Alcohol is the most widely consumed and socially accepted addictive substance, which generates a major social and economic problem globally, not only due to dependence but also due to morbidity and mortality related to its use. This is one of the most powerful teratogens known.
- Alcohol easily crosses the placental barrier, so it passes into the fetal bloodstream and in this way can interfere with the development of the brain, other organs (renal, cardiac, craniofacial malformations) and critical physiological systems. Therefore, alcohol consumption during pregnancy is a risk factor that has been associated with fetal death, spontaneous abortion, intrauterine growth restriction, low birth weight and premature birth.
- The concentration of alcohol in breast milk is similar to the concentration in maternal blood . Therefore, nursing mothers who decide to continue drinking should avoid breastfeeding for 3 to 4 hours after moderate to heavy alcohol consumption.
- Alcohol consumption can also significantly affect the mother’s neuroendocrine state, reducing the ability to breastfeed, because it generates a decrease in two main hormones during lactation: oxytocin, which is essential for the contraction of the mammary glands, and prolactin, which stimulates the production of breast milk.
- It has also been associated with an increase in adverse effects in infants with a significant reduction in the psychomotor index, intellectual deficiencies such as attention deficit hyperactivity disorder and affects the baby’s sleep patterns.
- The most effective way to help solve this public health problem is to plan health policies with primary, secondary and tertiary prevention strategies, with the support of health care providers to educate the population and reduce their risks.
- Screen pregnant women for alcohol consumption, advise on the risks of alcohol consumption, have a multidisciplinary team of medical and social service providers to comprehensively evaluate women with alcohol abuse and their offspring , schedule frequent prenatal visits for prenatal monitoring of maternal and fetal status, and obtain an early ultrasound to more accurately track fetal growth during gestation .
- Alcohol is a drug and belongs to the group of addictions, surpassing all of them in frequency, including cigarettes. The publication of the newspaper La Nación that consumption among children grew by almost 50% in those under 14 years of age in the last 7 years is more than alarming, it is depressing for society and its members. We will list below a summary of its consequences.
to. Exposure to violence or active exercise of it.
b. It has been proven that driving vehicles is one of the main causes of road incidents, what we now call trauma disease that produces disabilities or death itself.
c. Couples who are alcoholic due to their mentally altered condition frequently have unsafe sex with the consequent exposure to sexually transmitted diseases.
d. As a consequence of the aforementioned, unwanted pregnancies also occur with initiatives related to abortion.
and. Alcohol is especially harmful to pregnant women, compromising fetal health with subsequent deterioration in their neurodevelopment. As an aggravating factor, many women are unaware of their pregnancy status, sometimes for months, with the consequent greater exposure to alcohol and other drugs in early stages of development. embryonic and/or fetal.
F. Alcohol addiction increases the possibility of accessing other drugs, the most lethal of which is paco.
g. Alcoholic coma is a serious illness that requires emergency treatment and therefore should not be ignored or covered up.
2- Risk factors:
They are easily identifiable and many of them are part of negative social determinants.
- School instability
- Repetition and/or school dropout
- Domestic violence
- Absence of parents
- Higher incidence in women
- Previous alcohol consumption
According to the CDC, the percentage of pregnant women who consumed alcohol increased from 7.6% in 2012 to 10.2% in 2015, and the number of pregnant women who admitted to drinking alcohol increased from 1.4% to 3.1%.
For its part, the WHO reports 9.8% worldwide.
APS Diagnostic Criteria
• Prenatal demonstration of alcohol exposure
• Facial dysmorphias. And palmar crease on a hockey stick
• Growth retardation
• Central nervous system dysfunction
• Neurodevelopmental commitment
Diagnostic proposals
Clinical characteristics already defined (does not require confirmation of alcohol level during pregnancy).
In all suspected cases, perform neurobehavioral tests.
Contraceptives should be offered to women of childbearing age who consume alcohol. The recommendation in pregnancy is abstinence.
TACER-3 Screening Tool
Tolerance: How many drinks do you need to feel “good”?
Annoyance: Has anyone pointed out to you the inconvenience of drinking?
Withdrawal: Have you ever felt unable to abstain from drinking?
Dependency: Have you ever felt the need to drink in the morning?
Conclusions:
Currently, APS is underdiagnosed. Why don’t we ask?
There is a harmful promotion of alcohol intake from the mass media.
*Dr. Miguel Larguía. Pediatrician. Neonatologist. Member of the National Academy of Medicine
