Expert links autism to mothers drinking
MODERATE drinking during pregnancy could be the hidden cause of thousands of serious childhood disorders including autism, Scotland's leading authority on alcohol and health warned last night.
Dr Maggie Watts, vice chairman on alcohol for the Scottish Association of Alcohol and Drug Action Teams, fears that even low levels of drinking could be related to a range of behavioural problems in young children, the cause of which has previously been a mystery.
Watts, who is also a consultant in public health medicine at NHS Ayrshire and Arran, warned that up to one in 100 Scots children - as many as 9,000 - could be suffering from Foetal Alcohol Spectrum Disorder (FASD) with symptoms including behavioural and memory difficulties.
But she said many could be misdiagnosed as suffering from autism and other neurodevelopmental problems because doctors do not ask mothers about their pregnancy drinking habits when making their diagnosis.
In recent weeks, there have been a series of contradictory guidelines and reports on the 'safe' limit for alcohol during pregnancy. Abstention throughout pregnancy is now the Scottish Government's official advice but experts south of the Border say moderate consumption is acceptable after the first three months.
Watts is now firmly of the view that pregnant women should not drink. She said: "This condition is vastly under-recognised. It is certainly possible that children with this condition may have been diagnosed as having something else. We need to review some of these children with other labels to see whether they fit the criteria for FASD.
"Because they are not being recognised, some of the strategies and medication being used might not be appropriate, which is why we would say it's important to recognise them.
"The advice I would give to women is not to drink during pregnancy. We don't know at what point the damage is caused."
Experts believe alcohol crosses the placenta and the foetus in the womb is not able to process the toxins effectively. While the mother's body clears the alcohol within 12 hours, the foetus is exposed for up to 72 hours because it does not have a properly developed liver.
In the most serious cases of Foetal Alcohol Spectrum Syndrome, babies are born with growth problems and mental retardation. But even where babies suffering FASD appear physically normal, they can go on to develop behavioural problems, hyperactivity, attention deficit disorder, slow emotional development and short-term memory loss in childhood. Researchers now believe up to one in 100 children could be affected.
Watts is planning a Scotland-wide trial to identify children with the disorder which will mean pregnant women being asked searching questions about their drinking habits.
She hopes this will enable health workers to help expectant mothers stop drinking and give doctors a clearer picture of the extent of FASD.
Research by Watt within Ayrshire and Arran found up to two children a year in the area are diagnosed with the most severe form of FASD.
However official records for the number of the children with the condition across Scotland show just three or four diagnosed every year. Watt believes the real figure of new cases every year across Scotland could be around 20 but they are not being identified.
A survey she conducted of Scottish paediatricians showed most were not confident about making a diagnosis, uncertain that they were adequately trained and competent to do so.
Official advice from Scotland's Chief Medical Officer states that it is safest if no alcohol is consumed during pregnancy. However, controversial draft guidance from the health watchdog, the National Institute for Health and Clinical Excellence, states that after the first three months of pregnancy, women can consume up to 1.5 units per day.
Last week a review of existing research, conducted by Oxford University, found "no convincing evidence" that binge-drinking could harm the foetus.
Yet a recent study on low-level drinking by scientists at Bristol University found that women having as little as one drink per week had children with mental health problems.
Susan Fleischer, founder of the National Organisation on Foetal Alcohol Syndrome, said: "It is our experience that children are diagnosed with things like autism or attention deficit disorder before they get a diagnosis of foetal alcohol syndrome. A lot of children are misdiagnosed."
One mother who drank during her pregnancy, Tracey Hayter, gave birth to a son with foetal alcohol syndrome and has struggled for years to get help for him. Chris, now 22, was born weighing less than 5lbs and suffered from fits. He went on to become hyperactive with short-term memory loss. His mental age is around half his real age and he cannot hold down a job. His mother binge drank two to three bottles of wine at the weekends during her pregnancy to cope with depression.
Hayter, from Tonbridge in Kent, said: "I wasn't aware of the full effect my drinking would have on the baby. I was not given any advice at all."
A Scottish Government spokesman said it was reviewing how it collected information about drug and alcohol use in pregnancy.
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