Maternal Alcohol Use and the Neonate

Abstract

Maternal alcohol use and abuse can have devastating consequences to fetal development and outcomes. Although there is widespread societal pressure, particularly within developed countries, against the ingestion of any alcohol during pregnancy, many women may drink heavily before they recognize they are pregnant or may continue to do so despite their awareness. Much of the focus among healthcare professionals and biomedical investigators has been on the fetal alcohol syndrome (FAS), more commonly now referred to as the fetal alcohol spectrum disorder (FASD), which in its most advanced form is manifested by craniofacial abnormalities and severe neurocognitive deficits. However, FAS and FASD are disorders in term infants, and it is now being recognized that maternal alcohol ingestion appears to impact the risk for both premature delivery as well as medical complications associated with neonatal prematurity. In particular, experimental and clinical evidence is beginning to elucidate the mechanisms by which maternal alcohol ingestion can increase the already significant oxidative stress within the neonatal lung and impair host immune functions. As a consequence, the premature neonate with significant exposure to alcohol in utero appears to be at an even greater risk of developing serious infectious complications. Further, experimental models suggest that maternal alcohol ingestion can impair prenatal lung development and, if these findings translate to the human condition, could thereby render the premature infant at increased risk for adverse complications including bronchopulmonary dysplasia and late-onset sepsis. This chapter provides a brief overview of the epidemiology of maternal alcohol use during pregnancy and highlights some of the experimental and clinical evidence that show that such use can have devastating effects on neonatal outcomes.