Father's Toxic Alcoholism Causes Optic Nerve Damage in Baby

NICHD Research Seeks Clues into the Causes of Booze- and Drug-Related Birth Defects

According to the Centers for Disease Control and Prevention (CDC), birth defects occur in one of every 33 babies and are the leading crusade of babe decease. These problems, nowadays at birth, are caused by genetics, the environment, and other known and unknown causes. Environmental causes of birth defects include chemical and other exposures that occur during pregnancy, including exposure to booze and drugs.

The NICHD is aware that the term "birth defects" carries negative undertones and that the term does not reflect the many abilities and talents of those impacted by these issues. Communities are discussing alternative terms for describing these birth bug. Until a consensus is reached, and with the goal of highlighting inquiry on this important topic, this spotlight uses the term to describe health problems nowadays at birth.

Research shows that there is no safe level of alcohol use during pregnancy; even a very pocket-size amount can have negative effects on the developing fetus. For this reason, wellness care providers recommend that women avert drinking alcohol and eating foods or taking medications that may contain alcohol, such as certain coughing syrups, if there is a adventure they might be pregnant.

Drug exposure during pregnancy is non express to illegal drugs, such as cocaine, only includes prescription and over-the-counter drugs and supplements that might disrupt the development of the fetus.

Health care providers recommend that women who are thinking about pregnancy avert exposure to booze and drugs up to 3 months before starting to try to get pregnant. This and other aspects of pre-pregnancy care can assist to promote a healthy pregnancy.

Factors that affect pregnancy and fetal development are cardinal to the NICHD's research. The Institute supports and conducts enquiry to understand the ways in which exposures to alcohol and drugs may bear on pregnancy, a developing fetus, and development throughout the lifespan. Some of this inquiry is done in partnership with other NIH Institutes whose sole focus is on alcohol and drugs, such equally the National Institute on Alcoholism and Alcohol Abuse (NIAAA) and the National Institute on Drug Corruption (NIDA), while other efforts are handled solely by NICHD organizational units.

Within this context, some NICHD research is currently examining:

• Effects of booze consumption on fetal evolution and infant wellness
• Effects of exposure to different classes of drugs on fetal evolution and on later development
• Mechanisms by which alcohol causes nascency defects
• Effects of alcohol on maternal health, including placental furnishings
• Patterns of alcohol consumption and drug utilize during pregnancy

Contempo and ongoing research by NICHD scientists and NICHD-funded researchers on alcohol- and drug-related birth defects is described beneath. Select a link to learn more than:

Research on Booze- and Drug-Related Nativity Defects
Research on the Mechanisms that Cause These Birth Defects
Research on Patterns of Booze Consumption During Pregnancy
Other Research

Research on Alcohol- and Drug-Related Birth Defects

Absence of Eye Malformations in Alcohol-Exposed Children Who Practice Not Develop Fetal Alcohol Syndrome (FAS)

The effects of alcohol consumption during pregnancy on the fetus have been known for some time. Such consumption can cause fetal booze spectrum disorders (FASDs), which include physical abnormalities and problems with beliefs and learning that terminal throughout a person's life. FAS, which is characterized past more than serious growth deficits, neurological defects, and torso malformations, including problems with the construction of the head and face, is at the severe end of the FASD spectrum. Previous studies have plant some eye abnormalities resulting from prenatal alcohol exposure, but no studies take investigated the effects of heavy alcohol consumption on the middle development of children who practice not have FAS.

Contempo findings from a written report conducted by researchers in the NICHD Partition of Intramural Population Health Inquiry (DIPHR) aimed to accost this issue and prospectively tracked the children of women who drank booze heavily during their pregnancies. Heavy alcohol consumption was defined equally two or more ounces (or 48 grams or more) of alcohol per mean solar day. This level of booze intake per day has been linked to agin furnishings on the developing fetus, including effects on the central nervous organization. The participants in the study were from the NICHD University of Chile Alcohol in Pregnancy Study. The children in the written report were examined and observed for a period of upwardly to 9 years. None of the children developed FAS even though all had been prenatally exposed to alcohol. The study included a command cohort of children who were not prenatally exposed to alcohol.

Ophthalmologic examination of the children'south eyes over the study period of up to ix years did not show any differences between children who had been exposed to alcohol and those who had not. Eye examinations included measures to evaluate eye construction and role, including visual acuity, light refraction, amount of eyelid drooping, middle corner structure, and the spacing between the upper and lower eyelids. The findings suggest that children with heavy prenatal alcohol exposure, who do non develop FAS, have normal eye development during early babyhood. The findings also suggest that information technology is non be useful to employ presence of heart abnormalities equally a way to diagnose children suspected of having prenatal alcohol exposure-related effects. For details on this finding, visit PubMed ID: 18571671.

Exposure to Alcohol and Commercial Cigarettes Before and During Pregnancy and the Chance of Birth Defects

Few studies have simultaneously examined the effects of alcohol consumption and cigarette smoking during pregnancy, although both are known to harm a developing fetus. In a study co-funded past the NICHD, the March of Dimes, and the California Tobacco-Related Diseases Inquiry Plan, researchers from the NICHD's DIPHR did just this. They examined the effects of prenatal exposure to tobacco smoke and alcohol. In the study, the researchers examined ane,355 cases, which included alive-born infants, still-built-in fetuses (fetal decease at greater than twenty weeks gestation), and electively terminated fetuses, with birth defects. Control cases included 700 alive-born infants with no birth defects or other abnormalities. Women completed computer-based questionnaires during a 4-month periconceptional fourth dimension, which was defined as from 2 months earlier conception to 2 months after formulation.

In the study, maternal intake of alcohol less than 1 mean solar day per week was associated with about twice the run a risk of neural tube defects (NTDs), heart artery abnormalities, and cleft lip, with or without cleft palate (CLP), equally compared with nondrinkers. Crack lip and CLP are types of head and face abnormalities commonly seen in infants who have FAS. More frequent booze consumption during pregnancy led to higher rates of NTDs and CLP. Maternal smoking of cigarettes was not associated with an increased gamble of NTDs or eye defects. Unexpectedly, smoking was associated with a lower take chances of NTDs and a lower risk of certain types of heart defects. The results of this study suggested that maternal alcohol intake increases the take chances for neural tube, heart, and facial nativity defects. Although smoking cigarettes did not contribute to any of the nativity defects that were evaluated in the study, smoking during pregnancy is known to increase the adventure of miscarriage, stillbirth, preterm birth, low nativity weight, Sudden Infant Death Syndrome, lung problems, learning problems, and other short- and long-term health issues. For details on this finding, visit PubMed ID: 18481814.

Furnishings of Cocaine Exposure During Pregnancy on Child Development

Equally reported in a previous NICHD spotlight, researchers supported by the NICHD'due south Pregnancy and Perinatology (PP) Branch and NIDA examined the effects of prenatal exposure to cocaine on kid development, specifically on the child's stress response arrangement. The researchers constitute decreased cortisol response to stress in children who were exposed to cocaine in the womb compared to similarly anile children who were not exposed. Decreased cortisol response tin pb to increased sensitivity to stress, pain, and fatigue.

While previous studies focused only on infants, this study nerveless data on 743 children from nativity to age 11, testing the cortisol response to stress in samples of saliva. This immune the scientists to weigh environmental factors such as poverty, violence, and parental influence. The about meaning decrease in cortisol response was detected in children who were both exposed to cocaine prior to birth and exposed to domestic violence at any time since nascence. The findings of decreased cortisol response in children exposed to drugs prenatally not only confirm similar findings from past studies only also show how these negative furnishings may persist well into childhood. For more data, visit http://www.ncbi.nlm.nih.gov/pubmed/20400094.

Inquiry on the Mechanisms that Cause Birth Defects

Prenatal Alcohol Exposure Does Non Impact Maternal Oxidative Stress or Blood Vessel Constriction

Previous studies have been unable to make up one's mind, biologically, how alcohol causes FASDs. Some enquiry suggests that heavy alcohol intake past the mother during pregnancy causes blood vessel to tuck (called vasoconstriction), which amercement fetal cells. Vasoconstriction could also cause oxidative stress (an imbalance in the oxygen system that can disrupt normal cell signaling) and impair blood and tissue oxygenation, leading to additional cellular harm in the developing fetus. Researchers from the NICHD's DIPHR examined participants in the NICHD University of Republic of chile Booze in Pregnancy Study to acquire more than.

Study participants included a cohort of 29 women who heavily consumed alcohol during pregnancy, e.thou., two or more ounces of alcohol per mean solar day. The command cohort included 39 women who did not consume alcohol during their pregnancy. During the women's pregnancies, researchers collected urine samples and analyzed them for the presence of certain proteins that can indicate different levels of oxidative stress and blood vessel dilation/constriction.

The researchers found no differences in the levels of protein markers of oxidative stress and vasoconstriction betwixt women who drank heavily during pregnancy and those who did not. The results suggest that maternal oxidative stress and vasoconstriction do not contribute to mechanisms that cause alcohol damage in the developing fetus. Researchers are continuing to investigate other mechanisms of booze'south effect on the developing fetus. For details on this finding, visit PubMed ID: 18715278.

Prenatal Exposure to Alcohol Affects Growth-Associated Proteins in Infants and Children

Previous human and animal studies have shown that exposure to alcohol during pregnancy may interfere with both prenatal fetal and postnatal infant weight proceeds and height. In a study conducted by DIPHR, researchers examined the machinery that allows alcohol to interfere with postnatal growth. In a prospective cohort study, the researchers assessed the growth of 69 children born to women who heavily consumed alcohol during pregnancy and 83 children born to women who did non drink during pregnancy. Heavy alcohol consumption was defined as four or more alcoholic drinks per mean solar day (48 grams or more of booze per day). (Delight notation that different studies utilise different definitions of booze utilise.)

In the study, the researchers nerveless blood from infants and children from 1 month to five years of age and measured the levels of several regulatory proteins, including insulin-like growth gene (IGF)-I, IGF-II, and leptin. IGF-I and IGF-Ii are proteins that regulate growth and development; amongst its many activities, the hormone leptin regulates ambition and metabolism. In children ages 3, four, and v, IFG-Two levels were higher in those born to mothers who drank alcohol during pregnancy than in children who were not exposed to booze. IGF-I levels were as well higher, and leptin levels were lower in exposed children ages 1 and two.

Although the study did not identify how changes in these proteins might touch growth, the findings suggest that alcohol exposure during pregnancy affects the levels of several proteins that are critical in growth regulation. There are few known markers of prenatal alcohol exposure—this study was the showtime to identify IGF-Two as a possible marker. For details on this finding, visit PubMed ID: 20847545.

Research on Patterns of Booze Consumption During Pregnancy

Researchers Develop a New Questionnaire for Assessing Alcohol Consumption During Pregnancy

Developing constructive survey tools, such every bit questionnaires, to help study alcohol consumption during pregnancy is an important area of epidemiological inquiry. Knowing the patterns of alcohol exposure, including booze blazon, intake amount, and intake frequency, that contribute to developmental furnishings can help identify and design the most effective interventions. In a study conducted by DIPHR, in collaboration with the NIAAA, the NIH Office of Research on Minority Health, and the NIH Function of Research on Women'due south Health, researchers aimed to create and evaluate the usefulness of a questionnaire for studying alcohol consumption in pregnant women.

The 506 pregnant women in the study were older than age 18 years and participated in the study while they were visiting their local prenatal care clinics in Washington, DC. Women answered questions near themselves and nigh their drinking habits using a computer-based questionnaire. Questions included specifics about alcohol intake during the 3 months earlier pregnancy and during pregnancy, including the corporeality that the women drank, the blazon of alcohol, and the design of drinking throughout the week.

Afterward analyzing the answers, researchers were able to categorize women past their risk for alcohol consumption during the rest of pregnancy. They found that women who were at high risk for drinking alcohol during pregnancy were: aware that others were worried well-nigh their drinking; drank upon waking in the morn; felt that they needed to reduce the amount that they drank; and had a fracture or road injury in the last v years.

According to the researchers, the study validated the new estimator-based questionnaire every bit a useful tool and effective way to identify women who are at risk for drinking during pregnancy. This depression-cost screening tool could also help place women who could be at risk and who might do good from interventions seeking to lower prenatal alcohol exposure. For details on this finding, visit PubMed ID: 21649675.

Other Research

NICHD University of Chile Alcohol in Pregnancy Study

Although the information above describes some of the findings from the NICHD Academy of Chile Alcohol in Pregnancy Study, this is a continuing prospective report designed to determine the effects of heavy alcohol exposure on the developing fetus and longer-term effects on children. Working with pediatricians, psychologists, and other investigators at the University of Chile in Santiago, DIPHR researchers will continue to collect and analyze data to acquire as much as possible near this important grouping of participants.

Prenatal Alcohol and SIDS and Stillbirth (Laissez passer) Network

The PASS Network is maintained through a partnership of the NICHD Pregnancy and Perinatology Co-operative (PPB), the NIAAA, and the National Establish on Deafness and Other Communication Disorders, to gain knowledge that can assistance women, families, physicians, and scientists find ways to ameliorate pregnancy outcomes and infant wellness.

The Laissez passer Network, which is comprised of different community-linked studies, has several objectives, including determining:

• The clan betwixt prenatal alcohol exposure and the risk for sudden infant death syndrome (SIDS), stillbirth (fetal death at greater than xx weeks of gestation), FASD, and other adverse outcomes
• The role of the timing, pattern, and amount of prenatal alcohol exposure and other environmental factors in the chance for morbidity and mortality in early on homo life
• The role of genomic variation in modifying the risk for morbidity and mortality in early life associated with prenatal alcohol exposure
• The function of alcohol exposure during pregnancy and of interactions amid booze exposure and environmental and genetic modifiers in altering autonomic activity of the fetus and infant, and neurologic, audiologic, and neurobehavioral outcomes in the infant
• The part of maternal alcohol exposure, as influenced by specific environmental and genetic factors, in impairing placental role and, thereby, possibly increasing the risk for fetal and/or infant morbidity and mortality

• The abnormalities in primal neurotransmitter systems in the brains of fetuses and/or infants that convey risk for sudden death, and the role of prenatal alcohol exposure, every bit influenced by specific environmental and genetic factors

The Safe Passage Written report is currently the primary component of the PASS Network. The Study volition enroll approximately 12,000 pregnant women from the United States and South Africa and will rail the development of their infants through pregnancy and the infants' first twelvemonth of life.

Obstetric and Pediatric Pharmacology (OPP) Branch

Surveys betoken that nearly 2-thirds of all pregnant women take up to iv drugs during pregnancy and labor. These drugs might be bachelor by prescription or over-the-counter, or they could be categorized equally nutritional supplements. The OPP Branch was established in 2004 as a way to promote and coordinate enquiry to improve the safety and efficacy of pharmaceuticals used by women during pregnancy.

Surveys indicate that almost 2-thirds of all pregnant women take up to 4 drugs during pregnancy and labor. These drugs might be available by prescription or over-the-counter, or they could be categorized as nutritional supplements. In utero exposure to these drugs could accept unpredictable or harmful effects to the unborn fetus. The OPP Branch supports research to evaluate and improve the safety and efficacy of drugs used by women during pregnancy.

An important research projects funded by the OPP Co-operative is the Obstetric-Fetal Pharmacology Research Units (OPRU) Network. This Network provides the expertise and infrastructure to recruit significant women for clinical trials to evaluate the impact of various drugs already prescribed for the pregnant women during their pregnancies.

For more than information on alcohol- and drug-related nascency defects enquiry at the NICHD, select 1 of the following links:

• NICHD Resource
  • Sectionalization of Intramural Population Health Enquiry (DIPHR)
    • DIPHR Report to the NACHHD Council, January 2010 (Note: This is a scientific document geared toward an audience of researchers and scientists.)
    • NICHD University of Republic of chile Alcohol in Pregnancy Report
  • Pregnancy and Perinatology (PP) Branch
    • PP Co-operative Report to the NACHHD Quango, September 2008 (Note: This is a scientific certificate geared toward an audition of researchers and scientists.)
  • Obstetric and Pediatric Pharmacology (OPP) Branch
    • OPP Branch Report to the NACHHD Council, January 2008 (Note: This is a scientific document geared toward an audience of researchers and scientists.)
  • NICHD-Supported Networks
    • Prenatal Alcohol and SIDS and Stillbirth (PASS) Network
    • Obstetric-Fetal Pharmacological Research Units (OPRU) Network
• National Institute on Booze Abuse and Alcoholism
  • Fetal Alcohol Exposure
  • Drinking and Your Pregnancy
• Centers for Disease Control and Prevention: Alcohol Use in Pregnancy Web Page

Originally Posted: June 27, 2012

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Source: https://www.nichd.nih.gov/newsroom/resources/spotlight/062712-alcohol-drug-related-birth-defects

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