8 Fetal Alcohol Spectrum Disorder: Embryogenesis Under …
201
History
Connection Between Alcohol Exposure and Birth Defects
The connection between human pregnancy and alcohol goes back to ancient times
when man learned to ferment sugar-containing agricultural produce. In biblical times,
when Samson’s mother was notified of her pregnancy, she was warned:
And the angel of the LORD appeared unto the woman, and said unto her, Behold now, thou
art barren, and bearest not: but thou shalt conceive, and bear a son. Now therefore beware, I
pray thee, and drink not wine nor strong drink, and eat not any unclean thing:
{Judges XIII:3–4}.
This biblical quote has been used to imply a very early awareness of a connection
between alcohol ingestion and the induction of birth defects. This interpretation has
been disputed as the subsequent verse states that the “boy” will become a Nazirite,
individuals that for religious reasons abstain from drinking (Abel 1997; Randall 2001;
Brown et al. 2018). Early Greek scholars also wrote comments linking excessive
maternal alcohol ingestion during pregnancy to detrimental effects on the normal
development of offspring (Lemoine 2012; Brown et al. 2018).
During the 18th and 19th centuries, medical evidence accumulated suggesting
that drinking alcohol during pregnancy had harmful effects on the developing fetus.
These observations led to a number of studies in the late 19th and early 20th centuries
attempting to understand the effects of alcohol on fetal development (Warner and
Rosett 1975; Warren and Hewitt 2009; Warren 2015; Brown et al. 2018). In 1892,
Hertwig (1892) speculated that blood-borne chemicals, including alcohol, toxins, and
drugs, could pass through the placenta to the fetus to induce developmental damage.
These ideas prompted the proposal that the environment had a crucial effect on fetal
development. Then, in 1895, the French physician, Féré (1895) published one of the
earliest studies on the teratology of alcohol exposure. He studied the effect of various
alcohols on the development of the chicken nervous system during embryogenesis
by placing fertile eggs on a plate under a glass bell with different alcohols added to
the plate. This treatment led to multiple, and sometimes severe, teratogenic defects
ranging from developmental arrest, to atrophy of the head, spina bifida, and loss of
the eyes (anophthalmia).
More than a decade later, Mall (1908), published a study on malformations and
teratology in human embryos. This study, based on many clinical cases and on the
experimental work of Féré, promoted the idea that the environment plays important roles in the induction of developmental malformations, supporting the original
suggestions of Hertwig.
Soon thereafter, Stockard (1910) asked whether anesthetics in use at the time
(including alcohol) had teratogenic effects on fetal development. He exposed Atlantic
killifish (Fundulus heteroclitus) to chemicals used as anesthetics at the time, including multiple concentrations of ethanol. He found that alcohol affected embryonic
201
History
Connection Between Alcohol Exposure and Birth Defects
The connection between human pregnancy and alcohol goes back to ancient times
when man learned to ferment sugar-containing agricultural produce. In biblical times,
when Samson’s mother was notified of her pregnancy, she was warned:
And the angel of the LORD appeared unto the woman, and said unto her, Behold now, thou
art barren, and bearest not: but thou shalt conceive, and bear a son. Now therefore beware, I
pray thee, and drink not wine nor strong drink, and eat not any unclean thing:
{Judges XIII:3–4}.
This biblical quote has been used to imply a very early awareness of a connection
between alcohol ingestion and the induction of birth defects. This interpretation has
been disputed as the subsequent verse states that the “boy” will become a Nazirite,
individuals that for religious reasons abstain from drinking (Abel 1997; Randall 2001;
Brown et al. 2018). Early Greek scholars also wrote comments linking excessive
maternal alcohol ingestion during pregnancy to detrimental effects on the normal
development of offspring (Lemoine 2012; Brown et al. 2018).
During the 18th and 19th centuries, medical evidence accumulated suggesting
that drinking alcohol during pregnancy had harmful effects on the developing fetus.
These observations led to a number of studies in the late 19th and early 20th centuries
attempting to understand the effects of alcohol on fetal development (Warner and
Rosett 1975; Warren and Hewitt 2009; Warren 2015; Brown et al. 2018). In 1892,
Hertwig (1892) speculated that blood-borne chemicals, including alcohol, toxins, and
drugs, could pass through the placenta to the fetus to induce developmental damage.
These ideas prompted the proposal that the environment had a crucial effect on fetal
development. Then, in 1895, the French physician, Féré (1895) published one of the
earliest studies on the teratology of alcohol exposure. He studied the effect of various
alcohols on the development of the chicken nervous system during embryogenesis
by placing fertile eggs on a plate under a glass bell with different alcohols added to
the plate. This treatment led to multiple, and sometimes severe, teratogenic defects
ranging from developmental arrest, to atrophy of the head, spina bifida, and loss of
the eyes (anophthalmia).
More than a decade later, Mall (1908), published a study on malformations and
teratology in human embryos. This study, based on many clinical cases and on the
experimental work of Féré, promoted the idea that the environment plays important roles in the induction of developmental malformations, supporting the original
suggestions of Hertwig.
Soon thereafter, Stockard (1910) asked whether anesthetics in use at the time
(including alcohol) had teratogenic effects on fetal development. He exposed Atlantic
killifish (Fundulus heteroclitus) to chemicals used as anesthetics at the time, including multiple concentrations of ethanol. He found that alcohol affected embryonic