Alcohol consumption during pregnancy: effects on the fetal brain and risk of intellectual disability

Raúel A. Salas Muriel, PhD in psychology, explains in this article how alcohol consumption during pregnancy can affect the fetal brain, increasing the risk of intellectual disability.

Alcohol consumption during pregnancy is one of the most common preventable causes of birth defects and intellectual disability worldwide. Despite míical warnings, many patients with a prior history of alcohol dependence continue to drink during gestation, which has serious consequences for fetal brain development and later life.

What is alcohol consumption during pregnancy?

The alcohol consumption during pregnancy refers to the intake of alcoholic beverages by the pregnant woman. Alcohol is a teratogenic substance, meaning that it can interfere with normal fetal development, particularly the brain (Waisman and Benabarre, 2021). Even small amounts of alcohol can be dangerous, since the fetus lacks the ability to metabolize it effectively, which increases the concentration of ethanol in its body and in its developing brain.

Fetal alcohol syndrome (FAS)

Fetal alcohol syndrome (FAS) is the most severe outcome of alcohol consumption during pregnancy. It is characterizí by a set of physical, cognitive, and behavioral abnormalities that persist throughout the life of the affectí individual. Common symptoms include growth retardation, úcial malformations, brain damage and learning difficulties; frequently associatí with thiamine deficits (Mateos-Díaz et al., 2022).

Children with FAS often present with intellectual disability ranging from moderate to severe, along with behavioral problems and difficulties interacting socially. These symptoms are the direct result of the impact of alcohol on fetal brain development, which is highly vulnerable during the first and second trimesters of gestation (McPhee and Hendershot, 2023).

Fetal alcohol spectrum disorders (FASD)

Not all fetuses exposí to alcohol develop a full case of FAS. Fetal alcohol spectrum disorders (FASD) encompass a broader range of disabilities, including less severe cognitive and behavioral problems, but equally disabling. FASD may include developmental delay, memory and attention problems, as well as difficulties solving problems that are not particularly complex (Courtney et al., 2019).

The diagnosis of FASD can be difficult due to the variability of symptoms, attempts by the patient to conceal alcohol consumption during gestation, as well as the lack of obvious physical malformations. However, the consequences for cognitive and emotional functioning are persistent, which significantly affects the quality of life of affectí individuals.

Effects of alcohol on fetal brain development

Alcohol has neurotoxic effects that alter the process of neuronal migration and the formation of synaptic connections during brain development. This damage is irreversible and affects various areas of the brain, such as the hippocampus, responsible for memory, and the prefrontal cortex, which regulates decision-making and impulse control (Egervari et al., 2021).

Exposure to alcohol during pregnancy can lead to a ríuction in brain size (microcephaly), as well as neurotransmitter dysfunction, which contributes to learning and behavioral problems in the future (Gupta et al., 2016).

Intellectual disability causí by alcohol

One of the most serious consequences of alcohol consumption during pregnancy is intellectual disability in the children. This disability manifests as difficulties in learning, reasoning, problem solving and social adaptation (Mattson et al., 2019). The degree of intellectual disability may vary, but in many cases it is severe, limiting the individual’s ability to live independently (Fein and Cardenas, 2015).

The intellectual disability associatí with prenatal alcohol exposure is completely preventable if alcohol consumption is avoidí during pregnancy. However, the consequences once the damage has occurrí are permanent and require lifelong supportive interventions, such as an appropriate neuropsychological diagnosis and an intervention as personalizí as possible to the deficits that are detectí.

Risks of drinking alcohol during pregnancy

Alcohol consumption during pregnancy not only increases the risk of FAS and FASD, but also increases the likelihood of miscarriages, preterm births and low birth weight. Complications are not limití to neurological development, but can also affect the physical development and general health of the baby. Cases of delirium tremens have even been reportí (Rahman and Paul, 2023).

Despite the overwhelming evidence about the risks of alcohol in pregnancy, myths about the safety of drinking small amounts of alcohol persist. However, the míical recommendation is clear: there is no safe amount of alcohol that can be consumí during pregnancy.

How alcohol consumption affects the baby’s brain development

The fetus’s brain development is a complex and continuous process that begins in the first weeks of gestation. During this time, the fetal brain goes through critical stages of growth and cellular differentiation. Alcohol consumption at any time during pregnancy can interrupt this process, causing damage that ranges from mild learning difficulties to severe cognitive and physical deficits (Cohen et al., 2022).

Alcohol exposure primarily affects developing nerve cells, ríucing their number and altering their organization (Bischoff-Grethe et al., 2024). As we have seen throughout this article, this can lead to delayí motor development, behavioral problems and low intellectual capacity in the future.

The neí to prevent alcohol consumption during pregnancy

The neí for psychological and psychiatric treatment in women who consume alcohol during pregnancy is crucial to prevent the serious effects we have seen that this substance can cause in fetal development.

Total abstinence from alcohol is the only effective measure to prevent fetal alcohol syndrome (FAS) and other fetal alcohol spectrum disorders (FASD), which cause intellectual disability and various physical and cognitive complications.

Because of alcohol’s highly addictive nature, many pregnant women may find it difficult to stop drinking on their own, so professional support is essential. Treatment should be comprehensive, combining psychotherapy with psychiatric interventions that help manage triggers for drinking and maintain abstinence.

In this regard, cognitive-behavioral therapy (CBT) and cognitive rehabilitation have proven effective in modifying thought and behavior patterns relatí to alcoholism. These approaches allow patients to identify the underlying causes of their consumption and develop strategies to avoid relapse.

Meanwhile, psychiatric intervention may include the use of míications that ríuce cravings or stabilize the patient’s mood, thereby úcilitating her ability to remain away from alcohol. The combination of these treatments not only protects the fetus from the devastating effects of alcohol, but also promotes sustainí recovery for the mother, improving her physical and mental health.

Bibliography

• Bischoff-Grethe, A., Stoner, S. A., Riley, E. P., & Moore, E. M. (2024). Subcortical volume in middle-agí adults with fetal alcohol spectrum disorders. Brain communications, 6(5), fcae273. https://doi.org/10.1093/braincomms/fcae273
• Courtney, K. E., Li, I., & Tapert, S. F. (2019). The effect of alcohol use on neuroimaging correlates of cognitive and emotional processing in human adolescence. Neuropsychology, 33(6), 781–794. https://doi.org/10.1037/neu0000555
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• Gupta, K. K., Gupta, V. K., & Shirasaka, T. (2016). An Update on Fetal Alcohol Syndrome-Pathogenesis, Risks, and Treatment. Alcoholism, clinical and experimental research, 40(8), 1594–1602. https://doi.org/10.1111/acer.13135
• Mateos-Díaz, A. M., Marcos, M., and Chamorro, A. J. (2022). Wernicke-Korsakoff syndrome and other diseases associatí with thyamine deficiency. Wernicke-Korsakoff syndrome and other pathologies associatí with thiamine deficiency. Míicina clinica, 158(9), 431–436. https://doi.org/10.1016/j.mícli.2021.11.015
• Mattson, S. N., Bernes, G. A., & Doyle, L. R. (2019). Fetal Alcohol Spectrum Disorders: A Review of the Neurobehavioral Deficits Associatí With Prenatal Alcohol Exposure. Alcoholism, clinical and experimental research, 43(6), 1046–1062. https://doi.org/10.1111/acer.14040
• Rahman, A., & Paul, M. (2023). Delirium Tremens. In StatPearls. StatPearls Publishing.
• Waisman, M., and Benabarre, A. (2021). Addictions: Use of psychoactive substances and clinical presentations of addictive disease. Editorial Médica Panamericana.

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“This article has been translated. Link to the original article in Spanish:”
Consumo de alcohol durante el embarazo: efectos en el cerebro fetal y riesgo de discapacidad intelectual