Maternal risk factors in fetal alcohol syndrome: provocative and permissive influences.
We present an hypothesis integrating epidemiological, clinical case, and basic biomedical research to explain why only relatively few women who drink alcohol during pregnancy give birth to children with alcohol-related birth defects (ARBDs), in particular, Fetal Alcohol Syndrome (FAS). We argue that specific sociobehavioral risk factors, e.g., low socioeconomic status, are permissive for FAS in that they provide the context for increased vulnerability. We illustrate how these permissive factors are related to biological factors, e.g., decreased antioxidant status, which in conjunction with alcohol, provoke FAS/ARBDs in vulnerable fetuses. We propose an integrative heuristic model hypothesizing that these permissive and provocative factors increase the likelihood of FAS/ARBDs because they potentiate two related mechanisms of alcohol-induced teratogenesis, specifically, maternal/fetal hypoxia and free radical formation.
Abel
E L
EL
Department of Obstetrics & Gynecology, Wayne State University School of Medicine, C. S. Mott Center for Human Growth and Development, Detroit, MI 48201, USA.
Hannigan
J H
JH
D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000453:epidemiology* / Q000209:etiology; D005609:Free Radicals; D006801:Humans; D000860:Hypoxia / Q000150:complications; D015994:Incidence; D011247:Pregnancy; D011256:Pregnancy Outcome; D015995:Prevalence; D012307:Risk Factors; D012923:Social Class
D005609:Free Radicals