We certainly agree with the conclusion of Drs Mankad and Choksi that alcohol is a powerful teratogen in animals. It is equally potent in man.
Although the summary of findings in infants with the fetal alcohol syndrome that we presented in our article was uncontrolled, previous studies were not. One case-control study of the effects of maternal heavy alcohol consumption on the outcome of pregnancy has been previously reported1; another is in progress to assess possible additive effects of concurrent smoking and the use or abuse of other drugs. As pointed out by Drs Mankad and Choksi, it is difficult to conduct an ideally controlled study of these latter relationships. However, we would emphasize that no overall pattern such as we have described in these infants has ever been attributed to the effects of smoking or to the use of illicit drugs, despite a number of investigations.
Hanson JW, Jones KL, Smith DW. The Fetal Alcohol Syndrome-Reply. JAMA. 1976;236(10):1114. doi:10.1001/jama.1976.03270110016004
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