Alcohol in pregnancy: for the Italian Society of Neonatology (SIN), little information and too much cultural compliance with women of childbearing age
Alcohol in pregnancy
In the world, about 60% of women drink alcohol during pregnancy and every year they are born about 120 thousand children (in Italy almost 2500) which they will probably develop the spectrum of fetal-alcoholic disorders (FASD). It is a great heterogeneity of physical and neuro-behavioral anomalies, of very variable severity and related sequelae, which can affect the unborn child exposed toalcohol during pregnancy e breastfeeding.
“Worldwide, the estimated prevalence of fetal alcohol syndrome (FAS), which represents the most serious and evident form among the alterations attributable to alcohol, oscillates between 0.5 and 3 cases per 1000 live births in most populations, while the entire spectrum of related disorders (FASD) , affects about 1% of the global population. A fact that should make us reflect is that FASD is currently the leading cause of mental retardation in children in high-income countries “, says Fabio Mosca, President of the Italian Society of Neonatology (SIN).
On the occasion of the World Day on Fetal Alcoholic Syndrome and Related Disorders which is celebrated on September 9, the SIN draws attention to disability and the problems deriving from the use of alcoholic beverages during pregnancy, to counter the problem and contribute to the dissemination of correct information.
Risks of alcohol in pregnancy
It has long been known as the alcohol, even in very small doses, if taken during pregnancy and lactation, both a teratogenic substance and it can cause serious problems for the unborn child, even in the long term.
Among them the fetal alcohol syndrome (FAS), a complex malformative condition, diagnosable already in the neonatal period, characterized by specific facial malformations (short eyelid rims, thin upper lip, flat and elongated nasolabial filter), microcephaly, staturo-weight growth deficit and neuro-psychomotor retardation.
The cognitive-behavioral pattern of children with FAS can include deficit of executive and motor function, both fine and coarse, information processing / integration, discrepancies between verbal and non-verbal skills, learning, attention and hyperactivity disorders. If not properly identified and treated at an early age, these problems can lead to a series of secondary disabilities that tend to manifest themselves especially in adolescence, such as poor academic or work performance, lack of independent life and socio-relational difficulties.
Many expectant mothers are mistakenly convinced that consuming wine, beer, spirits, bitters or spirits in a “moderate” manner does not cause problems for the fetus. Conversely, few women are aware that alcohol consumption during pregnancy is always harmful regardless of the quantity consumed and the times in which it is consumed. Italy, where alcohol is culturally accepted and actually associated with positive images, is among the nations in the world with the highest prevalence of fetal-alcoholic syndrome.
Project of the Ministry of Health
There are currently no Italian data on alcohol consumption in pregnancy and on the incidence and prevalence of FAS / FASD. For this reason, the Ministry of Health recently financed the Istituto Superiore di Sanità (ISS) un two-year project on prevention, early diagnosis and targeted treatment of the FASD and FAS spectrum.
The project, also sponsored by SIN and directed by Dr. Simona Pichini of the National Center for Addiction and Doping, will involve various Neonatology and Obstetrics Structures in various Italian regions.
It has also been born for some years the Italian Association of Fetal Exposure Disorders to Alcohol and / or Drugs (AIDEFAD – APS), to provide information on disabilities and problems resulting from the use of alcoholic beverages during pregnancy, to support research and to provide support for those affected by this condition and not diagnosed.
How to prevent FASD and FAS
FASD is 100% preventable, but to do this it is essential that doctors provide pregnant women and women of childbearing age with all the information they need to understand what the consequences of alcohol consumption may be. Recently, many studies have shown that alcohol also acts on the DNA of spermatozoa and therefore it would be advisable that men also reflect on the possible consequences of drinking alcohol during the fertile period.
Unfortunately, despite the efforts made for education and information on FAS, neonatologists and pediatricians express concern about the possible future increase in the global prevalence of this disease.
The main cause of the spread of FAS is the widespread cultural compliance with alcohol consumption, which can also be found among some health professionals in contact with women of childbearing age. The only correct indication to provide would in fact be the total abstention from alcohol since one begins to think of wanting to conceive a child, an awareness unfortunately not yet widespread enough.
An increase in FAS in the future could also be due to the rates of alcohol consumption and binge drinking, which are constantly increasing among young people, and to unplanned pregnancies, today in a large percentage, which can unintentionally expose the fetus to alcoholic substances.
For children exposed to alcohol during pregnancy, early diagnosis is essential, to ensure care that includes medical and psychiatric / psychological care, speech therapy, physical therapy, special education and other essential services.