(1) Istituto Superiore di Sanità, Roma, Italy
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Alcohol consumed during pregnancy freely crosses the placental barrier and constitutes a significant risk for many adverse outcomes globally defined Fetal Alcohol Spectrum Disorders (FASD) up to the Fetal Alcohol Syndrome (FAS). Many teratogenic mechanisms have been proposed but, to date, one of the most studied and understood is the alcohol-related Oxidative Stress (OS). Alcohol-related OS can affect lipids and proteins and can produce DNA alteration and epigenetic modifications since DNA is very sensitive to the OS effect. Recent animal studies show that alcohol- related OS can affect mainly the brain that is physiologically more vulnerable than other organs as liver or kidney.
Experimental evidence show that alcohol-related OS significantly concur to produce the Fetal Alcohol Spectrum Disorders (FASD) and the Fetal Alcohol Syndrome (FAS). Animal experimentation show that OS is involved in developing FASD and that the individual vulnerability observed in different rat strain may reside, at least in part, in the regulation of REDOX equilibrium. The association between FASD and oxidative stress is confirmed by the evidence that alcohol effects are mitigated when antioxidants are administered. Clinical studies performed by OS biomarkers as plasmatic Malondialdehyde (MDA), Free Oxygen Radicals Testing (FORT) and Free Oxygen Radicals Defense (FORD) in the blood of heavy drinking subjects evidence their OS status. Gender difference are significant since OS level in drinking women is higher than that in drinking men.
Animal studies show that OS condition have a significant role in impairing pregnancy and in developing the neuro-behavioral symptoms of FASD. Evidence from clinical studies suggest that to include the study of OS biomarkers in obstetric and neonatal routine diagnostic procedures could be a good strategy to early detect at-risk situation and to improve treatment. The high reliability and practicability of current available tests for determination of OS biomarkers make easier to reach this goal.