TIME: Almanac 1990/1990 Time Magazine Compact Almanac, The (1991)(Time).iso/time/082889/08288900.070

Text File | 1990-09-17 | 6KB | 106 lines

MEDICINE, Page 60

Alcohol's Youngest Victims

Drinking during pregnancy is riskier than many women realize

By Andrea Dorfman


    Everyone should know by now that drinking alcohol during
pregnancy can cause serious physical and mental problems in the
unborn child. Most doctors have told their patients, television
announcements have dramatized the dangers, and warning signs have
gone up in restaurants and bars. But too many mothers-to-be are not
getting the message. More than 50,000 babies are born in the U.S.
each year with alcohol-related defects. In about one-fourth of
these cases, the damage -- ranging from facial deformities to heart
abnormalities -- is severe enough to be classified as fetal alcohol
syndrome.

    Many people still do not realize how common FAS is and how
devastating it can be. According to some researchers, FAS is
responsible for an estimated 20% of all U.S. cases of mental
retardation. That makes FAS the No. 1 threat to children's mental
health, greater than either Down syndrome or spina bifida.

    Unlike such drugs as barbiturates and opiates, which affect
the nervous system, alcohol can attack virtually any of the body's
cells. It can cause stunted growth, distorted faces, poor eyesight,
learning disabilities and hyperactivity. In the recently published
book The Broken Cord (Harper & Row; $18.95), author Michael Dorris
tells the heartbreaking story of his adopted son Adam, whose Sioux
parents died of alcohol abuse. Adam was institutionalized and
diagnosed as retarded before he turned three. At five, he still
wore diapers, could not count consecutively or even identify
colors. "Adam's birthdays are reminders for me," writes Dorris.
"For each celebration commemorating that he was born, there is the
pang, the rage, that he was not born whole."

    The tragedy of FAS is that it is entirely preventable. If a
woman, even an alcoholic one, stops drinking before she tries to
become pregnant, her fetus will not develop FAS or any
alcohol-related birth defects. But pregnancies are not always
planned. If a woman does not realize for several weeks that she is
pregnant, she may not stop drinking in time to prevent harm to the
fetus.

    Researchers believe the damage is probably minimal in the first
two weeks, but during the rest of the first trimester, when the
fetus' organs are forming, the effects may be especially severe.
If the drinking continues, additional damage can occur, since the
brain develops during all nine months and rapid body growth does
not occur until the third trimester. Even after the baby is born,
abstinence may be advisable. A study in last week's New England
Journal of Medicine suggests that when mothers have one or more
drinks a day, their children ingest alcohol in breast milk, which
may impede the infants' motor development.

    Nearly all known cases of FAS involve children whose mothers
have chronic alcohol problems. Says Barbara Morse, director of the
Fetal Alcohol Education Program at the Boston University School of
Medicine: "The more a woman drinks while she is pregnant and the
longer she drinks, the higher the risk of FAS." Even so, moderate
drinking is not considered safe. "Our best evidence is that we
cannot detect adverse consequences to very light drinking," says
Dr. Robert Sokol, head of the federally funded fetal alcohol
research center at Wayne State University, in Detroit. "But that
doesn't mean they don't exist." Beer, wine and hard liquor do not
seem to differ in their impact on the fetus.

    Studies conducted in Boston, Atlanta and Scandinavia indicate
that at least some of the injuries to the fetus may be corrected
in the womb if a mother gives up alcohol before her third
trimester. Says Sterling Clarren, professor of pediatrics at the
University of Washington School of Medicine: "It's pretty clear if
a woman stops drinking in her second trimester, the size and the
healthiness of the baby will improve, but there is no evidence that
its intelligence will improve." Moreover, even the improvement in
appearance may be deceptive. "The babies definitely are bigger and
look healthier," says Dr. Sokol, "but that doesn't mean that all
the effects go away."

    Scientists still do not know why FAS strikes the children of
some alcoholic mothers but not others, and why susceptibility
varies among different ethnic groups. Native Americans, for
example, are 33 times as likely as Caucasians to have a child with
FAS; for blacks, the rate is 6.7 times as high as for Caucasians.
Women who give birth to a child with FAS have a greater-than-
average risk of bearing additional children with the affliction.
Such evidence suggests there may be a genetic predisposition to
FAS, but scientists have not been able to identify the offending
genes.

    Researchers are also trying to determine whether fathers'
drinking habits play any role in FAS. At Wayne State, studies of
male laboratory rodents have shown that alcohol exposure affects
their sperm as well as the immune system and behavior of their
offspring. "I don't think the possibility of the father's effect
can be written off," says Dr. Sokol. "We're not saying the baby
would have FAS, but it's possible there may be some impact on how
the kid comes out."

    There is no treatment for FAS, and so the only way health
officials can fight the scourge is to step up educational efforts.
In New Hampshire, for example, couples must read a pamphlet on FAS
before they can obtain a marriage license. Beginning in November,
liquor bottles will carry a cigarette-style warning label advising
women that alcohol and pregnancy do not mix. But for women who are
addicted to alcohol, the need to drink often overcomes caution and
reason. Until better ways are found to identify and treat
alcoholics, they will continue to inflict a devastating toll on
their children.