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Fetal Alcohol Spectrum Disorder
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Metabolism of Alcohol Within the Baby's Body
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Metabolism of Alcohol Within the Mother's Body
Metabolism of Alcohol within the Baby's Body
Alcohol is a teratogenic. A teratogen is an agent that can cause malformations of an embryo or fetus. Alcohol is soluble in both water and fat, thus it can penetrate all cell membranes and body tissues. Alcohol passes from mother to fetus through the placenta until fetal alcohol concentration is almost equal to or more than the blood alcohol of the mother. Alcohol then stays in the baby's system 3 to 4 days longer than in the mom's system. Once there, the alcohol interferes with the fetus' ability to receive oxygen and nourishment for cell development in the brain and body organs, thus impeding growth. During quiet, sober times, the baby's brain tries to make up for the lost time with spurts of growth. (1)
How alcohol affects babies is related to the amount of alcohol consumed, period of gestation it occurs in, and maternal and fetal factors that include genetics and the susceptibility of the individuals involved. Severity of FASD goes up with the amount of alcohol consumed, but can result from drinking even small amounts of alcohol.
Because this Syndrome is NOT restricted to the fetal stage, the terms FAS and FAE can be misleading. In fact, the fetal stage doesn't begin until around 47 days after conception, when the first true bone cells replace cartillage.(2) But alcohol can, and does, have devastating effects within the 1st trimester, and as early as the pre-embryonic or blastocyst stage. Toxic levels of alcohol at this stage could result in delayed implantation and structural changes to most any cell within the forming body. (3) There is also a POSSIBILITY that if alcohol were to cause genetic damage to those cells very early in the pregnancy, that damage could become part of the genetic 'programming'. Thus, a child could pass on the damaged cells to his or her own children. The same theory exists for the possibility that a man's genetic material could be damaged early by his own mother's drinking. However, this is as yet unproved.
Next comes the embryonic stage in the early period after conception, between weeks 2 through 8. Generally, alcohol affects the baby during the 1st trimester by interfering with development. This is the stage of cell development. It is during these early weeks of the first trimester that facial changes can occur. The heart, eyes, legs, arms, teeth, ears, palate, and external genitalia are all vulnerable to alcohol in the first trimester. The cells begin to separate at this time, producing tissues and organs and growing into the fetal stage. Between weeks 4-8 there is also is an important transitory period from the embryonic to the fetal stage. It is a time of great vulnerability to alcohol. Damage to the Central Nervous System (CNS) can occur, and can usually happen at lower levels of alcohol exposure than those that cause structural changes. (4)
Further, brain development requires brain migration during the 1st trimester. Alcohol interferes with that, so vulnerability to brain damage is highest in the 1st trimester, from day 15 to 25. (5) But brain damage occurs throughout the pregnancy. There are two periods of rapid brain growth: in the 3rd month and from the 6th month to after birth. In the 2nd trimester, alcohol also increases the risk of spontaneous miscarriage, and during the 3rd trimester, alcohol causes decreased fetal growth and creates shortages in all areas of development.
Metabolism of Alcohol within the Mother's Body
Because women generally weigh less and have less body water than men, blood alcohol levels can be higher in women than men even if they both have had the same amount of alcohol. Women also tend to metabolize alcohol faster (6) and become drunk at a faster rate than men do. Their stomachs have less of the protective stomach enzyme, "alcohol dehydrogenase," which breaks down alcohol in the stomach. Because of this, about 30% more alcohol enters the bloodstream of a woman as pure alcohol.
We do not know whether certain ethnic groups have a genetic susceptibility to FAS, but we do know that there are ethnic differences in the metabolism of alcohol. In comparison to Caucasians, the Chinese, Native Americans and Japanese have a higher rate of alcohol metabolism. (7) There is also evidence of racial differences in acute reactions to alcohol in terms of sensitivity to dizziness and hangovers. Orientals of Mongoloid heritage and American Indian populations seem to suffer the worst. Therefore, fetal susceptibility to alcohol may depend on racial and genetic make-up as well as how the alcohol was used. (8)
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1. E. Smith, "As A Matter of Fact…" Fetal Alcohol Syndrome, February 1994, Missouri Department of Health, Division of Alcohol and Drug Abuse, online article, 26 Mar. 2005. <http://www.well.com/user/woa/fsfas.htm>.
2. H.G. Tittmar, ed. Advanced Concepts in Alcoholism, (Pergamon Press, P.6. N.Y., 1982), online, 27 Mar. 2005 < http://www.digitalism.org/hst/fasref.html >
3. L. Cervantes, “ Not for women Only FAS”. (Alcoholism, Nov/dec., 1984), online, 27 Mar. 2005 <http://www.digitalism.org/hst/fasref.html >
4. Anuppa Caleekal B.A., M.Sc. Fetal Alcohol Syndrome, 1989, Health Science and Technology Gallery, online article, 22 Mar. 2005, < http://www.digitalism.org/hst/fetal.html >
5. J.W. Santrock, Life Span Development, Brown Publishers, 1986, in Anuppa Caleekal B.A., M.Sc. Fetal Alcohol Syndrome, Health Science and Technology Gallery, online article, 22 Mar. 2005, <http://www.digitalism.org/hst/fetal.html >
6. S.C Harding,. and J.R. Wilson, “Ethanol Metabolism in Men and Women”, Journal of Studies in Alcohol, 1987, in Ibid.
7. D.P. Agarwal, and H.W. Goedde, “Ethanol Oxidation: Ethnic Variations in Metabolism and Response”. Ethnic Differences in Reactions to Drugs and Xenobiotics, Alan R. Liss. Inc., 1986, in Ibid.
8.
Ibid.
FASD resources
Contact us at
Christian Alliance for Indian Child Welfare
PO Box 253, Hillsboro, ND 58045 - 0253
writeus@caicw.org
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