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Comment l'alcool ingéré par la mère passe au foetus et altère certains organes ?

Réponse : voir la vidéo explicative ci dessous

 

What do you call a Fetal Alcohol Syndrome ?

Response from Dr. Denis Lamblin,  pediatrician at CAMSP of SAINT-LOUIS, Reunion Island
 

Fetal Alcohol Syndrome (FAS) is defined by:

1. prenatal exposure to alcohol

2. stunted prenatal and postnatal weight or size or both

3. dysmorphic facial features whose most caricatured in infants are small palpebral fissures, a middle level of the face flattened, a turned up nose, a smooth philtrum, convex, and long, and a thin upper lip.

4. impairment of the central nervous system as malformation of the brain (microcephaly, structural abnormalities), mental retardation, major and minor neurological signs such as difficulties with fine motor skills, eye-hand coordination, sensory impairments ... and a set of cognitive and behavioral abnormalities that are not related to IQ and that can not be explained by the family and environmental conditions.

Syndrome d'Alcoolisation Foetal (SAF) French Equivalent for FAS.
 

However there are violations of the child exposed in utero by alcohol less caricatured :

Partial FAS (pFAS)

This term is used to designate a group of disorders caused by prenatal alcohol abuse among children who have:
- Certain facial features of FAS (at least two).
- And other elements associated with FAS as the existence of growth retardation or cognitive or behavioral disorders not explained by family environment.

SAF partiel (SAFp) French Equivalent for pFAS.
 

Alcohol  Related to Neurodevelopmental Disorders (ARND)

This term characterizes the effect on the central nervous system (mental, cognitive disorders, neuromotor disorders, neurosensory disorders ...)linked to alcohol exposition in utero.

Troubles Neuro Développementaux Liés à l'Alcool (TNDLA) French equivalent for ARND.

 
Alcohol Related Birth Defects (ARBD) : the Institute of Medicine (IOM)'s definition, which includes the presence of congenital malformations related to prenatal exposure to alcohol

Anomalies Congénitales Liées à l’Alcool (ACLA ) French equivalent for ARBD

 
Finally, FASD: Fetal Alcohol Spectrum Disorders is the term used to talk about all forms of fetal clinical disorders caused by prenatal alcohol.

Ensemble des Troubles Causés par l'Alcoolisation Foetale (ETCAF) French equivalent for FASD

How to stop drinking alcohol and then to put his baby safe?

 

Response from Dr Laurent URSO, Manager of addiction treatment at the Hospital of Roubaix

- There was only one given to remember, would have to confide in a professional of his choice who is a total confidence : GP, midwife or obstetrician.

- Possibly, this may be a non-medical professional who can help us to entrust the competent professional. It may then be a social worker, an educator, or even a friend or family member.

- The person who aids, this trusted professional will then accompany us to abstinence.

- Any shutdown of alcoholic beverages is beneficial to the child at any stage of pregnancy, even in the 3rd quarter.

- However, support should be in a protected environment. The most acceptable to all is motherhood: the mother is safe, non-stigmatized and valued. She has a suitable obstetric monitoring and daily visits from the mobile team of addiction.

- Relay with pediatricians even with CAMSP can be optimized with the aim of monitoring maintained even after childbirth.

- Support will be through an aide drug through type benzodiazepine dose rapidly decreasing. Treatment decreased appetite are also advised as well as vitamin therapy.

- Reinsurance and medico-psycho-social support will finally be valuable to strengthen the therapeutic alliance.

- Support for smoking cessation, finally, will be routinely offered.

 

 

Response from Dr Lawrence URSO, Manager of addiction treatment at the Centre Hospitalier de Roubaix
- There was only one given to remember, would have to confide in a professional of his choice who is a total confidence: GP, midwife or obstetrician.
- Possibly, this may be a non-medical professional who can help us to entrust the competent professional. It may then be a social worker, an educator, or even a friend or family member.
- The person who aids, this trusted professional will then accompany us to abstinence.
- Any shutdown of alcoholic beverages is beneficial to the child at any stage of pregnancy, even in the 3rd quarter.
- However, support should be in a protected environment. The most acceptable to all is motherhood: the mother is safe, non-stigmatized and valued. She has a suitable obstetric monitoring and daily visits from the mobile team of addiction.
- Relay with pediatricians even with CAMSP can be optimized with the aim of monitoring maintained even after childbirth.
- Support will be through an aide drug through type benzodiazepine oxazepam dose rapidly decreasing. Treatment decreased appetite are also advised as well as vitamin therapy.
- Reinsurance and medico-psycho-social support will finally be valuable to strengthen the therapeutic alliance.
- Support for smoking cessation, finally, will be routinely offered.

Is FAS hereditary ?

 

FAS is a toxic fetopathy: well defined, it can't be transmitted through DNA, it is not genetic. But often, mothers are alcohol-dependent. And the predisposition to alcohol dependence is transmitted genetically. Individuals with FAS have more often than the general population a predisposition to alcohol dependence. In addition, they can inherit family habits. So often children with FAS have a mother herself suffering from FAS, and sometimes a grandmother! Thus, the FAS can occur without hereditary transmitted genetically.

Question par: Dr Alain Fourmaintraux, pediatrician

When is the worst period of pregnancy to drink alcohol ?

Response from Dr Anne lise Delezoïde, pédiatrician from Developmental Biology Service at Robert Debré Hospital in Pari

 

The very beginning of pregnancy (embryonic period, before two months of pregnancy or 10 weeks of gestation) is the most dangerous period, ie one where alcohol can cause visible and serious malformations. But alcohol is involved mainly on the wrong development of the nervous system, including the brain, which continues throughout pregnancy and continues even after it is therefore likely to lead throughout pregnancy abnormalities at the cellular level, not visible externally, responsible for dysfunction of the brain, thus disorders of the child or adult.

 

Question par: Murielle, du Tampon, à La Réunion

Can we afford a minimum of alcohol during pregnancy without putting the baby in danger ?

Response from Dr Anne lise Delezoïde, pédiatrician from Developmental Biology Service at Robert Debré Hospital in Paris

We do not know the minimum level of consumption of alcohol which may create abnormalities in the baby. Particularly because there is a large individual variability in sensitivity to alcohol for pregnant women, this threshold can be very variable from one mom’ to another. The precautionary principle requires therefore refrain from drinking alcohol during pregnancy.

Question par: Rémi, étudiant GEA

How to recognize a child affected with FAS ?

Answer from Dr Jean Pierre CHABROLLE, pediatrician, Head of Pediatrics Department at Centre Hospitalier du Havre (76)

A child  affected with FAS is a child with a disability that is manifested by an abnormality in his physical and mental health. His growth is in step with the values for age and emotional development is disturbed, it tends to be impulsive, hyperactive and inattentive and this impedes their learning and are unhappy at school and in later life adult. Psychiatric disorders are very frequent, and their behavioral problems lead them to commit crimes.

The child affected with FAS may be malformed and will require special supervision.

All these disorders are directly related to the effects of alcohol consumed by the mother during pregnancy. 

We do not know the rate of safe consumption. Also, the advice for a woman who wants a baby is zero alcohol during her pregnancy.

If we don't really know how to repair a brain damaged by alcohol, we can help this child and his family (brothers, sisters, father and mother) and do everything that the mother does not give birth to a newborn with FAS .

 

Does the baby have a risk of death if his mother drink alcohol while she's pregnant ?

Response of Professor Lejeune, Head of Neonatology Department at Louis Mourier Hospital - Colombes (92)

 
Alcohol consumption by pregnant women does not pose a risk to life for the child, except:

 - A small increase in spontaneous fetal deaths in utero, but difficult to interpret because other factors can interfere simultaneous and especially tobacco;

 - The occurrence is rare, severe malformations, resulting in an incurable death after birth, after a variable delay;

 - And a decision (proposed by doctors and accepted by the parents) for medical termination of pregnancy with the discovery of severe malformations, mainly brain.

How many children are affected by FAS in France ?

Response from Dr Denis Lamblin, a pediatrician at CAMSP of SAINT-LOUIS, Reunion Island

In France, it is estimated that the "trouble" caused by alcohol during pregnancy affects 1% of births, that is to say 7,000 new children each year. This means that about 500,000 French suffer to varying degrees of fetal alcohol effects. The fetal alcohol syndrome itself is, in France, the leading cause of mental retardation not genetic.

It affects one birth in 3000 in the Pas-de-Calais. Alcoholism in France affects 2 million people, including 600 000 women (the latter statistic is particularly questionable: rigorous evaluation is very difficult due to almost constant denial of facts).

During pregnancy, 5% of women drink three glasses of alcohol per day on average, which is already a danger to the unborn child. Experts now believe that the risk appears on the first glass is the reason why, during pregnancy, should maintain a strict abstinence.

Question par: Annelya de Saint-Joseph