Brain Development: Normal Processes and the Effects of Alcohol ...

10
Prenatal Ethanol Exposure
and Fetal Programming:
Implications for Endocrine
and Immune Development
and Long-Term Health
Ethanol use and abuse result in clinical abnormalities
of endocrin e functio n an d neuroendocrin e regula -
tion (Morgan, 1982 ; Adler, 1992). Direct and indirect
effects o f ethanol o n man y hormone systems , including
th e adrenal , gonadal, and thyroi d axes, as well as
on aldosterone , growt h hormone , parathyroi d hor -
mone, calcitonin , insulin , and glucagon , hav e been
reported. Secondar y complications suc h a s liver disease,
malnutrition , and othe r medica l condition s often
presen t i n alcoholic s ma y i n an d o f themselves
have endocrine consequences an d can potentially exacerbate
the adverse effects o f ethanol.
Whether ethanol-induce d endocrin e imbalance s
contribute t o th e etiolog y o f fetal alcoho l spectru m
disorders (FASD) is unknown, but i t is certainly a possibility
(Anderson , 1981) . Th e effect s o f ethanol o n
interactions betwee n th e pregnan t femal e an d fetu s
are comple x (Rudee n an d Taylor , 1992 ; Weinberg ,
1993a, 1993b , 1994) , and bot h direc t and indirec t effects
o f ethanol o n feta l developmen t occur . Ethano l
readily crosse s th e placenta , thu s directl y affectin g
Joanna H. Sliwowska
Xingqi Zhang
Joanne Weinberg
153
developing fetal cell s and tissues , including those re -
lated t o endocrin e function . I n addition , ethanol -
induced change s i n endocrin e functio n ca n disrup t
the hormona l interaction s betwee n th e pregnan t female
and feta l systems , altering the normal hormon e
balance an d indirectl y affecting th e developmen t of
fetal metabolic , physiological , an d endocrin e func -
tions. Ethanol-induce d change s i n metaboli c and/o r
endocrine function can also affect a female's ability to
maintain a successful pregnancy , resulting in miscarriage
or , i f the fetu s i s carried to term, possible con -
genital defects. Of particular relevance to the present
Chapter i s the notio n tha t disturbances of the recip -
rocal interconnection s betwee n (a ) th e pregnan t
female an d fetu s o r (b ) th e materna l an d neona -
tal hypothalamic-pituitary-adrena l (HPA ) axes, ma y
provide a common pathway by which perinatal exposure
t o differen t agent s results in feta l programmin g
(Angelucci e t al. , 1985) . Fetal o r early programming
refers to the concept that early environmental or nongenetic
factors , includin g pre- o r perinatal exposur e