Alcohol in pregnancy: "Nobody would ask how much radioactivity is okay for pregnant women"

Because their mothers drank during pregnancy, thousands live with disabilities. Heike Wolter, who treats them, says: Acceptance of alcohol is the main problem.


The consequences of passive drinking for babies are underestimated. In the journal "BMC Medicine" researchers recently reported that every year in Germany thousands of newborns with a fetal alcohol spectrum disorder (FASD) are born. Including just under 3,000 with a fetal alcohol syndrome (FAS), the full extent of the disorder. Heike Wolter is a child and adolescent psychiatrist at the Social Pediatric Center for Adolescent Psychiatry of the Berlin Charité.

ZEIT ONLINE: Ms. Wolter, that alcohol harms the unborn, everyone knows, or not?

Heike Wolter: You should think so, with some myths hold. From parents I hear again and again: "Well, the gynecologist said, now and then a glass is not a pity."

ZEIT ONLINE: Why is alcohol so harmful to the unborn child?

Wolter: The biggest problem is that the brain is damaged during its development. It is not yet clear what mechanisms this will happen, but there are indications that nerve cell connectivity and cell division are disturbed.

ZEIT ONLINE: And how does the alcohol get into the baby's circulation?

Wolter: About the maternal blood - about the placenta and the umbilical cord. The unborn child is thus at least exposed to the alcohol value, which has the mother in the blood - with the disadvantage that the organism of the unborn child can not break down the alcohol itself. As a result, the baby in the belly of the alcohol concentration is exposed for much longer.

ZEIT ONLINE: If children have visible or noticeable damage as a result of alcohol during the pregnancy of their mothers, doctors speak of a Fetalen Alkoholspektrumstörung with the English abbreviation FASD. What does all this mean?

Wolter: FASD is the generic medical term that covers the various diagnoses. If the full clinical picture is present, this is called Fetal Alcohol Syndrome (FAS). Its features include not only limitations in children's concentration, memory and learning ability, but external stigmata such as growth disorders and facial features, such as a narrow upper lip, a lapsed Philtrum - that is the crease over the upper lip - and shortened eyelids.

ZEIT ONLINE: And in contrast to it?

Wolter: Physicians distinguish the Partial Fetal Alcohol Syndrome (PFAS), which includes some visible visible malformations and impaired cognitive abilities. When people show no external abnormalities, but suffer from structural or functional impairments of the brain, one speaks of alcohol-related developmental neurological damage, in English Alcohol-Related Neurodevelopmental Disorder (ARND).

ZEIT ONLINE: Now some mothers say: Yeah, I also drank a glass of wine when I was pregnant, and my baby is healthy. So what does it depend on, if any damage really occurs?

Wolter: That's not exhaustively explored. But it is certain that genetic conditions of the unborn baby also play a role. There are cases of twins in which one is more affected than the other, even though they were exposed to the same amount of alcohol in the womb. And there are children of mothers who have drunk, who show no abnormalities after birth - or at least none, with whom the parents seek medical advice. These cases are also not documented for research. As a precaution, we generally recommend: No alcohol during pregnancy!

ZEIT ONLINE: Does the degree of damage increase with the amount of alcohol?

Wolter: One can assume that the more that is drunk, the greater the damage. Most are the information on how many mothers have drunk when, but inaccurate. Often they can not remember exactly how much they've drunk or how many times they drank.

ZEIT ONLINE: What role does the timing of pregnancy play?

Wolter: Especially at the beginning of the embryo is particularly sensitive to malformations - although it should be noted that the amount and frequency of alcohol consumption plays a more important role. It does not matter at what time: you should always support pregnant women not to drink.

ZEIT ONLINE: Regularly a glass or once a complete rush - makes a difference in the end?

Wolter: There are indications that a sudden, very high increase in alcohol in the blood of pregnant women is more damaging than small amounts over a longer period of time. When talking about alcohol in pregnancy, people keep asking: How much can you drink without harming the unborn child? For other substances that harm the unborn child, we are much stricter. Nobody would ask how much radioactivity is okay for pregnant women. The environment too often signals: Oh, you can drink a glass!

ZEIT ONLINE: But there are also women who are alcoholic. Anyone who suffers from an addictive disease will hardly be able to get all alone. Do you know how many of those affected are ultimately children of alcoholics?

Wolter: No, because we know little about the mothers and the alcoholism is often unknown or diagnosed. For alcoholic women, unfortunately, there is no known reliable helpful concept. Again and again, we are dealing with alcoholic mothers who do not manage to stop drinking alcohol even in the fifth and sixth years and avoid any help. Alcohol has too high a place in society. It is a dangerous drug that can also be purchased freely and cheaply.

ZEIT ONLINE: What offers of help are there for women who realize: I do not want to and can not drink because I'm pregnant, but can not do it alone?

Wolter: Here in Berlin there is the facility Wigwam Connect, which has taken care of these women to the task. There is also an outpatient department at the Charité Clinic for Obstetrics at Virchow-Klinikum, which looks after substance-dependent pregnant women. It is also important that the environment of pregnant women does not accept alcohol and helps women to maintain abstinence. Expectant fathers or friends should not sit with beer in the evening next to the woman and drink at a party in solidarity and sometimes only juice or water. As long as pregnant women who do not touch a drop are fun-seekers, many become weak.

ref: zeit