“Doc, I didn’t know I was pregnant. Does my baby have fetal alcohol spectrum disorder?”

Green, C., & Cook, J. (2014). “Doc, I didn’t know I was pregnant. Does my baby have fetal alcohol spectrum disorder?”. The International Journal Of Alcohol And Drug Research, 3(1), 117-120. doi:10.7895/ijadr.v3i1.176How much alcohol is “safe” during pregnancy? This is a question for which there is no conclusive answer. Although no mother wants to intentionally harm her baby, the reality is that consuming alcohol during pregnancy can lead to a variety of complex developmental disabilities, collectively termed Fetal Alcohol Spectrum Disorder (FASD). The precise dosimetry data for the timing and dose of alcohol in pregnancy is unknown, but several features of alcohol metabolism are well characterized and have significant implications for alcohol’s deleterious effects on the developing fetus. There are a number of critical periods in embryonic development, which can be brief or prolonged and that correspond to specific tissues and structures (organ systems). Alcohol at any one of these critical periods can have significant downstream effects on typical fetal development. Alcohol teratogenicity does not produce a single abnormality, but instead can lead to a cluster of birth defects and/or neurodevelopmental abnormalities (i.e., FASD). Each of these cognitive or behavioral problems can vary in its expression, from severe and obvious early in life, to subtle and apparent only years after birth. Based on the variability among women and their fetuses, genetics and environmental influences, it is very unlikely that “absolute risk” for alcohol and pregnancy will ever be established. The age-old question, “How much is too much?”, will also remain unanswered. The best advice: “NO exposure equals NO risk.”