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Übersicht

Alkoholkonsum während der Schwangerschaft

Welche Auswirkungen auf die frühkindliche Entwicklung sind bekannt?

Published Online:November 29, 2018https://doi.org/10.1026/0942-5403/a000267

Abstract

Zusammenfassung. Kinder sind bereits im Mutterleib sensitiv für Umwelteinflüsse. Pränataler Alkoholkonsum zählt dabei zu den einflussreichsten Risikofaktoren für die frühkindliche Entwicklung. Das Ziel ist es, einen Überblick über die aktuelle Forschungslage zum Thema Alkoholkonsum während der Schwangerschaft zu geben. Darüber hinaus wird der Forschungsstand zu Belastungen und Folgeschäden für die frühkindliche Entwicklung durch pränatale Alkoholexposition, aber auch zu weiteren Risikofaktoren zusammengefasst. Es wird gezeigt, dass das Wissen um die Prävalenz für Alkoholkonsum während der Schwangerschaft sowohl für die Erforschung der Folgen als auch für das Umsetzen von präventiven Maßnahmen ausschlaggebend ist. Die Prävalenzen unterscheiden sich nicht nur regional, sondern können auch durch andere Faktoren beeinflusst werden. Es wird deutlich, dass der Risikofaktor Alkohol und dessen mögliche Auswirkungen auf die frühkindliche Entwicklung nicht isoliert, sondern in Abhängigkeit von weiteren genetischen und Umweltfaktoren betrachtet werden müssen. Denn auch Folgen von weiteren perinatalen Risikofaktoren machen sich in den ersten beiden Lebensjahren bemerkbar. Beispiele für Entwicklungsstörungen in dieser Entwicklungsspanne sind externalisierendes Verhalten und kognitive Beeinträchtigungen. Inwieweit sich perinatale Risikofaktoren jedoch auf Entwicklungsverläufe von Kindern, die durch pränatalen Alkoholkonsum belastet sind, auswirken, erfasst eine umfassende Diskussion. Diese Lücke gilt es zu schließen um das Zusammenspiel perinataler Risiken genauer zu verstehen und adäquat entgegenwirken zu können.


Alcohol Consumption During Pregnancy: What Effects on Early Child Development Are Known?

Abstract. Children are already sensitive to environmental influences in the womb. Prenatal alcohol consumption is one of the most influential risk factors in early child development. The aim of this paper is to give an overview of the current research on alcohol consumption during pregnancy. In addition, the state of research on the burden and consequential damage for infant development caused by prenatal alcohol exposure, but also on other known risk factors, is summarized. It is shown that knowledge about the prevalence of alcohol use during pregnancy is crucial for both research on consequences and the implementation of preventive measures. The prevalence differs not only regionally, but may also be influenced by other factors. The average prevalence of alcohol consumption in women during pregnancy is highest in Europe (25.2 %; 95 % CI = 21.6 – 29.6 %). A large number of pregnancies worldwide are alcohol-related, although alcohol is known to be a risk factor for stillbirths as well as for abortions and premature births and can lead to serious developmental problems for the child. Currently, there is no fixed limit on the amount of alcohol that can be consumed during pregnancy without any harm to the unborn child. Compared with minor consumption, so-called binge drinking is of particular importance. There is a linear relationship between pregnant women’s alcohol consumption and the severity of developmental disorders in affected children. Serious consequences of prenatal alcohol exposure can manifest themselves in early childhood, in the form of physical, neuropsychological, and behavioral abnormalities. In addition to anatomical implications, functional effects such as cognitive and behavioral problems are already noticeable in children up to the first 2 years of life. However, the exact pathogenesis is still unclear despite a large number of animal and human analyses. It is apparent that the risk factor of alcohol consumption and its potential effects on early child development should not be considered in isolation, but depending on other genetic and environmental factors. Moreover, it is now known that the consequences of other perinatal risk factors, apart from prenatal alcohol consumption, can already emerge during the first 2 years of life too. At the behavioral level, secondary effects of the prenatal risk factor of alcohol consumption and other perinatal risk factors mostly manifest themselves in the form of externalizing behaviors and cognitive deficits. However, the extent to which perinatal risk factors affect the course of development of children who are affected by prenatal alcohol consumption remains an unanswered question. This gap should be closed in the literature in order to understand the interaction of perinatal risks more accurately and to be able to counteract these risks adequately. The current state of knowledge is intended to help health professionals to identify at-risk mothers and their children at an early moment in order to give newborns the best possible start in life.

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