Table 1.

Consequences of the hypothalamic pituitary adrenal (HPA) axis alterations produced by fetal alcohol exposure on various physiological systems in offspring

System	Effects
Central Nervous System	Alteration in the interaction between the serotonergic system and the HPA axis in a sex-specific manner (Hofman et al., 2007) Alteration in neurotransmitter catecholamine, serotonin, nitric oxide, glutamate and GABA release in response to stress (Lee et al., 2008) Increase in depressive and anxiety-like behaviors (Hellemans et al., 2010)
Neuroendocrine System	Hyperactivity of the HPA axis response to stress (Haley et al., 2006; Hellemans et al., 2010; Govorko et al., 2012) Alteration in feedback inhibition of the HPA axis by glucocorticoids (GCs) or β-endorphin (β-EP) at the level of the PVN (Hellemans et al., 2010; Boyadjieva et al., 2009)
Metabolic System	Increase in high-fat diet-induced metabolic syndrome (Xia et al., 2014) Showing insulin resistance in the glucose tolerance test (Harper et al., 2014) Increase in mild type 2 diabetes mellitus (Knee et al., 2004) Disruption of metabolic signaling in POMC neurons in the hypothalamus (Agapito et al., 2014)
Immune System	Impairment of humoral and/or cell-mediated immunity and changes in the release of cytokines (Johnson et al., 1981) Decrease in innate immune function and increase severity of adjuvant- induced arthritis (Arjona et al., 2006; Zhang et al., 2012) Increase in the susceptibility to various cancers (Polanco et al., 2010; Murugan et al., 2013)
Cardiovascular System	Induction of cardiovascular problems due to dysregulation of the SNS and HPA axis functions (Parkington et al., 2010)