The first MRI-based research of prenatal alcohol exposure noted significant changes in brain structure between exposed fetuses and healthy controls.
The findings, revealing finding early signs of Fetal alcohol syndrome in fetuses, were presented today at the Radiological Society of North America annual meeting (RSNA).
Alcohol consumption during pregnancy harms a baby’s brain and this study shows early signs of Fetal alcohol syndrome.
“Fetal alcohol syndrome is a worldwide problem in countries where alcohol is freely available,” says Gregor Kasprian, M.D., associate professor of radiology at the Medical University of Vienna in Austria.
“It’s estimated that 9.8% of all pregnant women are consuming alcohol during pregnancy, and that number is likely underestimated.”
Fetal alcohol syndrome is the most severe manifestation of a set of diseases known as fetal alcohol spectrum disorders, which are caused by alcohol consumption during pregnancy. Babies born with fetal alcohol spectrum disorders may have unique physical characteristics, as well as learning impairments, behavioral issues, and speech and language delays.
Fetal alcohol syndrome occurs in one out of every 70 pregnancies, according to Dr. Kasprian.
“There are many postnatal studies on infants exposed to alcohol,” Dr. Kasprian added.
“We wanted to see how early it’s possible to find changes in the fetal brain as a result of alcohol exposure.”
500 pregnant women who had been referred to an MRI for clinical reasons were included in the study. Fifty-one of the women who answered an anonymous questionnaire admitted to drinking alcohol while pregnant.
The Pregnancy Risk Assessment Monitoring System (PRAMS), a surveillance initiative of the Centers for Disease Control and Prevention and health departments, and the T-ACE Screening Tool, a four-question assessment tool that identifies risk drinking, were utilized as surveys.
“We provided a safe environment where women could feel comfortable honestly answering the questions,” said Dr. Kasprian.
The final study group included 26 fetal MRI tests from 24 alcohol-positive fetuses and a control group of 52 gender- and age-matched healthy fetuses after some of the fetal MRIs were eliminated due to structural brain malformations and/or poor picture quality. The fetuses were between the ages of 20 and 37 weeks at the time of imaging.
The researchers reconstructed each baby brain using super-resolution imaging, which allowed them to build a single dataset. They next computed total brain volume and segment volumes of various brain compartments after analyzing 12 different brain structures.
“One of the main hallmarks of our study is that we investigated so many smaller sub-compartments of the brain,” added co-author Marlene Stuempflen, M.D., scientific researcher at the Medical University of Vienna.
When comparing the alcohol-exposed fetuses to healthy controls, statistical analysis indicated two key differences: an increased volume in the corpus collosum and a decreased volume in the periventricular zone.
“This is the first time that a prenatal imaging study has been able to quantify these early alcohol-associated changes,” said Dr. Stuempflen.
The corpus collosum is the main link between the two hemispheres of the brain. Because the clinical symptoms of fetal alcohol spectrum diseases are exceedingly heterogeneous, or diversified, and cannot be linked to one specific substructure of the brain, Dr. Stuempflen believes it is natural that this very central component is impaired.
“The changes found in the periventricular zone, where all neurons are born, also reflect a global effect on brain development and function,” she added.
The presence of a thicker corpus collosum in alcohol-positive fetuses was surprising, according to the researchers, because the corpus collosum is thinner in infants with fetal alcohol spectrum disorders.
“It appears that alcohol exposure during pregnancy puts the brain on a path of development that diverges from a normal trajectory,” said Dr. Kasprian.
“Fetal MRI is a very powerful tool to characterize brain development not only in genetic conditions, but also acquired conditions that result from exposure to toxic agents.”
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