Consecuencias de la exposición prenatal al alcohol: desarrollo histórico de la investigación y evolución de las recomendaciones

Autores/as

  • Mariana Beatriz López
  • Vanessa Arán-Filippetti

DOI:

https://doi.org/10.18597/rcog.64

Palabras clave:

bebidas alcohólicas, embarazo, síndrome alcohólico fetal, prevención primaria

Resumen

Objetivo: diversos estudios señalan un déficit y una demanda de información entre distintos profesionales de la salud en relación con las características de los trastornos vinculados a la exposición prenatal al alcohol y su prevención. Este documento busca hacer una reflexión sobre los aspectos más relevantes por considerar en la detección y el manejo del consumo de alcohol durante la gestación.

Materiales y métodos: con base en la revisión de la evolución histórica de la investigación sobre los trastornos vinculados a la exposición prenatal al alcohol se da respuesta a las siguientes preguntas: 1) ¿Cuáles son los criterios diagnósticos actuales de los trastornos del espectro alcohólico fetal (TEAF)?, 2) ¿cuál es la prevalencia del síndrome de alcoholismo fetal (SAF) y otros TEAF?, 3) ¿cuál ha sido la evolución de las recomendaciones internacionales respecto al consumo de alcohol durante la gestación?, 4) ¿qué estrategias de prevención existen actualmente? Para esto se realiza una extensa revisión de la investigación publicada a nivel internacional.

Resultados: la investigación moderna respecto a la exposición prenatal al alcohol evidencia que esta puede dar lugar a un amplio espectro de problemas. Las dificultades para establecer una dosis de alcohol segura durante la gestación han conducido a la modificación progresiva de las recomendaciones respecto del consumo durante este periodo, desde el consumo moderado hasta la abstinencia.

Conclusión: el impacto y la magnitud de esta problemática exigen el desarrollo de planes de prevención específicos. Su implementación demanda la formación continua de los profesionales que trabajan en cuidados periconcepcionales y perinatales.

Biografía del autor/a

Mariana Beatriz López

Becaria posdoctoral, Centro Interdisciplinario de Investigaciones en Psicología Matemática y Experimental (Ciipme), Consejo Nacional de Investigaciones Científicas y Técnicas (Conicet), Argentina. Profesora Adjunta, Facultad de Humanidades, Artes y Ciencias Sociales, Universidad Autónoma de Entre Ríos, Buenos Aires, Argentina

Vanessa Arán-Filippetti

Investigadora Asistente, Centro Interdisciplinario de Investigaciones en Psicología Matemática y Experimental (Ciipme), Consejo Nacional de Investigaciones Científicas y Técnicas (Conicet), Buenos Aires, Argentina

Referencias bibliográficas

Maier SE, West JR. Drinking patterns and alcohol-related birth defects. Alcohol Res Health. 2001;25:168-74.

O'Leary C. Fetal alcohol syndrome. A literature review. Canberra: Department of Health and Ageing-Commonwealth of Australia; 2002.

Kesmodel U, Schioler Kesmodel P. Drinking during pregnancy: Attitudes and knowledge among pregnant Danish women, 1998. Alcohol Clin Exp Res. 2002;26:1553-60.

López MB. Saber, valorar y actuar: relaciones entre información, actitudes y consumo de alcohol durante la gestación. Health and Drugs. 2013;13:35-46.

Míguez H, Magri R, Suárez M. Consumo de tabaco y bebidas alcohólicas durante el embarazo. Acta Psiquiátrica y Psicológica de América Latina. 2009;55:76-83.

Pepino MY, Mennella JA. Advice given to women in Argentina about breast-feeding and the use of alcohol. Revista Panamericana de Salud Pública/Pan American Journal of Public Health. 2004;16:408-14.

Raymond N, Beer C, Glazebrook C, Sayal K. Pregnant women's attitudes towards alcohol consumption. BMC Public Health. 2009;9:175-92.

Dieckman ST, Floyd L, De´Coufle P, Schulkin J, Ebrahim SH, Sokol RJ. Survey of Obstetrician-Gynecologists on Their Patients' Alcohol Use During Pregnancy. Obstetrics & Gynecology. 2000;95:756-63.

Gahagan S, Telfair Sharpe T, Brimacombe M, Fry-Johnson Y, Levine R, Mengel M, et al. Pediatricians' Knowledge, Training, and Experience in the Care of Children with Fetal Alcohol Syndrome. Pediatrics. 2006;118:657-68.

Elliott EJ, Payne J, Haan E, Bower C. Diagnosis of foetal alcohol syndrome and alcohol use in pregnancy: A survey of paediatricians' knowledge, attitudes and practice. J Paediatr Child Health. 2006;42:698-703.

Payne J, Elliott E, D'Antoine H, O'Leary C, Mahony A, Haan E, et al. Health professionals' knowledge, practice and opinions about fetal alcohol syndrome and alcohol consumption in pregnancy. Aust N Z J Public Health. 2005;29:558-64.

Selleck CS, Redding BA. Knowledge and Attitudes of Registered Nurses Toward Perinatal Substance Abuse. JOGN Nurs. 1998;27:70-7.

Lemoine PH, Harousseau H, Borteyru JP, Menuet JC. Les enfants de parents alcooliques. Anomalies observées à propos de 127 cas. Ouest-Médical. 1968;25:477-82.

Sullivan WC. A note on the influence of maternal inebriety on the offspring. J Ment Sci. 1899;45: 489-503.

Jones KL, Streissguth AP. Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorders: A brief history. J Psychiatry & L. 2010;38:373-82.

Ulleland C. The Offspring of Alcoholic Mothers. Ann N Y Acad Sci. 1972;197:167-9.

Ulleland C, Wenneberg RP, Igo RP, Smith NS. The Offspring of Alcoholic Mothers. Pediatr Res. 1970;4:474.

Jones KL, Smith DW, Ulleland CN, Streissguth AP. Pattern of malformation in offspring of chronic alcoholic mothers. Lancet. 1973;301:1267-71.

Jones KL, Smith DW. Recognition of the Fetal Alcohol Syndrome in Early Infancy. Lancet. 1973;302: 999-1001.

Abel EL. Was the Fetal Alcohol Syndrome Recognized by Greeks and Romans? Alcohol and Alcoholism. 1999;34: 868-72.

Jones KL, Smith DW, Streissguth AP, MyrianthopoulosNC. Outcome in Offspring of Chronic Alcoholic Women. Lancet. 1974;303:1076-78.

Stratton KR, Howe CJ, Battaglia FC. Fetal alcohol syndrome diagnosis, epidemiology, prevention, and treatment. Washington, D.C: Institute of Medicine-National Academy Press; 1996.

Chudley AE, Conry J, Cook JL, Loock C, Rosales T, LeBlanc N. Fetal alcohol spectrum disorder: Canadian guidelines for diagnosis. CMAJ. 2005;172:1-21.

Center for Disease Control and Prevention. Improving methods for population-based surveillance of fetal alcohol syndrome. Final Report on meeting Convened. Atlanta, GA; 2008.

Hoyme HE, May PA, Kalberg WO, Kodituwakku P, Gossage JP, Trujillo P, et al. A practical clinical approach to diagnosis of fetal alcohol spectrum disorders: clarification of the 1996 Institute of Medicine Criteria. Pediatrics. 2005;115:39-47.

Kable JA, Coles CD. The impact of prenatal alcohol exposure on neurophysiological encoding of environmental events at six months. Alcohol Clin Exp Res. 2004;28:489-96.

Connor P, Sampson P, Bookstein F, Carr H, Streissguth AP. Direct and indirect effects of prenatal alcohol damage on executive function. Dev Neuropsychol. 2000;18:331-54.

Kodituwakku PW, Kalberg W, May PM. The effects of prenatal alcohol exposure on executive functioning. Alcohol Res Health. 2001;25:192-8.

Noland JS, Singer LT, Arendt RE, Minnes S, Short EJ, Bearer CF. Executive functioning in preschool-age children prenatally exposed to alcohol, cocaine, and marijuana. AlcoholClin Exp Res. 2003;27:647-57.

López MB, Arán Filippetti V. Perfiles ejecutivos en niños y adolescentes con Trastornos del Espectro Fetal Alcohólico (FASD): una revisión. Acta Psiquiatr Psicol Am Lat. 2010;56:294-304.

Löser H, Majewski F. Type and frequency of cardiac defects in embryofetal alcohol syndrome: Report of 16 cases. Br Heart J. 1977;39:1374-9.

Sulik KK, Johnston MC, Daft PA, Russell WE, Dehart DB, Opitz JM, et al. Fetal alcohol syndrome and Di George anomaly: Critical ethanol exposure periods for craniofacial malformations as illustrated in an animal model. Am J Med Genet A. 1986;2:97-112.

Burd L, Deal E, Rios R, Adickes E, Wynne J, Klug MG. Congenital heart defects and fetal alcohol spectrum disorders. Congenit Heart Dis. 2007;2:250-5.

Habbick BF, Zaleski WA, Casey R, Murphy F. Liver abnormalities in three patients with fetal alcohol syndrome. Lancet. 1979;313:580-1.

Hofer R, Burd L. Review of published studies of kidney, liver, and gastrointestinal birth defects in fetal alcohol spectrum disorders. Birth Defects Res A Clin Mol Teratol. 2009;85:179-83.

Chan T, Bowell R, O'Keefe M, Lanigan B. Ocular manifestations in fetal alcohol syndrome. Br J Ophthalmol. 1991;75:524-6.

Strömland K, Pinazo-Durán MD. Ophthalmic involvement in the fetal alcohol syndrome: clinical and animal model studies. Alcohol Alcohol. 2002;37:2-8.

Strömland K. Visual impairment and ocular abnormalities in children with fetal alcohol syndrome. Addict Biol. 2006;9:153-7.

May PA, Gossage JP, Kalberg WO, Robinson LK, Buckley D, Manning M, et al. Prevalence and Epidemilogic Characteristics of FASD from Various Research Methods with an Emphasis on Recent In-School Studies. Dev Disabil Res Rev. 2009;15:176-92.

May PA, Gossage JP, Brooke LE, Snell CL, Marais AS, Hendricks LS, et al. Maternal risk factors for fetal alcohol syndrome in the Western Cape Province of South Africa: a population-based study. Am J Public Health. 2005;95:1190-9.

May PA, Gossage JP, Marais AS, Hendricks LS, Snell CL, Tabachnick BG, et al. Maternal risk factors for fetal alcohol syndrome and partial fetal alcohol syndrome in South Africa: a third study. Alcohol Clin Exp Res. 2008;32:738-53.

Abel EL. An update on incidence of FAS: FAS is not an equal opportunity birth defect. Neurotoxicol Teratol. 1995;17:437-43.

Abel EL. Fetal alcohol syndrome in families. Neurotoxicol Teratol. 1998;10:1-2.

National Institute of Alcohol Abuse and Alcoholism. State of the Science report on the effects of moderate drinking. NIAAA Publications. 2003 [visitado 2014 May 3]. Disponible en: http://pubs.niaaa.nih.gov/publications/ModerateDrinking-03.htm

Gunzerath L, Faden V, Zakhari S, Warren K. National Institute on Alcohol Abuse and Alcoholism report on moderate drinking. Alcohol Clin Exp Res. 2004; 28:829-47.

Lewis SJ, Zuccolo L, Davey Smith G, Macleod J, Rodriguez S, Draper ES, et al. Fetal Alcohol Exposure and IQ at Age 8: Evidence from a Population-Based Birth-Cohort Study. PLoS ONE. 2012;7:e49407.

Streissguth AP, Barr HM, Sampson PD, Bookstein FL. Prenatal alcohol and offspring development: the first fourteen years. Drug Alcohol Depend. 1994;36: 89-99.

Windham GC, Fenster L, Swan SH. Moderate maternal and paternal alcohol consumption and the risk of spontaneous abortion. Epidemiology. 1992;3:364-70.

Munné M. Social Consequences of alcohol consumption in Argentina. En: Obot I, Room R, editors. Alcohol, gender and drinking problems. Ginebra: OMS; 2005. p. 25-48.

Maier SE, Miller JA, Blackwell JM, West JR. Fetal alcohol exposure and temporal vulnerability: Regional differences in cell loss as a function of the timing of binge-like alcohol exposure during brain development. Alcohol Clin Exp Res. 1999; 23:726-34.

Sulik KK. Genesis of alcohol-induced craniofacial dysmorphism. Exp Biol Med (Maywood). 2005;230:366-75.

West JR. Fetal alcohol-induced brain damage and the problem of determining temporal vulnerability: a review. Alcohol Drug Res. 1987;7:423-41.

Abel EL, Sokol RJ. Maternal and fetal characteristics affecting alcohol's teratogenicity. Neurobehav Toxicol Teratol. 1986;8:329-334.

Lee RD, An SM, Kim SS, Rhee GS, Kwack SJ, Seok JH, et al. Neurotoxic effects of alcohol and acetaldehyde during embryonic development. J Toxicol Environ Health A. 2005;68:2147-62.

Carter RC, Jacobson JL, Sokol RJ, Avison MJ, Jacobson SW. Fetal alcohol-related growth restriction from birth through young adulthood and moderating effects of maternal prepregnancy weight. Alcohol Clin Exp Res. 2013;37:452-62.

Dreosti IE. Nutritional Factors Underlying the Expression of the Fetal Alcohol Syndrome. Ann N Y Acad Sci.1993;678:193-204.

Zeisel SH. What choline metabolism can tell us about the underlying mechanisms of fetal alcohol spectrum disorders. Mol Neurobiol. 2011;44:185-91.

Bonthius DJ, Bonthius NE, Li S, Karacay B. The protective effect of neuronal nitric oxide synthase (nNOS) against alcohol toxicity depends upon the NO-cGMP-PKG pathway and NF-kappaB. Neurotoxicology. 2008;9:1080-91.

Schneider ML, Moore CF, Barr CS, Larson JA, Kraemer GW. Moderate prenatal alcohol exposure and serotonin genotype interact to alter CNS serotonin function in rhesus monkey offspring. Alcohol Clin Exp Res. 2011;35:912-20.

Feldman HS, Jones KL, Lindsay S, Slymen D, Klonoff-Cohen H, Kao K, et al. Prenatal alcohol exposure patterns and alcohol-related birth defects and growth deficiencies: a prospective study. Alcohol Clin Exp Res. 2012;36:670-6.

Day NL, Helsel A, Sonon K, Goldschmidt L. The association between prenatal alcohol exposure and behavior at 22 years of age. Alcohol Clin Exp Res. 2013;37: 1171-8.

International Center for Alcohol Policies. International Guidelines on Drinking and Pregnancy. ICAP. 2009 [visitado 2014 May 3]. Disponible en: http://www.icap.org/Table/InternationalGuidelinesOnDrinkingAndPregnancy

Centro Nacional de Genética Médica. Defectos Congénitos. CENAGEN. 2014 [visitado 2014 May 3]. Disponible en: http://www.anlis.gov.ar/inst/CeNaGeM/saludfetal/todo.htm

Universidad Nacional de Colombia - Alianza Cinets. Guía de Práctica Clínica para la Prevención y Detección Temprana de las Alteraciones del Embarazo. Rev Colomb Obstet Ginecol. 2013;64:245-88.

Ajzen I, Fishbein M. The influence of attitudes on behaviour. En: Albarracin D, Johnson BT, Zanna MP, editors. The handbook of attitudes. Mahwah, NJ: Erlbaum; 2005. p. 173-221.

Bandura A. Health Promotion by Social Cognitive Means. Health Educ Behav. 2004;31:143-64.

Prochaska JO, DiClemente CC. Transtheoretical therapy: Towards a more integrative model of change. Psychotherapy: Theor y, Research and Practice. 1983;19:276-88.

Strecher V, Rosentock I. The Health Belief Model. En: Glanz K, Lewis FM, Rimer B, editors. Health behavior and Health Education: Theory, Research and Practice. 2a ed. San Francisco: Jossey-Bass; 1997.

Organización Mundial de la Salud. Carta de Ottawa para la Promoción de la Salud. Ginebra: OMS; 1986.

Nutbeam D. Health promotion glossary. Health Promotion International. 1998;13:349-364.

International Center for Alcohol Policies. Health Warning Labels. ICAP. 2011 (visitado 2014 May 3). Disponible en: http://www.icap.org/Table/HealthWarningLabels/tabid/249/Default.aspx

Cómo citar

1.
López MB, Arán-Filippetti V. Consecuencias de la exposición prenatal al alcohol: desarrollo histórico de la investigación y evolución de las recomendaciones. Rev. colomb. obstet. ginecol. [Internet]. 30 de junio de 2014 [citado 16 de abril de 2024];65(2):162-73. Disponible en: https://revista.fecolsog.org/index.php/rcog/article/view/64

Descargas

Los datos de descargas todavía no están disponibles.

Descargas

Publicado

2014-06-30

Número

Sección

Artículo de Reflexión
QR Code

Métricas

Estadísticas de artículo
Vistas de resúmenes
Vistas de PDF
Descargas de PDF
Vistas de HTML
Otras vistas

Algunos artículos similares: