Foetal Alcohol Syndrome (FAS): Drinking alcohol during pregnancy could be ruled a crime in the UK

UK Lawyers plan to take a test case to the UK Court of Appeal over claims that children harmed in the womb by their mother's drinking should receive compensation as victims of crime

Harming an unborn child by consuming alcohol during pregnancy could be classified as a crime in the UK, if an unusual legal challenge succeeds.

An English council is planning to go to the UK Court of Appeal in an attempt to secure criminal injuries compensation for a six-year-old girl who was born with foetal alcohol spectrum disorder (FAS) as a result of her mother’s drinking while she was in the womb.

A UK tribunal ruled in 2011 that the unnamed child had sustained personal injury “directly attributable to a crime of violence” and so was eligible for a payout.

Her mother, who drank “grossly excessive quantities of alcohol” during her pregnancy, was never convicted of any offence.

But she was alleged to have maliciously administered poison so as to endanger life or inflict grievous bodily harm, a crime under section 23 of the UK Offences Against the Person Act 1861.

However, the UK Criminal Injuries Compensation Authority challenged the judgment, and it was overturned in December 2013 by the upper tribunal of the UK Administrative Appeals Chamber.

Judge Howard Levenson found that there had been “administration of a poison or other destructive or noxious thing, so as thereby to inflict grievous bodily harm”.

However, he concluded that the girl was “not a person” in legal terms at the time because she was still a foetus.

The judge added: “I conclude that the section 23 offence cannot be committed by a pregnant woman drinking alcohol during her pregnancy and thereby causing damage to her unborn child and that, in the present case, no evidence or argument has been offered in respect of the commission of any other offence.”

Now the council in north-west England which brought the original application for compensation on behalf of the girl, who is now in foster care, is preparing to take the case to the UK Court of Appeal.

Neil Sugarman, a managing partner at GLP Solicitors in Greater Manchester, who is handling the case, told the paper: "Sadly, we act for many, many children who have been damaged by excessive alcohol intake during pregnancy.

We were approached by a local authority with responsibility for a child very badly damaged as a consequence of foetal alcohol spectrum disorder (FAS).

“They considered making an application under the criminal injuries compensation scheme because they thought there was an argument that the child had been damaged by being victim of a crime. The crime being; the birth mother carrying on drinking knowing that it could damage the child.”

He added: "In all the cases we have, there is good evidence that warnings have been given either by social workers or treating consultants and nurses to say, 'you cannot go on doing this, you are going to damage your child'."

There is a history of similar cases being brought to the courts in the US but with limited success.

Listen to a spokeperson from the American Bar Association. This Podcast discusses what US legal representatives need to know about Fetal Alcohol Syndrome or Spectrum Disorder.

Autism: Anti-Epileptic drug use during pregnancy associated with increased risk

Maternal use of valproate (a drug used for the treatment of epilepsy and other neuropsychological disorders) during pregnancy was associated with a significantly increased risk of autism in offspring, according to a study in the April 24 issue of JAMA.

The authors caution that these findings must be balanced against the treatment benefits for women who require valproate for epilepsy control.

"Anti-epileptic drug exposure during pregnancy has been associated with an increased risk for congenital malformations and delayed cognitive development in the offspring, but little is known about the risk of other serious neuropsychiatric disorders," according to background information in the article. Jakob Christensen, Ph.D., of Aarhus University Hospital, Aarhus, Denmark, and colleagues evaluated the association between maternal use of valproate during pregnancy and the risk of autism spectrum disorder and childhood autism in offspring.

The population-based study included all children born alive in Denmark from 1996 to 2006. National registers were used to identify children exposed to valproate during pregnancy and diagnosed with autism spectrum disorders (childhood autism [autistic disorder], Asperger syndrome, atypical autism, and other or unspecified pervasive developmental disorders).

Data were analyzed and adjusted for potential confounders (factors that can influence outcomes) such as maternal age at conception, paternal age at conception, parental psychiatric history, gestational age, birth weight, sex, congenital malformations, and parity.

Children were followed up from birth until the day of autism spectrum disorder diagnosis, death, emigration, or December 31, 2010, whichever came first.

The analysis included 655,615 children born from 1996 through 2006. The average age of the children at end of follow-up was 8.8 years.

During the study period, 5,437 children were diagnosed with autism spectrum disorder, including 2,067 with childhood autism.

The researchers identified 2,644 children exposed to antiepileptic drugs during pregnancy, including 508 exposed to valproate.

The authors found that use of valproate during pregnancy was associated with an absolute risk of 4.42 percent for autism spectrum disorder and an absolute risk of 2.50 percent for childhood autism.

"In this population-based cohort study, children of women who used valproate during pregnancy had a higher risk of autism spectrum disorder and childhood autism compared with children of women who did not use valproate.

Their risks were also higher than those for children of women who were previous users of valproate but who stopped before their pregnancy," the researchers write.

"Because autism spectrum disorders are serious conditions with lifelong implications for affected children and their families, even a moderate increase in risk may have major health importance.

Still, the absolute risk of autism spectrum disorder was less than 5 percent, which is important to take into account when counseling women about the use of valproate in pregnancy."

Read more here

Too Much Vitamin D During Pregnancy Can Cause Food Allergies

Pregnant women should avoid taking vitamin D supplements. Substitution appears to raise the risk of children developing a food allergy after birth. 

This was the conclusion drawn from a new survey carried out by the Helmholtz Centre for Environmental Research and the Martin Luther University in Halle-Wittenberg in Germany. (Credit: André Kuenzelmann/UFZ)

Vitamin D has always had a good reputation: it strengthens bones, protects against infections particularly during the cold winter months and aids the nervous and muscular systems.

Especially in the prevention and treatment of rickets, it has been given to babies and infants around the world for around 50 years.

However, recent scientific investigations are increasingly questioning the positive aspect of the "bone vitamin."

At the end of the 1990's, for the first time people's attention was drawn to a link between high vitamin D levels and the development of allergies.

To pursue the problem, together with Prof. Gabriele Stangl's group from the Institute of Agricultural and Nutritional Sciences at the Martin-Luther University in Halle-Wittenberg, Dr. Kristin Weiße from the Helmholtz Centre for Environmental Research in Leipzig devoted herself to the following task: can it be proved that there is a correlation between the concentration of vitamin D in the blood of expectant mothers and in cord blood of the babies?

The researchers from the UFZ in Leipzig were furthermore interested in the association between vitamin D levels during pregnancy and at birth, the immune status and allergic diseases of the children later in life. Or, in other words: does the vitamin D level of pregnant women affect the allergy risk of their children?

To investigate the question, Dr. Kristin Weiße's team from Leipzig used samples from the LiNA cohort that the Helmholtz Centre for Environmental Research (UFZ) had established together with the St. Georg municipal clinic between 2006 and 2008 headed by Dr. Irina Lehmann.

In total, it was possible to include 622 mothers and their 629 children in the long-term study "Lifestyle and environmental factors and their impact on the newborn allergy risk."

The level of vitamin D was tested in the blood of the pregnant mothers and also in the cord blood of the children born. In addition to this, questionnaires were used to assess the occurrence of food allergies during the first two years of the children's lives.

The result was clear: in cases where expectant mothers were found to have a low vitamin D level in the blood, the occurrence of food allergies among their two-year old children was rarer than in cases where expectant mothers had a high vitamin D blood level.

In reverse, this means that a high vitamin D level in pregnant women is associated with a higher risk of their children to develop a food allergy during infancy.

Furthermore, those children were found to have a high level of the specific immunoglobulin E to food allergens such as egg white, milk protein, wheat flour, peanuts or soya beans.

The UFZ scientists also got evidence fot the mechanism that could link vitamin D and food allergies. Dr. Gunda Herberth -- also from the Department of Environmental Immunology at the UFZ -- took a closer look at the immune response of the affected children and analysed regulatory T-cells in cord blood in particular.

The cells are capable of preventing the immune system from overreacting to allergens, with the result that they protect against allergies. The UFZ researchers know from earlier analyses that the allergy risk increases in cases where too few regulatory T-cells are present in cord blood.

The interesting result of the current research project: the higher the level of vitamin D found in the blood of mothers and children, the fewer regulatory T-cells could be detected.

The correlation could mean that vitamin D suppresses the development of regulatory T-cells and thus increases the risk of allergy.

Apart from diet, Dr. Kristin Weiße explained that the level of vitamin D is mainly affected by conditions such as season, exposure to the sun and the amount of time spent outdoors -- these factors were also taken into account in the current risk analyses of vitamin D and food allergy.

Even though the occurrence of food allergies is undoubtedly affected by many other factors than just the vitamin D level, it is still important to take this aspect into consideration.

The UFZ researchers would rather advise pregnant women not to take vitamin D supplements. "Based on our information, an excess of vitamin D can increase the risk of children developing a food allergy in the first two years of their life."

Journal Reference: K. Weisse, S. Winkler, F. Hirche, G. Herberth, D. Hinz, M. Bauer, S. Röder, U. Rolle-Kampczyk, M. von Bergen, S. Olek, U. Sack, T. Richter, U. Diez, M. Borte, G. I. Stangl, I. Lehmann. Maternal and newborn vitamin D status and its impact on food allergy development in the German LINA cohort study. Allergy, 2013; 68 (2): 220 DOI: 10.1111/all.12081