August 15, 2005
Moderate Prenatal Alcohol Exposure Slows Down Baby Brains
Moderate prenatal alcohol exposure too low to cause recognizable Fetal Alcohol Syndrome makes the brains of the resulting children less able to carry out complex tasks.
- Prenatal alcohol exposure is often linked to slower cognitive reaction times and poorer attention.
- A new study investigates cognitive function and speed as tasks become more complex.
- Findings indicate that alcohol-exposed children can perform as well as other children on simple tasks, but as tasks become more demanding and challenging, processing speed slows down significantly.
As the kids grow up they are unable to advance to learning the increasingly complex tasks necessary for advanced education and intellectually complex occupations.
Decades of research have left little doubt that prenatal alcohol exposure has adverse effects on intellectual and neurobehavioral development. A recent study of the effects of moderate to heavy prenatal alcohol exposure on cognitive function confirms earlier findings of slower processing speed and efficiency, particularly when cognitive tasks involve working memory. Results are published in the August issue of Alcoholism: Clinical & Experimental Research.
"Prenatal alcohol exposure is often associated with slower reaction times and poorer attention in infancy, and some of these deficits may be at the core of poorer academic performance and behavior problems often seen later in childhood," said Matthew J. Burden, postdoctoral research fellow at Wayne State University School of Medicine and corresponding author for the study. "In cases of fetal alcohol syndrome (FAS) … lower IQ scores are common, often reaching the level of mental retardation. This is because alcohol consumed by the mother has a direct impact on the brain of the fetus. However, full FAS is not required to see this impact; it is just less obvious to detect across the array of exposures found in fetal alcohol spectrum disorders (FASD), which include effects of prenatal alcohol at lower drinking levels."
Julie Croxford, graduate research assistant at Wayne State University, says there is a need for researchers to look at the damage caused by prenatal alcohol exposure at lower-than-heavy levels of drinking. "In the past, much focus was placed on studying the full-blown FAS," she said. "More recent research has considered those individuals damaged by lower levels of exposure. This is an important focus."
For this study, researchers assessed 337 African-American children (197 males, 140 females) at 7.5 years of age; selected from the Detroit Prenatal Alcohol Longitudinal Cohort, the children were known to have been prenatally exposed to moderate-to-heavy levels of alcohol. Their mothers were originally recruited between September 1986 and April 1989 during their first prenatal visit to a maternity hospital clinic. The children were assessed on processing speed and efficiency in four domains of cognitive function – short-term memory scanning, mental rotation, number comparison, and arrow-discrimination processing – using a Sternberg paradigm, which examines speed of completion as problems become increasingly more difficult.
"We chose these four domains because they allow us to study distinct aspects of cognition within the same cognitive framework," said Burden. "This helps to distinguish potentially specific deficits from those that are more global in nature; that way we get a better understanding of how prenatal alcohol exposure affects cognitive functioning many years later in childhood. We used the Sternberg paradigm because it indicates how fast an individual generates the correct response to a number of problems, providing an overall measure of speed; and it examines the rate at which response times increase as problem difficulty increases, providing a processing efficiency measure."
Although the alcohol-exposed children were able to perform as well as the other children when tasks were simple – such as naming colors within a timed period – when pressed to respond quickly while having to think about the response, their processing speed slowed down significantly.
"This suggests that processing speed deficits are more likely to occur within the context of some cognitive demand," said Burden. "We also found that prenatal alcohol exposure was associated with poorer efficiency on number processing, a finding consistent with past research showing more specific adverse effects in the arithmetic domain. Arithmetic performance may be relatively more compromised with prenatal alcohol exposure than other types of intellectual performance, such as verbal abilities. We also looked at how processing speed related to other aspects of cognition, working memory in particular. Prenatal alcohol exposure had some impact on both speed and working memory, but the effect on working memory was partly accounted for by the deficits in speed – in other words, slower performance contributes in part to poorer working memory."
"The conclusion drawn here is that the reaction-time deficits associated with prenatal alcohol exposure are seen more in demanding/challenging cognitive tasks that involve the integration of working memory," said Croxford. "The real-world implications of this are that children exposed prenatally to alcohol may be able to perform simple tasks, but may struggle with tasks that are more challenging and require complex cognition and the use of working memory. This is likely to mean that these children may be more and more challenged the older they get by the demands placed on them within the school system and within their day-to-day social interactions."
Researchers controlled for many other variables and still found the effect.
Both Burden and Croxford noted that this study also examined the impact of "confounding" factors such as home environment, socioeconomic status, and current maternal drinking levels, which researchers believe may contribute to the poor outcomes seen in children exposed to prenatal alcohol.
"In this study, we accounted for more than 20 of these potentially confounding influences in the analyses," said Burden. "The effect of alcohol exposure in utero persisted above and beyond any other influences present."
What this means, said Croxford, is that alcohol itself causes specific, identifiable and permanent deficits in brain development and physiology. "This reinforces the current public health message that women should not drink alcohol during pregnancy," she said.
Burden said that he and his colleagues will continue to examine the long-term effects of prenatal alcohol exposure on the same children. "In addition to neuropsychological and behavioral measures, we will also be using electrophysiological techniques such as event-related potentials and neuroimaging (fMRI) to more directly connect cognitive performance with brain function," he said.
Look ahead 20 years. Imagine that implantable nanosensors can detect and record a pregnant mother's alcohol consumption. She could be checked periodically by passing a reading device over her body to read the records of her embedded nanosensors. If she has consumed alcohol or taken harmful drugs or smoked cigarettes or eaten food that contains toxins all this could be detected.
Well, assuming that becomes possible do you suppose some governments in more industrialized countries might require all pregnant women to have nanosensors implanted in them? The argument for why this would beneift society is easy to make. Why should pregnant women have a legal right to harm the cognitive development of their fetuses? The rest of us suffer the consequences (lower academic achievement, lower earnings, lower taxes paid, more state aid received, more behavioral problems, and probably more crime) if women do harm to their developing fetuses. So why shouldn't the fetuses be protected from avoidable harm by use of state powers?
As I see it the more we can measure ways that people harm each other (e.g. pollution or drug abuse while pregnant or while nursing or by child abuse) the more ways we should intervene to stop that harm. Now, an obvious argument to make is that fetuses are not yet legal humans and therefore do not have rights to protect. Even if one accepts the moral argument (and many don't) I still see a utilitarian argument for protecting fetuses from damage since we all benefit. I also see a rights-based argument: Fetuses that are not cognitively impaired by drug and alcohol exposure are less likely to develop into adults who have behavioral problems that cause them to violate the rights of others.
Update: Before anyone tells me that they can't imagine their government imposing fetal nanosensor monitors on women keep in mind that there are nearly 200 national governments in the world and most of them are not Western and not liberal. China has the biggest population in the world (though India will likely eventually surpass it by mid 21st century) and China imposes a One Child policy on its entire population. China is on course to become the largest economy in the world. Other East Asian countries similarly do not share Western conceptions of the proper role of government.
So, what if they took drugs or had a drink? You can't confiscate a fetus like you can a child. Would you force them to abort? Or would you hold them in a hospital for the remainder of their pregnancy to ensure they consume no more toxins, then take the kid away when they are born? I can see implanting nanosensors voluntarily to keep track of the health of the child if a parent is so inclined. But I don't see the state stepping in and making it a requirement. Women are not currently legally required to take any tests or even see a doctor if they are pregnant (at least, not that I'm aware of), so I don't see this happening.
Wow, Big Brother really shows his hand on this one, but in 2024 rather than in 1984. However, it might also be that by that time women will become more aware of the implications of what they do and will voluntarily refrain from doing things that might harm their children. That, of course, assumes that they won't yet be immortal and will still have reason to go on bearing children like in the old days.
I'd put them in an institution that controls what they eat and take.
Which state do you not see stepping in? Do you see China not stepping in? How about Vietnam if it becomes affluent enough to afford compulsory nanosensor fetal monitoring? what about Japan? How about Singapore?
I see some states making fetal nanosensor monitoring a requirement once the costs of drug, alcohol, and other toxin exposures become much more accurately measured and once the cost of the monitoring becomes dirt cheap.
I wouldn't be surprised to see some states use implanted nanosensors to reduce the incidence of illicit drug use in general.
Lots of women are junkies and other forms of addicts. They know this is terrible to them. They know this harms their babies. They do it anyway. What about them?
Barbara Harris offers many drug addict women money in exchange for getting sterilized. She adopted 4 babies from the same drug addict mom and finally said enough is enough. I think society as a whole should do likewise. Do you disagree?
And once the kid is born, do you take it away?
I don't see democractic states stepping in. You mention Japan. Japan is having trouble with a low birth rate - I doubt they would create a situation where women would be less likely to become pregnant. In fact, any democracy where women vote will have trouble instituting such a practice. As for non-democracies who are increasingly industrial, I think pregnant women having a couple of drinks or even shooting up are the least of their concerns. Honestly, how many non-democratic countries are worried about the rights of the unborn?
Are there any countries that currently require a woman to see a doctor if they get pregnant or to have pre-natal testing done? If there are, then I can see them requiring this or similar procedures when they become affordable (though they would have to do it quietly, because the humans rights groups would go ballistic). Otherwise, I don't see it happening.
Well, mom's alcohol use becomes far less a threat to the baby's brain development once the baby is born.
Women: Since most women do not want babies to be hurt during pregnancies and would avoid doing things that would hurt their babies why would they oppose efforts to prevent the harmful minority from hurting their babies? Look, women are more practical and less ideological than men. High principled rhetoric about liberty means less to them than whether babies are getting hurt and can be protected.
So do you oppose use of the power of the state to prevent women from doing permanent harm to their unborn babies?
"So do you oppose use of the power of the state to prevent women from doing permanent harm to their unborn babies?"
Sounds like the abortion debate in a nutshell. We can try to educate people to the consequences of what they do. But, Randall, you seem to be working on the premiss that if you (i.e., the state) just had sufficient power, you could cure all ills. Such thinking explains the paving of the road to hell.
No, the abortion debate is about when life begins. I'm assuming the fetuses will become babies and that we will have to deal with the consequences. Of course a woman who doesn't want nanosensor monitors could always opt to abort where that is legal.
If only the state had sufficient powers: I picture us back in 1970 debating the Clear Air Act. Toot says "You want to give the state power to cure all ills". Randall says: "No, I just want to prevent polluters from harming the rest of us".
As scientific knowledge advances we inevitably find new ways that the actions of one person harms other people. Are we supposed to not act on that knowledge for old times sake? I certainly agree that state action can be excessive and that the costs of state intervention can outweight the benefits.
But ghetto kids walking around with 5 or 10 point lower IQs and with emotional and behavioral problems as a result of mom's behavior while pregnant are a big and probably growing cost. Brains are extremely important. A single criminal harms dozens or hundreds or even thousands of people over their life of crime. Some of those harms include murder, maiming, and rape (which leaves its own emotional maiming).
As technologies improve it might be possible to build a more comprehensive system for fetal protection. The system would detect the presence of deleterious molecules and teratogenic substances that are trying to pass through the placental barrier and it would attempt to filter them out. It might convert the harmful substances into harmless metabolites or it might store them for later excretion. A system of this type would probably be less controversial ethically and politically because it would be valuable for a wide spectrum of pregnant women desiring extra fetal safety.
I think the 4th amendment protecting against unreasonable searches and seizures makes this idea dead in the water, except in cases of 'probable cause'. for that to fly, you have to recognize the rights of the fetus, which current (and seemingly illogical, imho) supreme court abortion opinion does not recognize the fetus having any rights. so to implement such a policy in the U.S. you'd have to 1) eliminate 4th amendment 2) modify current legal status of fetuses (which is probably some combination of legal fiat, federal statute, and constitutional law.
that being said, in the cases of known drug addicts/alcoholics a probably cause argument might be made for such a device. for normal, law-abiding citizens i don't think it has a chance in the U.S.
why not put such a device in all people to monitor their health decisions, removing free will of people is a sure way to force them to make better health decisions? (yes this is a rhetorical question)
I see a big difference between acts where a person harm's themself versus acts where they harm someone else. So does the law.
Suppose that a woman is known to be a drug abuser or alcohol abuser. Is it unreasonable search and seizure to require a nanosensor implant while they are pregnant?
What if an obviously pregnant woman shows up in a bar and wants a double scotch on the rocks and a cop is sitting next to her in the bar. Should she be allowed to take the drink?
yes, there are big differences between harming yourself and others, i put that '1984-ish' comment in to provoke thought. i have very libertarian instincts.
I think for a known drug abuser, you now have 'probable cause' for a 'search' that would no longer be 'unreasonable'. so in answer to your first question, my legal opinion is NO.
there isn't a current law, to my knowledge, to arrest on or search on currently. That doesn't mean a law couldn't be passed. The only constitutional challenge to such a law (that would drive the pro-abortion, er 'pro-choice' lawyers into a feeding frenzy) is whether that baby in her belly is a baby with rights or just a collection of baby-shaped cells that happen to be growing into a baby. My understanding of the R. v Wade ruling, is that the general privacy in the constitution was the driving force. There was no balancing with the rights of the unborn child. Hence, giving the unborn child rights would have implications for the r. v. wade decision. Practically speaking, I don't know what self-respecting bartender would knowingly serve that woman a drink.
I do wonder though, could the mildly-retarded kid of the alcoholic mom sue the mom for damages in civil court? that wouldn't require any new law.
China does require a couple to be screened prior to conception.
It's hardly a major point, but many Chinese are not sujbect to the one-child policy. It only applies to Han living in urban areas, and has been currently relaxed to allow two children for these couples if the first is a female.
Um, aren't there statistical problems here? Tiny sample size; little or no quantitative data on how much alcohol was consumed; sample all from one race! How can you possibly generalize from this study to human beings in general? It sounds like these kids were all lower-class inner-city kids from Detroit. They turn out to have various cognitive problems. Shocking. Those problems are highly correlated with income and socioeconomic status as well. How can you possibly control for factors that all your sample has in common? Saying you've controlled for something doesn't make it so. Sorry, but this study is highly suspect.
In developed countries, I think the only effect this might have is that women, particularly those most likely to actually do harm to their unborn children, would avoid seeing a doctor if they found out they were pregnant. They could claim they just gained a little weight until the day they went into labor. Are the cops going to stop you on the street and scan you to make sure you’ve got your nanosensors in? Or maybe they’ll just ask for papers from your doctor. And when a woman “unexpectedly” gives birth, will she be arrested for not reporting it? Maybe she'll just hide in her home until the kid is born, then claim she adopted. So now birth defects and genetic abnormalities are not caught early enough to fix, potential complications are not known about ahead of time, mothers do not get basic medical advice on proper diet and levels of activity. These will have long term effects, too, but on a much larger segment of the population. Women who would otherwise be responsible parents may refuse to see a doctor to avoid being treated like a criminal just for daring to contribute to the continuation of the species. So now, not only are the irresponsible women endangering their unborn children, but otherwise responsible women are too, putting more babies at risk, not fewer.
You want the government to step in to make healthier babies? Provide free per-natal care. Offer classes on proper diet and good parenting skills. Make it easier to become a responsible parent by offering lots of "learning to help yourself" help (as opposed to "here's some money, do as you will" help). Yes, there will still be irresponsible parents who don't care what happens to there kid before or after they're born. Whether we like it or not, there will always be stupidity. But the answer is to educate and give women more options, not fewer.
You argue the basic line for the therapeutic society. If only we provide more availability to care then the outcomes of pregnancies will be better. I don't believe it. Drug and abusers are going to lie to doctors. Addicts are great liars.
As for women who would avoid going to doctors for fear of being tested: Well, duh. Yes, abusers are deceivers.
We could certainly target legal requirements at women known to be at risk. Do you oppose legal requirements for testing for pregnant women who been busted for drugs, for DUI, and for disorderly conduct while drunk? After all, they already have demonstrated less than high levels of responsibility.
A good labor-saving strategy would just be mandatory screening of fetuses for genetic defects coupled with forced abortions. Available with current technology, benefits begin immediately in the form of decreased costs associated with salvaging defective newborns. Liquidation of the mentally retarded in general would also be quite cost-effective from the standpoint of society -- again, no new technology needed.
I'm saying that compelling all women to do this will not catch the ones you wish to target and will only punish those who are willing to at least try to be responsible. If you want to punish a drug and/or alcohol abuser for being irresponible with the life they carry, tie their tubes and be done with it. No sense in wasting taxpayer dollars locking them up in facility and forcing them to have a child they probably can't care for anyway, seeing as how they can't even care for themselves.
One surprising thing is that the children of alcoholics have the tendency to become alcoholics, and it seems to me that it is not simply because these children have inherited the genes of those people who are weak willed, but that the genetic modification that the children incur also include the need to consume alcohol. This is very strange, because I can understand that damage to the personality, mood, etc can be genetically induced by alcohol, but what kind of "intelligent" mutation is caused by alcohol so that the children of alcoholics would crave for alcohol? This seems very interesting. Is alcohol an intelligent molecule?
I think Jim's point needs more development.
In the western liberal democracies, it is more likely to occur via civil action. Once children with Fetal alcohol syndrome start suing their parents, then the insurance companies will step in to prevent coverage or charge huge premiums to women who drink while pregnant. And they'll need monitoring to enforce it.
It won't be a punishment thing (much as the insurance companies might like it to be...) instead it will be a "discount for those who voluntarily use the new monitoring technology" but it will work out to be the same thing.
Then... once the upper and middle classes have gotten used to the idea, why on earth would they stick up for the rights of the poor to keep "ripping off" the public insurance system?
On the other hand, if we could muzzle the FDA, and it's insane insistance that alcohol (And tobacco, too.) is SUPPOSED to be bad for you, darn it!, and nothing will be permitted that might change that, we might instead ask, "What is the mechanism of damage, and is there anything we could add to alcoholic beverages which would protect against it?"
With respect to Jim's speculations regarding the legal profession, I don't see where Randall's rights based argument relied on the rights of the fetus so I am not too clear on how this has any relevance to roe v. wade or the whole abortion issue.
I agree with Brett. At some point, I believe someone will come up with a way for women to enhance the outcome of their pregnancy by doing the things they want to do.
Bob, my rights-based argument and its connection to roe v. wade is this: if you argue that the mom can't make the fetus retarded, than arguing against the mom's right to kill the fetus seems to follow. roe v. wade decision considered just the mom's rights, not the rights of the fetus.
It might be easier and cheaper to figure out how to reverse the brain effects of fetal alcohol exposure than to guarantee that no women drink too much (however much that is) when pregnant.
No, I think brain repair will turn out to be incredibly difficult on that scale. Brain development is a very complex process coded for by large numbers of genes. Trying to recreate that development only partially would be extremely complex because (among other reasons) the distances within the brain will be wrong as a result of cell death during development. To scale up a shrunken brain and fill in what is missing will be a problem that won't be solved for decades.
While we can't prevent every single case of alcohol damage to fetuses we could reduce the incidence of damage right now with laws, law enforcement, monitoring, and selective institutionalization. Also, follow Barbara Harris's cue and offer money to drug and alcohol abusing and fertile women to get sterilized and to get Norplant.