World Fetal Alcohol Syndrome Day on September 9, lest we forget to say NO to alcohol.

September 9 is World Day on Fetal Alcohol Syndrome and Related Disorders. Fetal alcohol syndrome is the leading cause of mental retardation in children in high-income countries: it is the spectrum of fetal alcohol disorders (FASD).

Can I drink a glass of wine or beer when pregnant? This is a somewhat common question. The discussions on the subject are numerous, as are the clashes. In fact, there are those who defend the freedom of being able to drink a glass of wine occasionally even during pregnancy, and those who rightly point out the complete ban, supported by scientific evidence.

In fact, there are no doubts about alcohol during pregnancy. It is a combination that cannot exist. You cannot drink alcohol during pregnancy, not even a glass every now and then. 

In fact, alcohol is the cause of Fetal Alcohol Syndrome which represents the first cause of mental retardation in children of countries with a high economic standard: it is the Spectrum of Fetal Alcohol Disorders (FASD) .

September 9 is the World Day on Fetal Alcohol Syndrome and related disorders, and on this particular occasion the SIN, the Italian Society of Neonatology,   draws attention to the disabilities and problems deriving from the use of alcoholic beverages during pregnancy, to contrast the problem and contribute to the dissemination of correct information.

What causes alcohol in pregnancy?

Drinking alcohol while pregnant undermines your baby’s short- and long-term health. Too often the dangers of this lifestyle are underestimated partly because false knowledge is handed down from generation to generation, ” what do you want it to be for a glass of wine “, and partly because of too much cultural condescension towards wrong attitudes.

Indeed, the numbers speak for themselves, very dear: 120,000 children are born every year in the world (about 2,500 in Italy) to mothers who drank alcohol during pregnancy and who will probably develop the spectrum of fetal alcohol disorders (FASD).

The syndrome manifests itself with a great heterogeneity of physical and neuro-behavioral anomalies, of highly variable severity and related sequelae, which can affect the unborn child exposed to alcohol during pregnancy and breastfeeding.

In fact, around 60% of women are unable to give up alcoholic beverages during pregnancy, a very high number that must make everyone think.

Fabio Mosca, President of the Italian Society of Neonatology (SIN), explains the situation as follows: ” At a global level, the estimate of the prevalence of fetal alcohol syndrome (FAS), which represents the most serious and evident form among the alterations attributable to alcohol, it fluctuates 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 countries with high economic standards”.

Small doses, big effects

The most difficult concept to get across is that even very small doses of alcohol can have serious effects on the fetus. Alcohol, even in small quantities, if taken during pregnancy and while breastfeeding, is a teratogenic substance that can cause serious problems for the unborn child, even in the long term.

The World Day on Fetal Alcohol Syndrome and related disorders which is celebrated on September 9 , really wants to draw attention to the disabilities and problems deriving from the use of alcoholic beverages during pregnancy, to counter the problem and contribute to the diffusion of a correct information.

Living in contact with many mothers and expectant mothers, it is clear that many women are not correctly informed. Indeed, they are convinced that a moderate consumption of wine, beer, or even spirits does not cause any damage. Unfortunately this is not the case.

There is no safe amount, alcohol consumption during pregnancy is always harmful regardless of the amount consumed and the times it is consumed.

 Fetal Alcohol Syndrome (FAS)

One of the first consequences of alcohol abuse during pregnancy can be diagnosed already during pregnancy. It is a complex malformation condition,   characterized by specific facial malformations (short palpebral fissures, thin upper lip, flat and elongated nasolabial philtrum), microcephaly, height-weight loss and neuro-psychomotor retardation.

Cognitive-behavioral consequences for children with FAS can include:

• deficits in executive and motor function, both fine and gross,
• information processing/integration deficit,
• discrepancies between verbal and non-verbal skills,
• learning disorders, attention and hyperactivity.

All these problems, if not identified promptly, can cause further secondary disabilities which tend to manifest themselves especially in adolescence such as:

• poor school or work performance,
• lack of independent living and socio-relational difficulties.

The prevention project

Italy, either because there is a sort of culture of wine and spirits, as well as being an important producing country, is among the nations in the world with the highest prevalence of fetal alcohol syndrome. A primacy we will gladly do without.

Currently we do not have reliable data on alcohol consumption in pregnancy and for this reason the Ministry of Health has recently financed a two-year project on prevention, early diagnosis and targeted treatment of the FASD spectrum and FAS at the Istituto Superiore di Sanità (ISS) .

The project is sponsored by SIN and directed by Dr. Simona Pichini of the National Center for Addiction and Doping, and will see the participation of various Neonatology and Obstetrics Structures in various Italian regions.

Also active in this area is the Italian Association of Fetal Exposure Disorders to Alcohol and/or Drugs (AIDEFAD – APS) , created to provide information on disabilities and problems deriving from the use of alcoholic beverages during pregnancy, support research and give support for those affected by this condition and are not diagnosed.

Complete abstention from alcohol is the only way to prevent FASD, but to do this, widespread information is needed, starting from schools, where unfortunately the use of alcohol is widespread among boys and adolescents, unaware of the damage that these substances can cause long-term.

Information is also needed in the preconceptional phase . It has been seen from recent studies that alcohol also acts on the DNA of spermatozoa , with important negative implications on fertility.

The only correct indication to provide would in fact be total abstention from alcohol from when one begins to think of wanting to conceive a child, an awareness unfortunately not yet widespread enough.

For children exposed to alcohol during pregnancy, early diagnosis is essential to ensure management that includes medical and psychiatric/psychological care, speech therapy, physical therapy, special education and other essential services.