Derme Martina, Piccioni Maria Grazia, Brunelli Roberto, Crognale Alba, Denotti Marika, Ciolli Paola, Scomparin Debora, Tarani Luigi, Paparella Roberto, Terrin Gianluca, Di Chiara Maria, Mattia Alessandro, Nicotera Simona, Salomone Alberto, Ceccanti Mauro, Messina Marisa Patrizia, Maida Nunzia La, Ferraguti Giampiero, Petrella Carla, Fiore Marco
Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, 00185 Roma, Italy.
Dipartimento Della Pubblica Sicurezza, Direzione Centrale di Sanità, Centro di Ricerche e Laboratorio di Tossicologia Forense, Ministero dell'Interno, 00185 Roma, Italy.
Antioxidants (Basel). 2023 Jun 4;12(6):1216. doi: 10.3390/antiox12061216.
Fetal alcohol spectrum disorder (FASD) is a set of conditions resulting from prenatal alcohol exposure (PAE). FASD is estimated to affect between 2% and 5% of people in the United States and Western Europe. The exact teratogenic mechanism of alcohol on fetal development is still unclear. Ethanol (EtOH) contributes to the malfunctioning of the neurological system in children exposed in utero by decreasing glutathione peroxidase action, with an increase in the production of reactive oxygen species (ROS), which causes oxidative stress. We report a case of a mother with declared alcohol abuse and cigarette smoking during pregnancy. By analyzing the ethyl glucuronide (EtG, a metabolite of alcohol) and the nicotine/cotinine in the mother's hair and meconium, we confirmed the alcohol and smoking abuse magnitude. We also found that the mother during pregnancy was a cocaine abuser. As a result, her newborn was diagnosed with fetal alcohol syndrome (FAS). At the time of the delivery, the mother, but not the newborn, had an elevation in oxidative stress. However, the infant, a few days later, displayed marked potentiation in oxidative stress. The clinical complexity of the events involving the infant was presented and discussed, underlining also the importance that for cases of FASD, it is crucial to have more intensive hospital monitoring and controls during the initial days.
胎儿酒精谱系障碍(FASD)是一组由产前酒精暴露(PAE)导致的病症。据估计,FASD在美国和西欧影响着2%至5%的人群。酒精对胎儿发育的确切致畸机制仍不清楚。乙醇(EtOH)通过降低谷胱甘肽过氧化物酶的活性,导致子宫内暴露儿童的神经系统功能失调,同时活性氧物质(ROS)生成增加,从而引起氧化应激。我们报告了一例母亲在孕期有明确酒精滥用和吸烟情况的病例。通过分析母亲头发和胎粪中的葡萄糖醛酸乙酯(EtG,酒精的一种代谢物)以及尼古丁/可替宁,我们确定了酒精和吸烟滥用的程度。我们还发现这位母亲在孕期还滥用可卡因。结果,她的新生儿被诊断为胎儿酒精综合征(FAS)。分娩时,母亲而非新生儿的氧化应激水平升高。然而,几天后婴儿的氧化应激显著增强。文中呈现并讨论了涉及该婴儿事件的临床复杂性,同时强调了对于FASD病例,在最初几天进行更密切的医院监测和管控至关重要。