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Competency 1: Introduction to FASD

Historic Findings Related to Alcohol Use by Pregnant Women, Continued

Twentieth Century

For decades, physicians thought that the placenta provided a protective barrier that would prevent teratogens such as alcohol from reaching the fetus. Many believed children of alcoholics had defects related to poor genetic stock rather than alcohol exposure. That was the conclusion in a 1946 article in the Journal of the American Medical Association.

The Broken Cord, a book about alcoholic mothers and their babies

French researchers began to study alcohol and pregnancy in the 1950s. An unpublished thesis reported the prenatal effects of alcohol on children born to alcoholic parents. In 1968, Dr. Paul Lemoine published a study of 127 children from 69 French families.5 Twenty-five children had distinct features related to prenatal alcohol exposure. Dr. Lemoine called this alcoholic embryopathy.

A few years later, Christy Ulleland, a pediatric resident in Seattle, became interested in babies with failure to thrive. She noticed that many had alcoholic mothers. In reviewing delivery records, she found more babies that fit the pattern. Her colleagues, Drs. David Smith and Kenneth Jones, asked to have all the children examined at one time.

In 1973, Jones and Smith identified a specific pattern of malformations, growth deficiencies, and central nervous system defects in 10 children of alcoholic mothers. Their study not only noted the connection between prenatal alcohol and developmental disabilities, but gave it a name: fetal alcohol syndrome (FAS).6

It was originally believed that malnutrition might be responsible for these defects. However, the pattern of malformation associated with FAS is not seen in children born to malnourished women. In addition, alcohol has been found to be acutely toxic to the fetus independently of the effects of malnutrition.7,8

Similar cases were found in Germany, France, and Sweden.9-11 As a result, FAS prevention programs were developed in the late 1970s.12

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