Pharmacology of Alcohol Relating to Pregnancy and Lactation

  • Ernest L. Abel


The main intoxicant in alcoholic beverages is ethyl alcohol (alcohol, ethanol), a relatively simple organic chemical, made up of carbon, oxygen, and hydrogen, that is soluble in both water and fat. The various other ingredients in alcoholic beverages are called congeners. Different alcoholic beverages contain different types and different amounts of congeners and other substances, e.g., minerals, coloring agents. About 400 different ingredients have now been identified.1 Some of the more common of the congeners are acetaldehyde, iso-amyl alcohol, iso-butanol, n-propanol, ethyl acetate, and methanol. Although some congeners may produce toxic or pharmacological effects on the fetus, thus far little attention has been focused on this possibility. Relevant studies of this issue are discussed in Chapter 9.


Amniotic Fluid Alcoholic Beverage Maternal Blood Alcohol Exposure Blood Alcohol 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Kricka, L. J., and Clark, P. M. S. Biochemistry of alcohol and alcoholism. Chichester, England: Ellis Horwood, 1979.Google Scholar
  2. 2.
    Wallgren, H., and Barry, H. Actions of alcohol. Amsterdam: Elsevier, 1970.Google Scholar
  3. 3.
    Kalant, H . Absorption, diffusion, distribution, and elimination of ethanol: Effects on biological membranes. In B. Kissin, and H. Begleiter (Eds.), The biology of alcoholism. New York: Plenum Press, 1971. Pp. 1–62.Google Scholar
  4. 4.
    Wiener, S. G., Shoemaker, W. J., Koda, L. Y., and Bloom, F. E. Interaction of ethanol and nutrition during gestation: Influence on maternal and offspring development in the rat. Journal of Pharmacology and Experimental Therapeutics, 1981, 216, 572–579.PubMedGoogle Scholar
  5. 5.
    Gottfried, E. B., Korsten, M. A., and Lieber, C. S. Gastritis and duodenitis induced by alcohol: An endoscopic and histologic assessment. Gastroenterology, 1976, 70, 890.Google Scholar
  6. 6.
    Barone, E., Pirola, R. C., and Lieber, C. S. Small intestinal damage and changes in cell population produced by ethanol ingestion in the rat. Gastroenterology, 1974, 66, 226–234.Google Scholar
  7. 7.
    Abel, E. L. Prenatal effects of alcohol on adult learning in rats. Pharmacology, Biochemistry and Behavior, 1979, 10, 239–243.CrossRefGoogle Scholar
  8. 8.
    Jones, B. M., and Jones, M. K. Alcohol effects in women during the menstrual cycle. Annals of the New York Academy of Sciences, 1976, 273, 576–587.PubMedCrossRefGoogle Scholar
  9. 9.
    Abel, E. L., and York, J. L. Age-related differences in response to ethanol in the rat. Physiological Psychology, 1979, 7, 391–395.Google Scholar
  10. 10.
    Nicloux, M. Sur le passage de l’alcool ingéré de la mère au foetus, en particulier chez la femme. Comptes Rendus des Séances de la Société de Biologie et de Ses Filiates, 1899, 51, 980–982.Google Scholar
  11. 11.
    Belinkoff, S., and Hall, O. W. Intravenous alcohol during labor. American Journal of Obstetrics and Gynecology, 1950, 59, 429–432.Google Scholar
  12. 12.
    Chapman, E. R., and Williams, P. T. Intravenous alcohol as an obstetrical analgesia. American Journal of Obstetrics and Gynecology, 1951, 61, 676–679.PubMedGoogle Scholar
  13. 13.
    Fuchs, F., Fuchs, A. R., Poblete, V. F., and Risk, A. Effect of alcohol on threatened premature labor. American Journal of Obstetrics and Gynecology, 1967, 99, 627–637.PubMedGoogle Scholar
  14. 14.
    Seppala, M., Raiha, N. C., and Tamminen, V. Ethanol elimination in a mother and her premature twins. Lancet, 1971, 1, 1188–1189.PubMedCrossRefGoogle Scholar
  15. 15.
    Waltman, R., Iniquez, F., and Iniquez, E. S. Placental transfer of ethanol and its elimination at term. American Journal of Obstetrics and Gynecology, 1972, 40, 180–185.Google Scholar
  16. 16.
    Jung, A. L., Roan, Y., and Temple, A. R. Neonatal death associated with acute transplacental ethanol intoxication. American Journal of Diseases of Children, 1980, 134, 419–420.PubMedGoogle Scholar
  17. 17.
    Cook, L. N., Shott, R. J., and Andres, B. F. Acute transplacental ethanol intoxication. American Journal of Diseases of Children, 1975, 129, 1075–1076.PubMedGoogle Scholar
  18. 18.
    Fitzsimons, R. B., Mahony, M. J., and Cussen, G. H. Ethanol intoxication of the newborn: A case report and review of the literature. Irish Medical Journal, 1981, 74, 230–231.PubMedGoogle Scholar
  19. 19.
    Puschel, K., and Seifert, H. Bedeutung des Alkohols in der Embryofetalperiode und beim Neugeborenen. Zeitschrift für Rechtsmedizin, 1979, 83, 69–76.Google Scholar
  20. 20.
    Idanpaan-Heikkila, J. E., Jouppila, P., Akerblom, H. K., Isoaho, R., Kouppila, E., and Koivisto, M. Elimination and metabolic effects of ethanol in mother, fetus, and newborn infant. American Journal of Obstetrics and Gynecology, 1972, 112, 387–393.PubMedGoogle Scholar
  21. 21.
    Akesson, C. Autoradiographic studies on the distribution of 14C-2-ethanol and its non-volatile metabolites in the pregnant mouse. Archives Internationales de Pharmacodynamic et de Thérapie, 1974, 209, 296–304.Google Scholar
  22. 22.
    Abel, E. L., and Greizerstein, H. B. Relation of alcohol content in amniotic fluid, fetal and maternal blood. Alcoholism: Clinical and Experimental Research, 1980, 4, 209.CrossRefGoogle Scholar
  23. 23.
    Ho, B. T., Fritchie, G. E., Idänpään-Heikkilä, J. E., and Mclsaac, W. M. Placental transfer and tissue distribution of ethanol-l-14C: A radioautographic study in monkeys and hamsters. Quarterly Journal of Studies on Alcohol, 1972, 33, 485–493.PubMedGoogle Scholar
  24. 24.
    Bergstrom, R. M., Sainio, K., and Taalas, J. The effect of ethanol on the EEG of the guinea pig foetus. Medicina et Pharmacologia Experimentalis, 1967, 16, 448–452.PubMedGoogle Scholar
  25. 25.
    Himwich, W. A., Hall, J. S., and MacArthur, W. F. Maternal alcohol and neonatal health. Biological Psychiatry, 1977, 12, 495–505.PubMedGoogle Scholar
  26. 26.
    Ellis, F. W., and Pick, J. R. An animal model of the fetal alcohol syndrome in beagles. Alcoholism: Clinical and Experimental Research, 1980, 4, 123–134.CrossRefGoogle Scholar
  27. 27.
    Dilts, P. V., Jr. Effect of ethanol on external and fetal umbilical hemodynamics and oxygen transfer. American Journal of Obstetrics and Gynecology, 1970, 106, 221–228.Google Scholar
  28. 28.
    Mann, L. I., Bhakthavathsalan, A., Liu, M., and Marowski, P. Placental transport of alcohol and its effect on maternal and fetal acid-base balance. American Journal of Obstetrics and Gynecology, 1975, 122, 837–844.Google Scholar
  29. 29.
    Ayromlooi, J., Tobias, M., Berg, P. D., and Desiderio, D. Effects of ethanol on the circulation and acid-base balance of pregnant sheep. Obstetrics and Gynecology, 1979, 54, 624–630.PubMedGoogle Scholar
  30. 30.
    Horiguchi, T., Suzuki, K., Comas-Urrutia, A. C., Mueller-Heubach, E., Boyer-Milic, A. M., Baratz, R. A., Morishima, H. O., James, L. S., and Adamsons, K. Effect of ethanol upon uterine activity and fetal acid-base state in the rhesus monkey. American Journal of Obstetrics and Gynecology, 1971, 109, 910–917.PubMedGoogle Scholar
  31. 31.
    Ng, P. K., Cottle, M. K., Baker, J. M., Johnson, B., Van Muyden, P., and Van Petten, G. R. Ethanol kinetics during pregnancy. Study in ewes and their fetuses. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 1982, 6, 37–42.PubMedCrossRefGoogle Scholar
  32. 32.
    Loomis, C. W., Tranmer, J., and Brien, J. F. Disposition of ethanol in human maternal blood and amniotic fluid during pregnancy. Pharmacologist, 1982, 24, 204.Google Scholar
  33. 33.
    Catz, C. S., and Giacoia, G. P. Drugs and breast milk. Pediatric Clinics of North America, 1972, 19, 151–167.PubMedGoogle Scholar
  34. 34.
    Rasmussen, F. Excretion of drugs by milk. In O. Eichler (Ed.), Handbook of pharmacology. New York: Springer-Verlag, 1971. Pp. 390–402.Google Scholar
  35. 35.
    Kesaniemi, Y. A. Ethanol and acetaldehyde in the milk and peripheral blood of lactating women after ethanol administration. Journal of Obstetrics and Gynecology of the British Empire, 1974, 81, 84–86.CrossRefGoogle Scholar
  36. 36.
    Bessey, W. E. On the act of alcoholic stimulants by nursing mothers. Canadian Medical Record, 1872, 1, 195–200.Google Scholar
  37. 37.
    Bisdom, C. J. W. Alkohol- en nicotinevergiftiging bij zuigelingen. Mundschrift Kindergenese, 1936, 6, 332–341.Google Scholar
  38. 38.
    Binkiewicz, A., Robinson, M. J., and Senior, B. Pseudo-Cushing syndrome caused by alcohol in breast milk. Journal of Pediatrics, 1978, 93, 965–967.PubMedCrossRefGoogle Scholar
  39. 39.
    Cowie, A. T., and Tindal, J. S. The physiology of lactation. Baltimore: Williams and Wilkins, 1971.Google Scholar
  40. 40.
    Fuchs, A.-R. Ethanol and the inhibition of oxytocin release in lactating rats. Acta Endocrinologica, 1969, 62, 546–554.PubMedGoogle Scholar
  41. 41.
    Cobo, E., and Quintero, C. A. Milk-ejecting and antidiuretic activities under neurohypophyseal inhibition with alcohol and water overload. American Journal of Obstetrics and Gynecology, 1969, 105, 877–887.PubMedGoogle Scholar
  42. 42.
    Lieber, G. S., and DeCarli, L. M. The role of the hepatic microsomal ethanol oxidizing system (MEOS) for ethanol metabolism in vivo. Journal of Pharmacology and Experimental Therapeutics, 1970, 170, 78–80.Google Scholar
  43. 43.
    Thurman, R. C., Levy, H. G., and Scholz, R. Hepatic microsomal ethanol oxidation: Hydrogen peroxide formation and the role of catylase. European Journal of Biochemistry, 1972, 25, 420–426.PubMedCrossRefGoogle Scholar
  44. 44.
    Khanna, J. M., Kalant, H., and Line, C. Significance in vivo of the increase in microsomal ethanol-oxidizing system after chronic administration of ethanol, pentobarbital, and chlorcyclizine. Biochemical Pharmacology, 1972, 21, 2215–2226.PubMedCrossRefGoogle Scholar
  45. 45.
    Petersen, D. R., Panter, S. S., and Collins, A. C. Ethanol and acetaldehyde metabolism in the pregnant mouse. Drug and Alcohol Dependence, 1977, 2, 409–420.PubMedCrossRefGoogle Scholar
  46. 46.
    Abel, E. L., Greizerstein, H. B., and Siemens, A. J. Influence of lactation on rate of disappearance of ethanol in the rat. Neurobehavioral Toxicology, 1979, 1, 185–186.PubMedGoogle Scholar
  47. 47.
    Thiessen, D. D., Whitworth, N. S., and Rodgers, D. A. Reproductive variables and alcohol consumption of the C57BL/Crgl female mouse. Quarterly Journal of Studies on Alcohol, 1966, 27, 591–595.Google Scholar
  48. 48.
    Abel, E. L. Effects of lactation on rate of blood ethanol disappearance, ethanol consumption and serum electrolytes in the rat. Bulletin of the Psychonomic Society, 1979, 14, 365–367.Google Scholar
  49. 49.
    Greizerstein, H. B., and Abel, E. L. Time parameters for increased blood ethanol disappearance rates in lactating rats. Alcoholism: Clinical and Experimental Research, 1980, 4, 216.Google Scholar
  50. 50.
    Wagner, L., Wagner, G., and Guerrero, J. Effect of alcohol on premature newborn infants. American Journal of Obstetrics and Gynecology, 1970, 108, 308–315.PubMedGoogle Scholar
  51. 51.
    Gartner, U., and Ryden, G. The elimination of alcohol in the premature infant. Acta Paediatrica Scandinavica, 1972, 61, 720–721.PubMedCrossRefGoogle Scholar
  52. 52.
    Pikkaraine, P. H., and Raiha, N. C. R. Development of alcohol dehydrogenase in the human liver. Pediatric Research, 1967, 7165–168.Google Scholar
  53. 53.
    Raiha, N. C. R., Koskinen, M., and Pikkarainen, P. Developmental changes in alcohol dehydrogenase activity in rat and guinea-pig liver. Biochemical Journal, 1967, 103, 623–626.PubMedGoogle Scholar
  54. 54.
    Yavorsky, V. M., and Menshchishen, I. F. Effect of chronic alcoholic poisoning on the activity of liver alcohol dehydrogenase in the progeny. Farmakologiya i Toksikologiya, 1980, 43, 622–625.Google Scholar
  55. 55.
    Sjoblom, M., Pilstrom, L., and Morlund, J. Activity of alcohol dehydrogenase in the liver and placenta during the development of the rat. Enzyme, 1978, 23, 108–115.PubMedGoogle Scholar
  56. 56.
    Hawkins, D., Kalant, H., and Khanna, I. M. Effects of chronic intake of ethanol on rate of ethanol metabolism. Canadian Journal of Physiology and Pharmacology, 1966, 44, 241.CrossRefGoogle Scholar
  57. 57.
    Sze, P. Y., Yanai, J., and Ginsburg, P. W. Effects of early ethanol input on the activities of ethanol-metabolizing enzymes in mice. Biochemical Pharmacology, 1976, 25, 215–217.PubMedCrossRefGoogle Scholar
  58. 58.
    Niimi, Y. Studies on effects of alcohol on fetus. Sanfujinka No Shimpo, 1973, 25, 55–78.Google Scholar
  59. 59.
    Duncan, R. J. S., and Woodhouse, B. The lack of effect on liver alcohol dehydrogenase in mice of early exposure to alcohol. Biochemical Pharmacology, 1978, 27, 2755–2756.PubMedCrossRefGoogle Scholar
  60. 60.
    Sjoblom, M., Oisund, J. F., and Morlund, J. Development of alcohol dehydrogenase and aldehyde dehydrogenase in the offspring of female rats chronically treated with ethanol. Acta Pharmacologica et Toxicologica, 1979, 44, 128–131.PubMedCrossRefGoogle Scholar
  61. 61.
    Sippel, H. W., and Kesaniemi, Y. A. Placental and foetal metabolism of acetaldehyde in the rat. II. Studies on metabolism of acetaldehyde in the isolated placenta and foetus. Acta Pharmacologia et Toxicologica, 1975, 37, 49–55.CrossRefGoogle Scholar
  62. 62.
    Kesaniemi, Y. A. Metabolism of ethanol and acetaldehyde in intact rats during pregnancy. Biochemical Pharmacology, 1974, 23, 1157–1162.PubMedCrossRefGoogle Scholar
  63. 63.
    Kesaniemi, Y. A., and Sippel, H. W. Placental and foetal metabolism of acetaldehyde in rat. Acta Pharmacologica et Toxicologica, 1975, 37, 43–48.PubMedCrossRefGoogle Scholar
  64. 64.
    Randall, C. L., Taylor, W. J., Tabakoff, B., and Walker, D. W. Ethanol as a teratogen. In R. G. Thurman (Ed.), Alcohol and aldehyde metabolizing systems. New York: Academic Press, 1977. Pp. 659–670.Google Scholar
  65. 65.
    Veghelyi, P. V., Osztovics, M., Kardos, G., Leisztner, L., Szaszovsky, E., Igali, S., and Imrei, J. The fetal alcohol syndrome: Symptoms and pathogenesis. Acta Paediatrica Academiae Scientiarum Hungaricae, 1978, 19, 171–189.PubMedGoogle Scholar
  66. 66.
    Majewski, F . Alcohol embryopathy: Some facts and speculations about pathogenesis. Neurobehavioral Toxicology and Teratology, 1981, 3, 129–144.PubMedGoogle Scholar
  67. 67.
    Kouri, M., Koivula, T., and Koivusalo, M. Aldehyde dehydrogenase activity in human placenta. Acta Pharmacologica et Toxicologica, 1977, 40, 460–463.PubMedGoogle Scholar
  68. 68.
    Lindblad, B., and Olsson, R. Unusually high levels of blood alcohol? Journal of the American Medical Association, 1916, 236, 1600–1602.CrossRefGoogle Scholar
  69. 69.
    Hammond, K. B., Rumack, B. H., and Rodgerson, D. O. Blood ethanol: A report of unusually high levels in a living patient. Journal of the American Medical Association, 1973, 226, 63–64.PubMedCrossRefGoogle Scholar
  70. 70.
    Poklis, A., and Pearson, M. An unusually high blood ethanol level in a living patient. Clinical Toxicology, 1977, 10, 429–431.PubMedCrossRefGoogle Scholar
  71. 71.
    Chesler, A., La Belle, G. C., and Himwich, H. E. The relative effects of toxic doses of alcohol on fetal, newborn and adult rats. Quarterly Journal of Studies on Alcohol, 1942, 3, 1–4.Google Scholar
  72. 72.
    Schaefer, O. Alcohol withdrawal syndrome in a newborn infant of a Yukon Indian mother. Canadian Medical Association Journal, 1962, 87, 1333–1334.PubMedGoogle Scholar
  73. 73.
    Nichols, M. M. Acute alcohol withdrawal syndrome in a newborn. American Journal of Diseases of Children, 1967, 113, 714–715.PubMedGoogle Scholar
  74. 74.
    Pierog, S., Chandavasu, O., and Wexler, I. Withdrawal symptoms in infants with the fetal alcohol syndrome. Journal of Pediatrics, 1977, 90, 630–633.PubMedCrossRefGoogle Scholar
  75. 75.
    Zelson, C. Acute management of neonatal addiction. Addictive Diseases, 1975, 2, 159–168.PubMedGoogle Scholar

Copyright information

© Ernest L. Abel 1984

Authors and Affiliations

  • Ernest L. Abel
    • 1
  1. 1.Research Institute on AlcoholismBuffaloUSA

Personalised recommendations