FASD History

It has been suggested that the adverse effects of alcohol on the developing fetus have been recognized for centuries. Some of the earliest references date back to Greek and Roman mythology and Judeo-Christian tradition, such as the ancient Carthaginian custom that forbade bridal couples from drinking wine on their wedding night, and the belief that alcohol consumption at the time of procreation leads to the birth of defective children (Jones and Smith, 1973). Passages in Robert Burton's The Anatomy of Melancholy allegedly quote Aristotle describing an association between alcoholic mothers and disabled children in Problemata : "...foolish, drunken and harebrained women [for the] most part bring forth children like unto themselves, morose and languid" (Burton, 1621).

However, there remains much controversy regarding the validity of these claims and sources. Although many authors have assumed Burton to be quoting Aristotle's words verbatim, there is no evidence of any such statement in Problemata, nor in any of Aristotle's other works (Abel, 1999). Others have claimed that the Carthaginians did not truly understand that drinking during pregnancy caused problems; rather, they believed that intoxication at the exact moment of conception led to the birth of a deformed offspring (Calhoun and Warren, 2007).

More recent and credible historical reports, however, have documented alcohol's teratogenic effect. During the 1700s, a group of English physicians described children born to alcoholic mothers as "weak, feeble, and distempered" (Royal College of Physicians of London, 1726). A deputy medical officer of the Convict Prison in Parkhurst, England, noticed that imprisoned pregnant alcoholic women had high rates of miscarriage, and that those offspring which survived displayed distinctive patterns of birth defects (Sullivan, 1899). From these observations, Sullivan concluded that alcohol had a direct effect on the developing embryo.

Despite these observations and early animal studies supporting an association between gestational alcohol exposure and adverse outcomes (e.g., Stockard, 1910), the first clinical accounts of alcohol's teratogenic effects were not published until the late 1960s. In 1968, Lemoine and colleagues published their report entitled "Outcome of children of alcoholic mothers" (Lemoine et al., 1968), which established a connection between maternal alcohol consumption during pregnancy and abnormal fetal development, describing common problems of children born to mothers who drank heavily during pregnancy.

Though many attribute the beginning of scientific inquiry to the 1960s and 1970s, physicians have been aware of the negative effects of maternal consumption of alcohol on the developing fetus since ancient times. The Bible in Judges 13:7 states: "Behold thou shalt conceive and bear a son: and now drink no wine or strong drink" hinting at the problems associated alcohol and pregnancy. In Carthage, there was reported to be a prohibition against couples drinking on their wedding night to prevent producing an affected offspring. Aristotle, the founder of western thought, even proclaimed "Foolish,, drunken and harebrained women most often bring forth children like unto themselves, morose and languid" (Streissguth at al, 1980).