Grapes of Wrath

An uncertain future: When baby suffersfrom Fetal Alcohol Syndrome.

By Alexander Dorozyaski, published on January 01, 1993 - last reviewed on October 18, 2004

Dateline: PARIS, FRANCE

When French pediatrician Paul Lemoine first noticed facial malformations in infants of alcoholic mothers, no one took him seriously. Maybe that's because France is Europe's leading consumer of alcohol. Soon enough, however, others confirmed his observations and fetal alcohol syndrome was born.

Now, 25 years later, after taking another took at his once-tiny patients, the Gallic doctor reports that as affected infants become adults, they are profoundly mentally retarded, have severe learning disabilities, and suffer serious behavioral disorders. What's even more disturbing is that kids who appeared to be normal in infancy also grew up to show the full impact of maternal drinking on the developing brain.

Maternal drinking, says Lemoine, is a national tragedy, perhaps a major cause of intellectual deficiency in France.

In his first study, published in 1968 in France, Lemoine examined 127 children of alcoholic moms. Most had a small head, a ridge over a deep nasal base and a snub nose, a convex upper lip, and malformed ears with a horizontal upper ridge. Many also had heart, bone, or genitourinary defects.

The French thought the findings inconclusive, because many other children of alcoholic mothers appeared normal. But two Seattle pediatricians eventually confirmed the link and called it "fetal alcohol syndrome (FAS)."

Two years ago, after retiring from active practice, Lemoine took the money he was awarded for his prize-winning work to find out the fate of his now-grown patients. He located 106 of them in institutions.

In most cases, the facial malformations have become less pronounced, although cardiac, bone, palate, and genitourinary anomalies have persisted, and many have misshapen hands. But most dramatic is that all of them have clear-cut microcephaly and are mentally retarded; IQs range from 50 to 75. They are emotionally unstable and unable to keep a job. Those who had the severest forms of FAS as children are now profoundly retarded, even unable to speak.

Lemoine also located 14 siblings of FAS kids. Although he had not detected signs of the disorder among the 14 as children, as young adults they now had the same problems as those diagnosed early in life.

Even if children born to alcoholic mothers appear to be normal in infancy, this normalcy is very often only apparent, not real, Lemoine reports in the French medical journal Annales de Pediatrie. "Only today can we gauge the extent of the damage caused by maternal alcoholism."

He has no doubt that drinking during pregnancy is the cause of the syndrome: alcoholic mothers who bore FAS children and then quit drinking have since had normal children. Conversely, chronic alcoholism appears to intensify the effects of drinking: if mothers of FAS children continue to drink and bear other children, the later children are more severely affected with FAS than those who came before.

Since his first study, many animal experiments have documented the teratogenic effects of alcohol. It has a particular affinity for rapidly growing fetal tissue such as the brain. And tobacco appears to potentiate the damaging effect of alcohol on the fetus. Lemoine says he has diagnosed severe FAS in children of "moderately alcoholic" mothers who were also heavy smokers.

SHATTERED DREAMS

TO THE LONG LIST of problems caused by exposure to alcohol in the womb, add one mom.

W.S. Stone, Ph.D., of the Medical College of Virginia discovered that FAS offspring have enduring sleep problems. Specifically, he reported to the Society for Neuroscience, they have less sleep characterized by rapid eye movement, when dreaming occurs. Other researchers at the same meeting found that dream sleep is essential for the consolidation of memory; without it, learning does not take place.