Poziom trudności: B1
Foetal alcohol syndrome: Why fathers need to watch what they drink too
A father's alcohol consumptionspożycie has long been overshadowedprzyćmiony; zepchnięty w cień by the focus onskupienie na what a mother drinks. But that could be about to change following new researchnajnowsze badania.
For more than 50 years, scientists have warned about the risks of drinking alcohol in pregnancyciąża. Recent research has found that a mother's consumptionspożycie of as little aszaledwie one drink a week may affect a child's brain developmentrozwój mózgu, cognitivepoznawczy function and behaviourzachowanie, and facial shape, while for decades, public health campaignskampanie zdrowia publicznego have repeatedlywielokrotnie said that there's no safe amount of alcohol for mums to drink while pregnantw ciąży.
The scientific consensuskonsensus, powszechna zgoda seems pretty clear – that prenatalprenatalny, przedurodzeniowy alcohol exposurenarażenie, ekspozycja can cause a variety of problems (although some questions remain around the precise risk of light compared to heavy drinking, for example). Potential harmsszkody, negatywne skutki include neurodevelopmentalneurorozwojowy impairmentsupośledzenia, zaburzenia, deficyty as well as particularokreślony, konkretny facial features most commonlypowszechnie, często associated with foetalpłodowy alcohol spectrumspektrum, zakres disorderszaburzenia (FASD), but also behaviouralbehawioralny, dotyczący zachowania, cognitivepoznawczy and learning problems, such as speech delaysopóźnienia. The effects cover a broad spectrumspektrum, zakres, which is part of why FASD is now the preferredpreferowany, bardziej odpowiedni descriptionokreślenie, opis to "foetalpłodowy alcohol syndromezespół chorobowy", or FAS.
But as the risks of maternalmatczyny, związany z matką alcohol consumptionspożycie, konsumpcja have become better-documentedudokumentowany, potwierdzony, another potential contributingprzyczyniający się, mający wpływ factorczynnik to FASD has remained largely overlookedpomijany, przeoczony: how much the father drinks. Research on fertilitypłodność and reproductionrozmnażanie, reprodukcja "has been so woman-focusedskoncentrowany na kobietach, so maternalmatczyny, związany z matką centriczorientowany na, skoncentrowany na, that we've not really done our due diligencenależyta staranność on the male sidestrona męska", says Michael Golding, a developmental physiologistfizjolog at Texas A&M University who researches alcohol exposurenarażenie, ekspozycja and foetalpłodowy developmentrozwój.
Yet researchers like Golding have suspectedpodejrzewali a paternalojcowski role for a long time. "For years now, we've been hearing stories from women who said, 'I never drank during pregnancy, but now I have an FAS kid – and my male partner was a chronicprzewlekły alcohol abuserosoba nadużywająca alkoholu'," he says. But such stories often were dismissedodrzucali as mothers being forgetfulzapominalski, if not outright lyingzwykłe kłamanie / kłamstwo w żywe oczy.
Recent research, however, raises an intriguingintrygujący, budzący zainteresowanie – and possibly game-changingprzełomowy, mogący wszystko zmienić – possibilitymożliwość: these mothers were right all alongod samego początku, przez cały czas.
The idea that a father's alcohol consumption before conceptionpoczęcie could have an impact onmieć wpływ na the offspringpotomstwo may seem far-fetchedmało prawdopodobny; naciągany. But recent population studies have found that babies whose fathers drank are at a higher riskw grupie podwyższonego ryzyka for various poor health outcomesniekorzystne wyniki zdrowotne. One 2021 observationalobserwacyjny study of more than half a million couples in China, for example, found that the risk of birth defectswady wrodzone – including cleft palaterozszczep podniebienia, congenitalwrodzony heart disease, and digestive tractprzewód pokarmowy anomalies – was higher if the father drank before conceptionpoczęcie, even when the mother did not drink. Another population study from China compared 5,000 children with congenitalwrodzony heart defects to 5,000 without. Again, while overall risk remained relativelystosunkowo low, it found that babies were nearly three times more likely tobardziej prawdopodobne, że have a congenitalwrodzony heart defect if their father drank – definedokreślony; zdefiniowany as having more than 50ml (1.7fl oz) of alcohol per day in the three months before pregnancy – than if he didn't.
It's important to note that the overall riskogólne ryzyko of birth defectswady wrodzone still remained relatively low. In the 2021 study of various birth defectswady wrodzone in China, for example, the most-impacteddotknięty; negatywnie oddziaływany type – cleft palaterozszczep podniebienia – was found in just 105 babies of the 164,151 whose fathers drank. But this made cleft palaterozszczep podniebienia 1.5 times more likely among offspringpotomstwo; potomkowie of fathers who drank, than if the fathers didn't drink. "Our finding suggests that future fathers should be encouraged to modifyzmodyfikować; zmienić their alcohol intakespożycie; pobór; ilość przyjmowana before conceivingpoczęcie; zajście w ciążę to reduce foetalpłodowy risk, considering a paternalojcowski; pochodzący od ojca drinking rate of 31.0% substantiallyznacząco; w dużym stopniu elevatedpodwyższony; zwiększony the risk of birth defectswady wrodzone," the researchers wrote.
In July 2024, meanwhile, a study found that if fathers drank alcohol before conceptionpoczęcie, foetalpłodowy, dotyczący płodu growth appearedwydawało się, sprawiało wrażenie to be impactedwpłynęło na, oddziałało na.
Still, pinpointingdokładne ustalanie; precyzyjne określanie whether the father's alcohol consumption actually caused these issues, as opposed tow przeciwieństwie do; zamiast just being correlatedpowiązany statystycznie; skorelowany with them, is difficult. While researchers of both studies controlleduwzględniali; kontrolowali for confoundingzakłócający; mylący wpływowy factorsczynniki, such as if the father also smoked, it isn't possible to account foruwzględnić; wyjaśniać every single potentialpotencjalny; możliwy contributorczynnik przyczyniający się; uczestnik procesu. "Human studies are extremely messy – there are a lot of confoundingzakłócający; mylący wpływowy factorsczynniki there," says Golding. "What is the individual's diet? Do they exercise? There are a whole bunch of things there that make it incredibly difficult."
Meanwhile, setting upprzeprowadzanie; organizowanie; zakładanie a randomisedrandomizowany controlledkontrolowany trial (RCT), the gold standardzłoty standard of scientific research, isn't exactly an option when it comes to alcohol consumption and pregnancy. Even if it were ethicaletyczny; zgodny z etyką to tell some fathers to drink before conceptionpoczęcie, knowing it might have a negative impact on the offspringpotomstwo; potomkowie, it's unlikely that those who were normally teetotalersabstynenci alkoholowi would start imbibingpijąc alkohol; spożywając alkohol – or, in a theoretical control groupteoretyczna grupa kontrolna, that those who frequently drank would completely stop.
But you can set upzałożyć; przygotować; zorganizować such an RCTrandomizowane badanie kontrolowane for animals – specificallydokładnie; konkretnie, mice.
Which is what Golding did. First, his team mapped the physical abnormalitiesnieprawidłowości associatedpowiązane, związane with FASD in humans, such as smaller eyesmniejsze oczy and a reduced head sizezmniejszony rozmiar głowy, on to a mouse modelmodel, wzorzec. Then they divided mice into groups where just pregnant mothersciężarne matki were given alcohol; where only the fathers were, pre-conceptionprzed poczęciem; and where both parents were. When they compared the features of the offspringspotomstwo, they found a clear thememotyw, wspólny wzorzec.
If a mouse mum consumedspożyła; wypiła alcohol in pregnancy, her offspringpotomstwo showed some of the physiologicalfizjologiczny symptoms of FASD that might be expected. But some changes in both cranial-facial patterningukładanie się cech czaszkowo-twarzowych and in overall growthogólny wzrost got worse when both parents drank. More surprisingly still, some abnormalitiesnieprawidłowości in the jaw, teeth spacingodstępy między zębami, eye sizewielkość oczu and eye spacingrozstaw oczu – all symptoms of human FASD – were more pronouncedwyraźniejszy; bardziej nasilony if the father drank comparedw porównaniu to if the mother did.
Golding was taken abackzaskoczony, zbity z tropu. "I told my students to do it again," he says with a chucklechichotać, parsknąć śmiechem. They did and got the same outcomesrezultaty, wyniki, as they have every time they've replicatedpowtórzyli, odtworzyli the study since.
In July 2024, his team published two more studies that underscoredpodkreślały, uwydatniały paternalojcowski, ze strony ojca alcohol effects on mice offspringpotomstwo. One found that, at midlifeśredni wiek, okres średniego wieku, those mice whose parents had both been exposednarażony, wystawiony to alcohol had signs of increased cellularkomórkowy ageingstarzenie się in the brain and liver, a possible result of something else they found – markerswskaźniki, markery of mitochondrialmitochondrialny dysfunctiondysfunkcja, nieprawidłowe działanie, which occurs when the tiny organellesorganella that produce energywytwarzać energię within our cells stop working correctly. This was true whether the alcohol-exposednarażony, wystawiony parent was the mother or the father, but was most dramatic if both parents were exposednarażony, wystawiony. This could help explain the results of observational studiesbadania obserwacyjne on humans, where people diagnosedzdiagnozowany FASD have found to be hospitalisedhospitalizowany more often than those without FASD and have a life expectancydługość życia, przewidywana długość życia that is 42% that of the general populationogół populacji, populacja ogólna.
Golding's team also found that the face shape of a mouse changed according to how much alcohol its father had consumedspożyty; wypity. "The take-home messagenajważniejszy wniosek… is that male alcohol use is not going to have a yes/no impact on children; it will have gradedstopniowany; zróżnicowany effects where the more a man drinks, the worse the outcomes," he says.
Golding isn't the only researcher to find a link between paternalojcowski, ze strony ojca alcohol consumption and FASD-like outcomes in mice. Other studies have found that the offspringpotomstwo, młode of alcohol-exposednarażone na alkohol male mice are more likely to show foetalpłodowy, dotyczący płodu growth restrictionograniczenie, zahamowanie, metabolicmetaboliczny defects and various differences in genetic expressionekspresja, ujawnianie się (genów), compared with mice that were not given alcohol. At University of California Riverside, Kelly Huffman, a psychology professor with a background in developmentalrozwojowy neuroscienceneuronauka, has been running experiments that have also found that the mouse offspringpotomstwo, młode of alcohol-exposednarażone na alkohol dads are more likely to show certain outcomes.
The effects aren't as strong as when the mothers are given alcohol after conceptionpo zapłodnieniu / po poczęciu. "Which makes sense – remember, these babies have never been [directly] exposed to alcohol," Huffman says. "But look." On screen, she pulls upwyświetla, otwiera na ekranie images of the mouse offspringpotomstwo's neocortexesneokorteksy, kora nowa mózgu – the part of the brain involved in higher functionswyższe funkcje poznawcze. In control micemyszy kontrolne whose parents weren't exposed to alcohol, the primary somatosensorysomatosensoryczny, czuciowy cortexkora mózgowa – part of the brain that responds as it receives input from the mouse's whiskers – was in a distinctly different area to the primary visual cortexkora mózgowa, which interpretsinterpretuje, odczytuje visual cueswskazówki wzrokowe, bodźce wzrokowe. There was a clear boundarywyraźna granica between them, with no overlapnakładanie się, częściowe pokrywanie się.
In the mice whose fathers, but not mothers, were exposed to alcohol, this region looks very different. "They're all mixed upWszystko im się miesza; są kompletnie pomieszane," Huffman says.
Not only were the mice's brains organised differently, but their behaviour and motor skillsmotoryka; sprawność ruchowa differed too. Offspringpotomstwo; młode of alcohol-exposed fathers were more likely to fall and take misstepspotknięcia; błędne kroki, more hesitantniepewny; ociągający się to move aroundporuszać się; krzątać się, and took longer to learn how to stay on spinning bars. "They don't improve at the same ratew tym samym tempie," Huffman says. "Their learning trajectorytrajektoria; przebieg is a little slowed. That has to do, we think, with perhaps a little hyperactivitynadpobudliwość, and just problems with sensory motor integrationintegracja; scalanie."
Given that the pupsmłode zwierząt; szczenięta; młode aren't being directly exposednarażone; wystawione to alcohol in uterow łonie matki, how could this be happening? The most common explanationwyjaśnienie; objaśnienie is a mechanismmechanizm; mechanizm działania of genetic changes known as epigeneticsepigenetyka. In this, bits of the genomegenom are switched "on" or "off" without any physical changesfizyczne zmiany to the DNA sequencesekwencja; układ; kolejność. Instead, they work through processes that modify the ability of the DNA being read by the cellularkomórkowy machinerymachina komórkowa; aparatura, through processes such as DNA methylationmetylacja, where chemical groupsgrupy chemiczne are attached to bits of the DNA molecule. Research has found that alcohol disruptszakłóca; zaburza the normal DNA methylationmetylacja of sperm, which may go onprzechodzić dalej; prowadzić do tego, że to change how genes are expressedeksprymowane; ujawniane; wyrażane in the resulting embryopowstały zarodek.
Golding has also found evidence in mice that paternalojcowski; ze strony ojca alcohol use can lead to other changes in sperm that affect foetalpłodowy growth. He and his colleagues have found that chronicprzewlekły; długotrwały alcohol use alterszmienia; modyfikuje the ratiostosunek; proporcja of inheriteddziedziczony; odziedziczony fragmentsfragmenty; kawałki a type of geneticgenetyczny material called RNARNA, kwas rybonukleinowy in sperm.
While the epigeneticepigenetyczny effects of paternalojcowski alcohol consumptionspożycie is a relatively new field of researchdziedzina badań, the consequenceskonsekwencje of other paternalojcowski forms of exposurenarażenie are better-documentedlepiej udokumentowany. In both humans and in mice, there's particularly good evidence when it comes to smoking and the effect it has on inheriteddziedziczony geneticgenetyczny materialmateriał. The offspringpotomstwo of fathers who smoke are more likely to have birth defectswady wrodzone, develop leukaemiabiałaczka, and have excessnadmiarowy body fattkanka tłuszczowa, for example, possibly also due to epigeneticepigenetyczny processesprocesy.
Despite the role that male drinking appears to play, most researchers agree a mother's alcohol consumption plays a larger role in foetalpłodowy development than alcohol consumption by fathers. "The alcohol in the blood of the woman is passed directly across the placentałożysko into the foetuspłód, so that's a very direct effectbezpośredni wpływ" on development, says Elizabeth Elliott, a paediatricianpediatra and professor of child and adolescentnastoletni; młodzieżowy health at Australia's University of Sydney. She has been a long-time FASDspektrum płodowych zaburzeń alkoholowych (FASD) researcher and is the senior co-authorwspółautor of a recent academic review of FASDspektrum płodowych zaburzeń alkoholowych (FASD). "It affects the brain and the part of the brain that determines the development of the face, and it affects the development of all these organ systemsukłady narządów, the lungs, in the heart, the ears and the eyes, and so on."
It's worth notingWarto zauważyć, of course, that humansludzie aren't micemyszy. Mouse models can, and often do, providedostarczać, zapewniać us with some ideas of what might be happening in terms of human processesprocesy, but they don't mean this is definitelyna pewno, zdecydowanie what's happening. Much more researchbadania is needed before we can determineokreślić, ustalić the contributionswkład, udział of a father's alcohol consumption in humansludzie with any certaintypewność.
Still, the role that a father's drinking could play should not be ignored, Elliott and others say. While the research is still ongoingtrwający, nadal prowadzony, Elliott believes it's time for public health campaignskampanie zdrowia publicznego to addressodnosić się do; zająć się this more directly. It's not just because the father's consumptionspożycie might cause harm, she says. It would also have "real benefitprawdziwa korzyść… because we know that one of the key determinants of a woman drinking in pregnancyciąża is if her male partner [if she has one] is drinking in pregnancyciąża", she says. "It would be a win-winsytuacja korzystna dla obu stron."
Based on the research so far, how much alcohol is "safe" for a father – not a mother – to drink if he knows his partner may conceivepocząć; zajść w ciążę?
We don't have that data. But Golding, for his partjeśli chodzi o niego / z jego strony, believes that a "very, very occasional drinkbardzo, bardzo okazjonalny drink / bardzo sporadyczne picie" is probably fine – especially if a father reduces his drinking in combinationpołączenie; zestawienie with other factors that we know can improve health outcomeswyniki zdrowotne; efekty zdrowotne for offspringpotomstwo; potomkowie, like exercising and eating well. Still, he adds, "If it were my sons, I would tell them to stop drinking altogethercałkowicie; zupełnie."
While the exact impactdokładny wpływ of paternalojcowski, dotyczący ojca drinking has yet to be teased outwyjaśnione, ustalone do końca, researchers agree on one thing.
"There's this enormousogromny burdenciężar; obciążenie that's put on womenspoczywać na kobietach; być nakładanym na kobiety," says Golding. "But male health is important to foetalpłodowy developmentrozwój. There is a responsibilityodpowiedzialność of both partiesobie strony here to support and provide forwspierać i zapewniać utrzymanie the health of the baby."