[Alcohol and pregnancy: diagnostic aspects and abnormalities in the placental vitamin A pathway]

Maternal alcohol drinking during pregnancy is a reality in France leading to new-born specific clinical signs called "Fetal alcoholic syndrome/FAS" in 1.5 per 1000 births and to common clinical signs grouped into "Fetal Linked to Alcohol Spectrum Disorders" in 5 per 1000 births. Our works presented for the attribution of the SFBC 2007 price talked about two aspects of this public health problem. The first presented the recent evaluation of the alcohol consumption during pregnancy in Auvergne by the realization of the DATAMATER clinical and biological study on more than 800 "mother/baby" couples. We confirmed the reality of such maternal drinking (1.8 FAS per 1000 births) and also the useless of biological tools to help the diagnosis of the clinician where the clinical signs did not clearly belonged to FAS and when the maternal consumption was asked. The second aspect reviewed the placental abnormalities occurring during the FAS, which could explain the intra-uterine growth retardation. To better understand the genesis of such alterations, we proposed a new physio-pathological mechanism. The alcohol could alter the retinol (vitamin A) activation into retinoic acid, a fundamental morphogenic molecule for the optimal development and functions of the placenta.