Fetal alcohol spectrum disorders: from research to policy

Abstract

Forty years ago, alcohol was not commonly recognized as a teratogen, an agent that can disrupt the development of a fetus. Today, we understand that prenatal alcohol exposure induces a variety of adverse effects on physical, neurological, and behavioral development. Research supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) has contributed to the identification of the range and prevalence of fetal alcohol spectrum disorders (FASD), as well as methods for prevention and treatment of FASD. The worldwide prevalence and high personal and societal costs of FASD speak to the importance of this research. This article briefly examines some of the ways that NIAAA has contributed to our understanding of FASD, the challenges that we still face, and how this research is translated into changes in public policy.

Figure 1

Facial features of FAS.

Figure 2

Magnetic Resonance Imaging (MRI) scans of four children: (A) shows a typically developing 10-year-old boy who has not been exposed to alcohol (B) features an 11-year-old boy with partial fetal alcohol syndrome (pFAS) (C) shows a 7-year-old girl with FAS, and (D) shows a 14-year-old boy with FAS. Notice the variability in brain structures among the individuals with fetal alcohol syndrome disorders, including alcohol-related changes in areas such as the corpus callosum (red arrow) and cerebellum (yellow arrow). SOURCE: Sowell, E.; Nunez, S.; Roussotte, F. Structural and functional brain abnormalities in fetal alcohol spectrum disorders, Alcohol Research & Health, in press.

Figure 3

3D reconstruction of the faces and brains of mice at 17 days of gestation. Control mice are shown in a and c, mice exposed to alcohol are shown in b and d. Mouse fetuses in b and d illustrate dysmorphology resulting from exposure to alcohol at 7 days of gestation. Compared to the control (a), the ethanol-exposed fetus (b) has a smaller head size, a small nose, and an elongated/abnormal philtral portion of the upper lip. These facial features are characteristic of fetal alcohol syndrome. The brain of the ethanol-exposed animal also is dysmorphic (d); the olfactory bulbs are absent and the cerebral hemispheres are united rostrally (open arrow). Color codes: red=cerebral cortex, pink=olfactory bulbs, magenta=mesencephalon, light green=diencephalon, dark green=pons and medulla, teal=cerebellum. SOURCE: O’Leary-Moore, S.K.; Parnell, S.E.; Godin, E.A.; and Sulik, K.K. Magnetic resonance-based studies of FASD in animal models, Alcohol Research & Health, in press. Modified from Godin, E.A.; O’Leary-Moore, S.K.; Khan, A.A.; et al. Magnetic resonance microscopy defines ethanol-induced brain abnormalities in prenatal mice: effects of acute insult on gestational day 7. Alcoholism: Clinical and Experimental Research 34(1):98–111, 2010. PMID: 19860813