Page 12 - Zero for nine: Reducing alcohol use during pregnancy via health counselling and Internet-based computer-tailored feedback

Chapter 1
The need for an effective intervention to reduce prenatal alcohol use
The need for an effective intervention to reduce prenatal alcohol use is explained by reviewing the literature on the harmfulness of prenatal alcohol exposure and on how many pregnant women consume alcohol.
The seriousness of the health problem: How risky is alcohol use in pregnancy?
The effects of alcohol on cellular processes during prenatal development
After a woman consumes an alcoholic drink, the alcohol is absorbed in the gastrointestinal tract, where it enters the bloodstream. Alcohol is then distributed throughout the body via the circulatory system: as the blood circulates in the body, alcohol enters and dissolves in the liquid of each tissue in the body (Kerssemakers, et al., 2008). When a woman in her early pregnancy drinks alcohol, the alcohol dissolves in the embryonic body fluids. In a later stage of the pregnancy, alcohol can pass freely through the placenta, it enters the foetus’ bloodstream and is then distributed throughout the body of the foetus via its circulatory system. The alcohol level of the foetus attains the same level as that of the mother and remains in the body until it is broken down by the liver of the mother (Idanpaan-Heikkila, et al., 1972), which takes approximately one to one-and-a-half hours for one standard glass of alcoholic beverage (van Faassen & Niemela, 2011).
Alcohol in the foetus affects various cellular processes that occur during the foetal development. For example, alcohol can disturb the development of the cells of organs (proliferation and mitosis). Alcohol can alter the migration of cells leading to nerve cells arriving at abnormal locations. Alcohol can interfere with cell adhesion, which may have various consequences for the brains of the unborn baby, including mental retardation, complete absence of the corpus callosum (the white brain substance that connects the two hemispheres) or abnormal development of small brains. By altering the functions of certain neurotransmitter systems, alcohol can disorder the organization of the
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