# Organ‐Specific Histopathological Effects of Prenatal Alcohol Exposure: A Narrative Review

**Authors:** Rana Nur Gursu, Dilan Cetinavci, Hulya Elbe

PMC · DOI: 10.1002/cga.70047 · Congenital Anomalies · 2026-03-06

## TL;DR

This review summarizes how alcohol exposure during pregnancy causes specific organ damage in fetuses and highlights the need for prevention and further research.

## Contribution

The paper uniquely integrates histopathological effects of prenatal alcohol exposure across multiple organs within a developmental framework.

## Key findings

- Prenatal alcohol exposure causes reproducible histopathological changes in organs like the brain, heart, and liver.
- Ethanol-induced damage involves oxidative stress, inflammation, and disrupted developmental signaling.
- Current research should focus on molecular mechanisms and potential therapies like antioxidants.

## Abstract

The role of alcohol‐induced epigenetic modifications that predispose the fetus to metabolic dysregulation, increased susceptibility to future substance use, and long‐term behavioral and cognitive impairments has received increasing attention. Fetal alcohol syndrome (FAS) and fetal alcohol spectrum disorders (FASDs) remain underdiagnosed worldwide. As evidence continues to demonstrate that no safe level of alcohol consumption exists during pregnancy, strengthening public awareness, maternal education, and prenatal care services has become increasingly imperative. Prenatal alcohol exposure (PAE) induces distinct and reproducible histopathological alterations in multiple developing organs, including the brain, heart, liver, kidneys, lungs, eyes, limbs, and placenta. These alterations involve cellular degeneration, tissue disorganization, inflammatory infiltration, vascular abnormalities, and impaired organ architecture, arising from oxidative stress, inflammation, apoptosis, and disrupted developmental signaling during critical periods of fetal development. This narrative review provides a comprehensive synthesis of the organ‐specific histopathological consequences of PAE and integrates the underlying cellular and molecular mechanisms contributing to these alterations. Future research should further elucidate the molecular basis of ethanol teratogenicity and explore potential therapeutic strategies, such as antioxidant supplementation, nutritional modulation, and neuroprotective agents. Nevertheless, complete maternal abstinence from alcohol remains the most effective preventive strategy. By integrating histopathological findings across multiple fetal organ systems within a unified developmental framework, this review offers a distinct contribution beyond existing literature focused primarily on epidemiology or diagnosis.

## Linked entities

- **Diseases:** Fetal alcohol syndrome (MONDO:0000408), Fetal alcohol spectrum disorders (MONDO:0000408)

## Full-text entities

- **Genes:** Glul (glutamate-ammonia ligase) [NCBI Gene 24957] {aka Glns}, AKT1S1 (AKT1 substrate 1) [NCBI Gene 84335] {aka Lobe, PRAS40}, Irs4 (insulin receptor substrate 4) [NCBI Gene 315350] {aka IRS-4}, Htr1a (5-hydroxytryptamine receptor 1A) [NCBI Gene 24473] {aka 5HT1A, RAT5HT1A}, POMC (proopiomelanocortin) [NCBI Gene 5443] {aka ACTH, CLIP, LPH, MSH, NPP, OBAIRH}, HAMP (hepcidin antimicrobial peptide) [NCBI Gene 57817] {aka HEPC, HFE2B, LEAP1, PLTR}, SOD2 (superoxide dismutase 2) [NCBI Gene 6648] {aka GC1, GClnc1, IPO-B, IPOB, MNSOD, MVCD6}, GGTLC1 (gamma-glutamyltransferase light chain 1) [NCBI Gene 92086] {aka GGTL6, GGTLA3, GGTLA4, dJ831C21.1, dJ831C21.2}, Ghr (growth hormone receptor) [NCBI Gene 25235] {aka GHR/BP}, Igf1r (insulin-like growth factor 1 receptor) [NCBI Gene 25718] {aka IGF-1 receptor, IGFIRC, Igfr1, JTK13}, SHH (sonic hedgehog signaling molecule) [NCBI Gene 6469] {aka HHG1, HLP3, HPE3, MCOPCB5, SMMCI, ShhNC}, NTRK2 (neurotrophic receptor tyrosine kinase 2) [NCBI Gene 4915] {aka DEE58, EIEE58, GP145-TrkB, OBHD, TRKB, trk-B}, MYH14 (myosin heavy chain 14) [NCBI Gene 79784] {aka DFNA4, DFNA4A, FP17425, MHC16, MYH17, NMHC II-C}, Odc1 (ornithine decarboxylase 1) [NCBI Gene 24609] {aka Odc}, PFAS (phosphoribosylformylglycinamidine synthase) [NCBI Gene 5198] {aka FGAMS, FGAR-AT, FGARAT, GATD8, PURL}, BDNF (brain derived neurotrophic factor) [NCBI Gene 627] {aka ANON2, BULN2}, ALDH2 (aldehyde dehydrogenase 2 family member) [NCBI Gene 217] {aka ALDH-E2, ALDHI, ALDM}, Igf2 (insulin-like growth factor 2) [NCBI Gene 24483] {aka IGFII, RNIGF2}, PIK3CB (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit beta) [NCBI Gene 5291] {aka P110BETA, PI3K, PI3KBETA, PIK3C1}, Adh1c (alcohol dehydrogenase 1C (class I), gamma polypeptide) [NCBI Gene 24172] {aka Adh, Adh1, Adh1a}, IGF2 (insulin like growth factor 2) [NCBI Gene 3481] {aka C11orf43, GRDF, IGF-II, PP9974, SRS3}, SOD1 (superoxide dismutase 1) [NCBI Gene 6647] {aka ALS, ALS1, HEL-S-44, IPOA, SOD, STAHP}, NGF (nerve growth factor) [NCBI Gene 4803] {aka Beta-NGF, HSAN5, NGFB}, Tfrc (transferrin receptor) [NCBI Gene 64678] {aka Trfr}, AVP (arginine vasopressin) [NCBI Gene 551] {aka ADH, ARVP, AVP-NPII, AVRP, VP}, CTNNB1 (catenin beta 1) [NCBI Gene 1499] {aka CTNNB, EVR7, MRD19, NEDSDV, armadillo}, IGF1 (insulin like growth factor 1) [NCBI Gene 3479] {aka IGF, IGF-I, IGFI, MGF}, PRPH2 (peripherin 2) [NCBI Gene 5961] {aka AOFMD, AVMD, CACD2, DS, MDBS1, RDS}, CAT (catalase) [NCBI Gene 847], XIAP (X-linked inhibitor of apoptosis) [NCBI Gene 331] {aka API3, BIRC4, IAP-3, ILP1, MIHA, XLP2}, CYP2E1 (cytochrome P450 family 2 subfamily E member 1) [NCBI Gene 1571] {aka CPE1, CYP2E, P450-J, P450C2E}, Asph (aspartate-beta-hydroxylase) [NCBI Gene 312981], ODC1 (ornithine decarboxylase 1) [NCBI Gene 4953] {aka BABS, NEDBA, NEDBIA, ODC}, FAS (Fas cell surface death receptor) [NCBI Gene 355] {aka ALPS1A, APO-1, APT1, CD95, FAS1, FASTM}, INS (insulin) [NCBI Gene 3630] {aka IDDM, IDDM1, IDDM2, ILPR, IRDN, MODY10}, BCL2 (BCL2 apoptosis regulator) [NCBI Gene 596] {aka Bcl-2, PPP1R50}, AKR1A1 (aldo-keto reductase family 1 member A1) [NCBI Gene 10327] {aka ALDR1, ALR, ARM, DD3, HEL-S-6}, Tf (transferrin) [NCBI Gene 24825] {aka Tfn, Trf}, Notch1 (notch receptor 1) [NCBI Gene 25496] {aka NOTCH, TAN1}, Casp3 (caspase 3) [NCBI Gene 12367] {aka A830040C14Rik, AC-3, CASP-3, CC3, CPP-32, CPP32}, Akt1 (AKT serine/threonine kinase 1) [NCBI Gene 24185] {aka Akt}, AKT1 (AKT serine/threonine kinase 1) [NCBI Gene 207] {aka AKT, PKB, PKB-ALPHA, PRKBA, RAC, RAC-ALPHA}, Hes1 (hes family bHLH transcription factor 1) [NCBI Gene 29577], S100B (S100 calcium binding protein B) [NCBI Gene 6285] {aka NEF, S100, S100-B, S100beta}, Igf1 (insulin-like growth factor 1) [NCBI Gene 24482] {aka IGF}, Akt1s1 (AKT1 substrate 1) [NCBI Gene 292887] {aka PRAS40}, SFTPD (surfactant protein D) [NCBI Gene 6441] {aka COLEC7, PSP-D, SFTP4, SP-D}
- **Diseases:** cyst (MESH:D003560), ciliopathy (MESH:D000072661), impairments in visuospatial processing and working memory (MESH:D008569), bradycardia (MESH:D001919), maternal iron deficiency (MESH:D000090463), intravascular (MESH:D006461), Nervous System (MESH:D009422), Cognitive impairment (MESH:D003072), ectrodactyly (MESH:C574275), structural abnormalities of the urinary tract (MESH:D014570), Limb defects (MESH:C537754), necrosis (MESH:D009336), ventricular septal defects (MESH:D006345), developmental delay (MESH:D002658), -specific injury (MESH:D000080888), hypopnea (MESH:D012891), Respiratory Distress Syndrome (MESH:D012128), cardiac teratogenesis (MESH:D064793), metabolic abnormalities (MESH:D008659), vascular fragility (MESH:D005600), NTD (MESH:D009436), cardiovascular abnormalities (MESH:D018376), chronic alcohol problem (MESH:D019973), deficits (MESH:D009461), malformations (MESH:C564254), metabolic dysregulation (MESH:D021081), cardiac defects (MESH:D006331), microcephaly (MESH:D008831), liver pathology (MESH:D017093), strabismus (MESH:D013285), dilation of fetal cerebral arteries (MESH:D005315), aldosterone deficiency (MESH:D006929), ophthalmological abnormalities (MESH:C536647), sleep-related disturbances (MESH:D020183), impairments in spatial learning (MESH:D007859), pathology (MESH:D005598), myocardial wall abnormalities (MESH:D056988), ocular malformations Deficits in visuospatial (MESH:D000377), depression (MESH:D003866), teratogenic (MESH:C535542), obesity (MESH:D009765), renal abnormalities (MESH:D007674), aspiration pneumonia (MESH:D011015), structural (MESH:D020914), Peter's (MESH:C537884), dead (MESH:D001926), white matter damage (MESH:D056784), alcoholic liver disease (MESH:D008108), ventricular thinning (MESH:D013851), facial dysmorphology (MESH:D005153), disruption of pulmonary function (OMIM:608852), Anterior segment anomalies (MESH:C537775), neuronal loss (MESH:D009410), structural and neurodevelopmental abnormalities (MESH:C566527), multiple facial anomalies (MESH:C535639), facial anomalies (MESH:C557821), steatosis (MESH:D005234), apnea/hypopnea (MESH:D020181), skeletal defects (MESH:C567306), neuroinflammation (MESH:D000090862)
- **Chemicals:** citral (MESH:C007076), Folic acid (MESH:D005492), ROS (MESH:D017382), hydroxyl radicals (MESH:D017665), diphenyleneiodonium (MESH:C007517), glucose (MESH:D005947), Ethanol (MESH:D000431), serotonin (MESH:D012701), PK11195 (MESH:C037850), glutamate (MESH:D018698), CH3CHO (MESH:D000079), H+ (MESH:D006859), Alcohol (MESH:D000438), vitamin C (MESH:D001205), NAD+ (MESH:D009243), N-methyl-D-aspartate (MESH:D016202), resveratrol (MESH:D000077185), GABA (MESH:D005680), 4-(Diethylamino) benzaldehyde (MESH:C055506), acetate (MESH:D000085), eosin (MESH:D004801), Oil Red O (MESH:C011049), endocannabinoid (MESH:D063388), lipid (MESH:D008055), sucrose (MESH:D013395), glycogen (MESH:D006003), iron (MESH:D007501), chlorothiazide (MESH:D002740), GSH (MESH:D005978), phospholipid (MESH:D010743), isoproterenol (MESH:D007545), polyamine (MESH:D011073), bicarbonate (MESH:D001639), MDA (MESH:D008315), corticosterone (MESH:D003345), thymidine (MESH:D013936), homocysteine (MESH:D006710), ammonium chloride (MESH:D000643), alpha-lipoic acid (MESH:D008063), hematoxylin (MESH:D006416), 5-methyltetrahydrofolate (MESH:C005984), oxygen (MESH:D010100), potassium (MESH:D011188), DEAB (MESH:C007368), Nile red (MESH:C044808), mucopolysaccharide (MESH:D006025), retinoic acid (MESH:D014212), unsaturated fatty acids (MESH:D005231), curcumin (MESH:D003474), 3H (MESH:D014316), melatonin (MESH:D008550), B[a]P (MESH:D001564), ipsapirone (MESH:C043077), cGMP (MESH:D006152), EGCG (MESH:C045651), AMPA (MESH:D018350), superoxide (MESH:D013481), CH3COO (-), silybin (MESH:D000077385), hydrogen peroxide (MESH:D006861)
- **Species:** Gallus gallus (bantam, species) [taxon 9031], Papio hamadryas (baboon, species) [taxon 9557], Ovis aries (domestic sheep, species) [taxon 9940], Cavia porcellus (domestic guinea pig, species) [taxon 10141], Xenopus laevis (African clawed frog, species) [taxon 8355], Homo sapiens (human, species) [taxon 9606], Mus musculus (house mouse, species) [taxon 10090], Rattus norvegicus (brown rat, species) [taxon 10116], Danio rerio (leopard danio, species) [taxon 7955]

## Full text

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## Figures

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## References

108 references — full list in the complete paper: https://tomesphere.com/paper/PMC12966814/full.md

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Source: https://tomesphere.com/paper/PMC12966814