A current view on the alcohol-related teratogenic effects during pregnancy. Potential preventive measures
https://doi.org/10.17749/2313-7347/ob.gyn.rep.2021.254
Abstract
Aim: to analyze and summarize the available data of studies aimed at obtaining deeper insight in the field of alcohol-related effects on the course of pregnancy and potential consequences thereof; to study the prevalence of alcohol consumption by women in Russia, as well as potential preventive measures.
Materials and Methods. The results of the Russian and foreign studies on the alcohol-related effect on the fetus and pregnancy outcome, published in the international databases Scopus, Web of Science, PubMed/MEDLINE, Cochrane Library, have been analyzed. The search for scientific publications was limited to the period from the years 2012 to 2021. We used search queries in Russian and English ("alcohol", "pregnancy", "prevention", "fetus", "fetal alcohol syndrome").
Results. The presented data analysis indicates an extremely negative effect of alcohol on the body of pregnant women, as well as on the health of our future generation. This article proves the importance of the problem, the need for further research on the mechanisms of fetal alcohol syndrome (FAS) and the development of effective prevention measures, potential treatment methods, and assistance for FAS. At present, in Russia there is an acute lack of information on the real extent of the problem with maternal alcohol consumption during pregnancy. Still, no precise data on FAS prevalence in Russia are available.
Conclusion. Preventing FAS is an urgent and unexplored issue in Russia. Medical doctors able to conduct pregravid preparation of a married couple while they plan to conceive a healthy child are highly demanded. It is necessary to raise awareness and improve the quality of training for obstetricians and gynecologists in order to identify women with high risk factors for alcohol abuse and childbirth with FAS at early stages of pregnancy management. It is also necessary to identify new or use already identified maternal blood biomarkers to verify excessive alcohol consumption during pregnancy.
About the Authors
A. Yu. MarianianRussian Federation
MD, Dr Sci Med, Leading Researcher, Head of the Laboratory of Socially Important Problems of Reproductology,
16 Timiryazeva Str., Irkutsk 664003
A. N. Kalkova
Russian Federation
MD, Research Laboratory Assistant, Clinical Resident, Department of Obstetrics and Gynecology,
16 Timiryazeva Str., Irkutsk 664003
References
1. Subramoney S., Eastman E., Adnams C. et al. The early developmental outcomes of prenatal alcohol exposure: a review. Front Neurol. 2018;9:1108. https://doi.org/10.3389/fneur.2018.01108.
2. Kuznetsova O.S., Chernyshev A.V. Problem of fetal alcohol syndrome during prenatal development (according to the literature). [Problema fetal'nogo alkogol'nogo sindroma v period prenatal'nogo razvitiya ploda (po dannym literatury)]. Vestnik rossijskih universitetov. 2014;19(2):758– 60. (In Russ.).
3. Epifanova A.K., Surmach M.Yu. Behavioral risk factors for the health disorders of pregnant women and their optimization in maternity consultation clinics. [Povedencheskie faktory riska narusheniya zdorov'ya beremennyh zhenshchin i ih optimizaciya v usloviyah zhenskoj konsul'tacii]. Zhurnal Grodnenskogo gosudarstvennogo medicinskogo universiteta. 2018;16(2):165–9. (In Russ.).
4. Sobriety – the COURSE of Russia. Proceedings of the XVI International Scientific and Practical Conference of the Public Movement «Union for the approval and preservation of Sobriety "Sober Ural"». Тyumen': Trezvaya Tyumen', 2018. 335 p. (In Russ.).
5. Shmatova Yu.E. Economic and statistical evaluation of the problem of alcohol dependence in Russia (regional aspect). [Ekonomicheskaya i statisticheskaya ocenka problemy alkogol'noj zavisimosti v Rossii (regional'nyj aspekt)]. Society and Security Insights. 2019;2(3):64–79. (In Russ.). https://doi.org/10.14258/ssi(2019)3-6361.
6. O'Leary C., Lawrence D., Hafekost K. et al. Maternal alcohol-use disorder and child outcomes. Pediatrics. 2020;145(3):e20191574. https://doi.org/10.1542/peds.2019-1574.
7. Mahabir C.A., Anderson M., Cimino J. et al. Derivation and validation of a multivariable model, the alcohol withdrawal triage tool (AWTT), for predicting severe alcohol withdrawal syndrome. Drug Alcohol Depend. 2020;209:107943. https://doi.org/10.1016/j.drugalcdep.2020.107943.
8. Van Loon M., Van der Mast R.C., van der Linden M.C., van Gaalen F.A. Routine alcohol screening in the ED: unscreened patients have an increased risk for hazardous alcohol use. Emerg Med J. 2020;37(4):206– 11. https://doi.org/10.1136/emermed-2019-208721.
9. Saal W., Kagee A., Bantjes J. Gender differences in the utility of the alcohol use disorder identification test in screening for alcohol use disorder among HIV test seekers in South Africa. AIDS Behav. 2020;24(7):2073–81. https://doi.org/10.1007/s10461-019-02772-6.
10. Chistokhina K.P. Female alcoholism. [Zhenskij alkogolizm]. Intellektual'nyj potencial XXI veka: stupeni poznaniya. 2014;(23):102–7. (In Russ.).
11. Turdalieva B.S., Aimbetova G.E., Bagiyarova F.A., Abzalieva A. Analysis of alcoholism and narcomania spread in world community and Kazakhstan. [Analiz rasprostra-neniya alkogolizma i narkomanii v razreze mirovogo soobshchestva i Kazahstana]. Vestnik Kazahskogo nacional'nogo medicinskogo universiteta. 2014;(2):49–52. (In Russ.).
12. Gaidukov S.N., Nekrasov T.V., Atlasov V.O. The prevalence of alcohol consumption by Russian women before and during pregnancy and its sociodemographic determinants. [Rasprostranennost' upotrebleniya zhenshchinami alkogolya do i vo vremya beremennosti ee social'nodemograficheskie determinant]. Zhurnal akusherstva i zhenskih boleznej. 2008;57(2):11–6. (In Russ.).
13. Balachova T.N., Isurina G.L., Skitnevskaya L.V. et al. Alcohol consumption among pregnant and non-pregnant women in Russia: evidence for prevention. Acta Biomedica Scientifica. 2018;3(3):59–67. https://doi.org/10.29413/ABS.2018-3.3.9.
14. Bandoli G., Coles C.D, Kable J.A. et al. Patterns of prenatal alcohol use that predict infant growth and development. Pediatrics. 2019;143(2):e20182399. https://doi.org/10.1542/peds.2018-2399.
15. Marianian A., Atalyan A., Bohora S. et al. The effect of low alcohol consumption during pregnancy on the lipid peroxidation-antioxidant defense system of women, their alcohol-exposed infants, and growth, health, and developmental outcomes. Birth Defects Res. 2019;112(1):40– 53. https://doi.org/10.1002/bdr2.1582.
16. Popova S., Lange S., Shield K. et al. Comorbidity of fetal alcohol spectrum disorder: a systematic review and meta-analysis. Lancet. 2016;387(10022):978–87. https://doi.org/10.1016/S0140-6736(15)01345-8.
17. Niclasen J., Andersen A.M.N., Teasdale T.W., Strandberg-Larsen K. Prenatal exposure to alcohol, and gender differences on child mental health at age seven years. J Epidemiol Community Health. 2014;68(3):224–32. https://doi.org/10.1136/jech-2013-202956.
18. Flak A.L., Su S., Bertrand J. et al. The association of mild, moderate, and binge prenatal alcohol exposure and child neuropsychological outcomes: a meta-analysis. Alcohol Clin Exp Res. 2014;38(1):214–26. https://doi.org/10.1111/acer.12214.
19. Easey K.E., Dyer M.L., Timpson N.J., Munafo M.R. Prenatal alcohol exposure and offspring mental health: A systematic review. Drug Alcohol Depend. 2019;1:344–53. https://doi.org/10.1016/j.drugalcdep.2019.01.007.
20. Ichikawa K., Fujiwara T., Kawachi I. Prenatal alcohol exposure and child psychosocial behavior: A sibling fixed-effects analysis. Front Psychiatry. 2018;9:570. https://doi.org/10.3389/fpsyt.2018.00570.
21. Lelevich S.V., Velichko I.M., Lelevich V.V. Neurochemical aspects of alcohol intoxication. [Nejrohimicheskie aspekty alkogol'noj intoksikacii]. Zhurnal Grodnenskogo gosudarstvennogo medicinskogo universiteta. 2017;15(4):375–80. (In Russ.). https://doi.org/10.25298/2221-8785-2017-15-4-375-380.
22. Weyrauch D., Schwartz M., Hart B. et al. Comorbid mental disorders in fetal alcohol spectrum disorders: A systemaic rewiew. J Dev Behav Pediatr. 2017;38(4):283–91. https://doi.org/10.1097/DBP.0000000000000440.
23. Popova S., Lange S., Probst C. et al. Prevalence of alcohol consumption during pregnancy and fetal alcohol spectrum disorders among the general and aboriginal populations in Canada and the United States. Eur J Med Genet. 2017;60(1):32–48. https://doi.org/10.1016/j.ejmg.2016.09.010.
24. Salem N.A., Mahnke A.H., Konganti K. et al. Cell-type and fetal-sexspecific targets of prenatal alcohol exposure in developing mouse cerebral cortex. iScience. 2021;24(5):102439. https://doi.org/10.1016/j.isci.2021.102439.
25. Loubaba M., Timothy J., Sharea I. et al. Evidence of detrimental effects of prenatal alcohol exposure on offspring birthweight and neurodevelopment from a systematic review of quasi-experimental studies. Int J Epidemiol. 2020;49(6):1972–95. https://doi.org/10.1093/ije/dyz272.
26. Protopopova N.V., Kolesnikova L.I., Maryanyan A.Yu. The effects of alcohol on the fetus, and pregnancy outcome. Fetal alcohol syndrome and fetal alcohol spectrum disorders. [Vliyanie alkogolya na plod i ishod beremennosti. Fetal'nyj alkogol'nyj sindrom i fetal'nyj alkogol'nyj spektr narushenij]. Byulleten' VSNC SO RAMN. 2013;(6):187–92. (In Russ.).
27. Mather M., Wiles K., O’Brien P. Should women abstain from alcohol throughout pregnancy? BMJ. 2015;351:h5232. https://doi.org/10.1136/bmj.h5232.
28. Burgess S., Davies N.M., Thompson S.G. Instrumental variable analysis with a nonlinear exposure-outcome relationship. Epidemiology. 2014;25(6):877–85. https://doi.org/10.1097/EDE.0000000000000161.
29. Miyake Y, Tanaka K., Okubo H. et al. Alcohol consumption during pregnancy and birth outcomes: the Kyushu Okinawa Maternal and Child Health Study. BMC Pregnancy Childbirth. 2014;14:79. https://doi.org/10.1186/1471-2393-14-79.
30. Voronina I.D., Bokhan T.G., Terekhina O.V. et al. Demographic parameters, lifestyle and health in families with natural and induced pregnancy in Russia and Great Britain. [Demograficheskie pokazateli, obraz zhizni i zdorov'e v sem'yah s estestvennoj i inducirovannoj beremennost'yu v Rossii i Velikobritanii]. Teoreticheskaya i eksperimental'naya psihologiya. 2016;9(4):63–76. (In Russ.).
31. Loubaba M., Hannah B.E., Jelena S. et al. Low alcohol consumption and pregnancy and childhood outcomes: time to change guidelines indicating apparently ‘safe’ levels of alcohol during pregnancy? A systematic review and meta-analyses. BMJ Open. 2017;7(7):e015410. https://doi.org/10.1136/bmjopen-2016-015410
32. Skitnevskaya L.V. Prevention fetal alcohol syndrome in Russia. [Profilaktika fetal'nogo alkogol'nogo sindroma v Rossii]. Vestnik Mininskogo universiteta. 2013;(4):1–5. (In Russ.).
33. Finlay-Jones A., Symons M., Tsang W. et al. Community priority setting for fetal alcohol spectrum disorder research in Australia. Int J Popul Data Sci. 2020;5(3):1359. https://doi.org/10.23889/ijpds.v5i1.1359
34. Burina E.A., Isurina G.L. Physician training as a part of fetal alcohol syndrome prevention programme. [Obuchenie vrachej v ramkah programmy profilaktiki fetal'nogo alkogol'nogo sindroma]. Medicinskaya psihologiya v Rossii. 2018;10(1):11. (In Russ.). https://doi.org/10.24411/2219-8245-2018-11110.
35. Trusova A.V. Motivational interviewing: teaching aid. [Motivacionnoe interv'yuirovanie: uchebno-metodicheskoe posobie]. SPb.: Izdatel'stvo Sankt-Peterburgskogo universiteta, 2015. 27 p. (In Russ.).
36. O'Donnell A., Anderson P., Newbury-Birch D. et al. The impact of brief alcohol interventions in primary healthcare: a systematic review of reviews. Alcohol Alcohol. 2014;49(1):66–78. https://doi.org/10.1093/alcalc/agt170.
37. Burina E.A. Fetal alcohol syndrome and short-term psychological intervention as a method for its prevention. [Fetal'nyj alkogol'nyj sindrom i kratkosrochnoe psihologicheskoe vmeshatel'stvo kak metod ego profilaktiki]. Vestnik Yuzhno-Ural'skogo gosudarstvennogo universiteta. Seriya: Psihologiya. 2016;9(3):50–4. (In Russ.). https://doi.org/10.14529/psy160305.
38. Grechanaya T.B. Early detection and effective care for alcohol abuse: international approaches and prospects for their application in Russian practice. [Rannee vyyavlenie i okazanie effektivnoj pomoshchi pri zloupotreble-nii alkogolem: mezhdunarodnye podhody i perspektivy ih primeneniya v rossijskoj prak-tike. Pod red. E.A. Savostinoj, nauchnyj konsul'tant G.A. Korchagina. ANO «Sovet po voprosam upravleniya i razvitiya»]. Moscow: OOO «Akvarel'», 2014. 184 p. (In Russ.).
39. Brief preventive alcohol counseling: WHO primary health care training manual. [Kratkoe profilakticheskoe konsul'tirovanie v otnoshenii upotrebleniya alkogolya: uchebnoe posobie VOZ dlya pervichnogo zvena mediko-sanitarnoj pomoshchi]. Vsemirnaya organizaciya zdravoohraneniya, 2017. 134 p. (In Russ.). Available at: http://www.euro. who.int/__data/assets/pdf_file/0004/364279/alcohol-training-manual-rus.pdf?ua=1.
40. Miller W., Rollnik S. Motivational counseling. How to help people change. [Motivacionnoe konsul'tirovanie. Kak pomoch' lyudyam izmenit'sya]. Moscow: Izdatel'stvo «E», 2017. 540 p. (In Russ.).
41. Burina E.A., Marianian A.Yu. Psychological aspects of fetal alcohol syndrome prevention in pregnant women of childbearing age. [Psihologicheskie aspekty profilaktiki fetal'nogo al-kogol'nogo sindroma u beremennyh zhenshchin reproduktivnogo vozrasta]. Acta Biomedica Scientifica. 2018;3(3):149–54. (In Russ.). https://doi.org/10.29413/ABS.2018-3.3.23
42. Maryanyan A.Yu. Role of short-term intervention in the prevention of fetal alcohol syndrome and fetal alcohol spectrum disorders. [Rol' kratkosrochnogo vmeshatel'stva v profilaktike fetal'nogo alko-gol'nogo sindroma i fetal'nogo alkogol'nogo spektra narushenij]. Byulleten' VSNC SO RAMN. 2014;(2):110–5. (In Russ.).
43. Schölin L. Prevention of harm caused by alcohol consumption during pregnancy. Rapid situation analysis and case studies from WHO Member States. [Profilaktika vreda, prichinyaemogo upotrebleniem alkogolya vo vremya be-remennosti. Ekspress-analiz situacii i primery iz praktiki gosudarstv-chlenov VOZ]. Vsemirnaya organizaciya zdravoohraneniya, 2017. 57 p. (In Russ.). Available at: http://www.euro.who.int/__data/assets/pdf_file/0011/330959/Prevention-harmcaused-alcohol-exposurepregnancy-ru.pdf?ua=1.
44. Fadeeva E., Kirienko E. Prevention of fetal alcohol syndrome. Practical guide. [Profilaktika fetal'nogo alkogol'nogo sindroma. Prakticheskoe posobie]. Sankt-Peterburg: ROBO «CPN», 2019. 64 p. (In Russ.). Available at: https://www.eegyn.com/pdf/FAS_prevention.pdf.
45. Yaltonskaya A.V. Prevention of alcohol consumption during pregnancy and fetal alcohol spectrum disorders. [Profilaktika upotrebleniya alkogolya vo vremya beremennosti i fetal'nogo alkogol'nogo spektra narushenij. In: Narkologiya. Nacional'noe rukovodstvo]. Moscow: GEOTAR-Media, 2016. 849–55. (In Russ.).
46. Maryanyan A.Yu. Screening methods used to identify the risk group of women by birth of children with fetal alcohol syndrome and fetal alcohol spectrum disorders. [Metody skrininga, primenyaemye dlya vyyavleniya gruppy riska zhenshchin po rozhdeniyu detej s fetal'nym alkogol'nym sindromom i fetal'nym alkogol'nym spektrom narushenij]. Sovremennye problemy nauki i obrazovaniya. 2015;(2–1). (In Russ.). Available at: http://science-education.ru/ru/article/view?id=17540
47. Kolesnikova L.I., Protopopova N.V., Kolesnikov S.I. et al. Lipid peroxidation – antioxidant defense system in newborns and women drinking small amounts of alcohol during pregnancy. [Sostoyanie sistemy lipoperoksidacii – antioksidantnoj zashchity novorozhdennyh i zhenshchin, upotreblyavshih nebol'shie kolichestva alkogolya v period beremennosti]. Byulleten' eksperimental'noj biologii i mediciny. 2015;159(5):545–8. (In Russ.).
48. Myagkova M.A., Pushkina V.V., Petrochenko S.N., Morozova V.S. Determination marker of chronic alcohol abuse by capillary electrophoresis. [Opredelenie markerov hronicheskogo zloupotrebleniya alkogolem metodom kapilyarnogo elektroforeza]. Mezhdunarodnyj zhurnal prikladnyh i fundamental'nyh issledovanij. 2015;(12–9):1640–3. (In Russ.).
49. Andreev E.M., Kiryanov N.A., Leon D. et al. Hazardous alcohol drinking and premature mortality in Russia: a population based case-control study. [Zloupotreblenie alkogolem i prezhde-vremennaya smertnost' v Rossii na primere Izhevska]. Narkologiya. 2016;7(7):38–51. (In Russ.).
50. Khapkina A.V., Mikhailova A.V., Ilyukhina D.M., Zheltkova L.A. Use of laboratory biomarkers in the diagnostics of chronic abuse of alcohol. [Ispol'zovanie laboratornyh biomarkerov v diagnostike hronicheskogo zloupotrebleniya alkogolya]. Izvestiya Tul'skogo gosudarstvennogo universiteta. Estestvennye nauki. 2019;(4):45–55. (In Russ.).
51. Maryanyan A.Yu. Alcohol as one of the factors affecting the fetus. Fetal alcohol syndrome and fetal alcohol spectrum disorders. Tutorial. [Alkogol' kak odin iz faktorov, vliyayushchij na plod. Fetal'nyj alko-gol'nyj sindrom i fetal'nyj alkogol'nyj spektr narushenij. Uchebnoe posobie]. Irkutsk: IGMU, 2013. 72 p. (In Russ.).
52. Petukhov A.E., Nadezhdina A.V., Bogstrand S.T. et al. Phosphatidylethanol as the new alcohol abuse biomarker. [Fosfatidiletanol kak biomarker zloupotrebleniya alkogolem]. Narkologiya. 2017;(2):42–7. (In Russ.).
53. Hoyme H.E., Kalberg W.O., Elliott A.J. et al. Updated clinical guidelines for diagnosing fetal alcohol spectrum disorders. Pediatrics. 2016;138(2):e20154256. https://doi.org/10.1542/peds.2015-4256.
54. Putin A.V., Putina T.N., Sidorov G.N. et al. Ecological, physiological and ethological features house mice have been exposed to ethanol. [Ekologo-fiziologicheskie i etologicheskie osobennosti domovyh myshej, podvergshihsya vozdejstviyu etilovogo spirta]. Vestnik Omskogo gosudarstvennogo agrarnogo universiteta. 2012;(4):103–6. (In Russ.).
Review
For citations:
Marianian A.Yu., Kalkova A.N. A current view on the alcohol-related teratogenic effects during pregnancy. Potential preventive measures. Obstetrics, Gynecology and Reproduction. 2022;16(1):48-57. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2021.254

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