary astrocyte cultures to alcohol also impairs astrocyte proliferation induced by serum, IGF-1, the cholinergic agonist carbachol, and PDGF (Resnicoff et al., 1994; Guizzetti and Costa, 1996; Kötter and Klein, 1999). Alcohol appears to affect astrocyte proliferation by inhibiting specific signal transduction pathways. Prenatal alcohol exposure has been reported to cause a decrease in astrocyte number (Miller and Potempa, 1990), an observation that supports the in vitro studies.

How do I determine where to refer her for treatment?

The U.S. Food and Drug Administration (FDA) designated specific drugs for treating the symptoms of withdrawal from alcohol in babies. However, it’s important to note that there is no treatment for life-long birth defects and retardation. As previously described, at first glance, prenatal exposure to alcohol may not be expected to exert a substantial effect on myelination in adults, given that much of the myelination that occurs in humans happens long after birth. Nevertheless, developmental exposure to alcohol permanently impacts the programming of OPCs, as imaging studies indicate widespread anomalies in children and adults with FASD (Archibald et al., 2001; Sowell et al., 2008). These findings are recapitulated in rat models of FASD, where alcohol slows myelination and disrupts the myelin ultrastructure (Lancaster, 1994; Phillips, 1994; Pinazo-Duran et al., 1997).

• If you are having unprotected sex and not using birth control, you must abstain from alcohol.
• In some cases, your healthcare provider might be able to diagnose a child with fetal alcohol syndrome at birth based on small size and specific physical appearance.
• This condition can be prevented if you don’t drink any alcohol during pregnancy.

Signs and symptoms of FASD in a baby

However, 25% of the population are considered to be at-risk alcohol users. Non-alcohol dependent drinkers will benefit most from brief, straightforward education and support from their primary care provider. Symptoms of alcohol withdrawal usually start within a few hours of the last drink and include tremors, sweating, hypertension, tachycardia, restlessness, and nausea. This begins one to three days after the last drink and may continue up to 10 days. The delirium consists of disorientation, altered sleep-wake cycles, and hallucinations.

Characteristics of fetal alcohol spectrum disorder (FASD)

The hypothesis that glial cells in males vs. females are differentially affected by alcohol during brain development is worth further examination. To gain a greater understanding of alcohol effects on brain development and behavioral effects of prenatal alcohol exposure, several animal models have been developed. Models are present for nonhuman primates and sheep, which are advantageous due to gestation periods comparable to humans; however this is offset by substantially higher costs. Paralleling the human gestation period, the brain growth spurt in nonhuman primates and sheep occurs prenatally (Cudd, 2005).

Access answers to questions frequently asked about identification, diagnosis, treatment and care management of individuals with an FASD. This section provides information on evidence-based interventions, resources for clinicians, and helping families of children with an FASD access services and community supports. First-line treatments for children with ADHD and FAS include methylphenidate- and amphetamine-derived stimulants.

Adolescents exposed prenatally to cocaine, alcohol, or cigarettes showed reductions in total brain volume and in gray matter in the brain’s cerebral cortex, important in many cognitive functions. There were too few children to find statistically significant effects of any single substance after accounting for other exposures, but the more substances a child was exposed to, the greater the reduction in brain volume. Fetal alcohol syndrome includes a characteristic group of drunken baby syndrome physical defects, including small head and brain and facial abnormalities, as well as defects in other organs. There is no “safe” amount of alcohol you can drink during pregnancy. And there is no time during pregnancy when it’s considered safe to drink alcohol, either.

• Withdrawal is managed with thiamine and benzodiazepines, sometimes with other drugs to address symptoms.
• However, it’s important to note that there is no treatment for life-long birth defects and retardation.
• The findings are of public health significance, since it’s estimated that more than 1 million babies born annually in the United States have been exposed to at least one of these things in utero.
• The U.S. surgeon general also recommends abstaining from alcohol if you’re trying to conceive.
• It’s important to understand that FASDs can result from occasional drinking as well.
• Therefore, people who are trying to get pregnant may be pregnant for 1 month or more without knowing it.

This data suggests that myelin and more specifically, oligodendrocyte development is a target of alcohol effects in the developing brain and that early exposure can lead to persistent, life-long deficiencies. Disruptions in survival and maturation of oligodendrocytes are likely to impair the formation of neurocircuitry and the efficient conduction of neuronal signals. Future studies are needed, however, to elucidate the effects of alcohol on oligodendrocytes and OPCs to understand the pathways that lead to alcohol-induced dysfunction. Examination of the impact of alcohol on oligodendrocytes and by extension, myelination has been intermittent at best, with the bulk of studies occurring in the late 1970s or early 1990s. With the availability and affordability of advanced imaging techniques, interest is once again growing and high resolution examination of myelin in FASD subjects is now possible.

• They may be able to direct you to further options for achieving your goals and provide the medical care that may be necessary to withdraw from alcohol.
• In 2019, CDC researchers found that 1 in 9 pregnant people drank alcohol in a 30-day period of time.
• More recent reports indicate reduced gyrification of the cortex (Infante et al., 2015) and a reduction in the surface area of the anterior cingulate cortex (Migliorini et al., 2015) among adolescents with heavy prenatal alcohol exposure.
• Our studies indicate that alcohol upregulates expression of ABCA1 and ABCG1 in astrocyte cultures, thereby increasing cholesterol efflux and reducing brain cholesterol levels (Guizzetti et al., 2007).
• Before trying any alternative therapy for FAS, parents or caregivers should speak with the child’s pediatrician or a doctor who specializes in FASDs.

What are the types of FASDs?

While some growth issues may improve, children with FASDs may have short height or developmental delays through adulthood. Other issues, like learning disabilities or ADHD, may improve with appropriate therapies, medications, and other support. An FASD diagnosis provides families, pediatricians and nonphysician clinicians a framework for understanding an individual’s behavior. Science indicates that therapeutic interventions, special education and support services improve outcomes for patients and families. The protective effect of early FASD diagnosis can reduce the risk of additional disabilities and mitigate lifelong consequences.

Fetal alcohol syndrome

Alcohol can cause problems for a developing baby throughout pregnancy, including before a woman knows she’s pregnant. All types of alcohol are equally harmful, including all wines and beer. It’s also recommended that you not drink alcohol if you’re sexually active and not using effective birth control. Alcohol consumption could harm the developing fetus at any time during pregnancy — especially early on in the development process.