Fetal Alcohol Syndrome
Fetal alcohol syndrome is the manifestation of specific growth, mental, and physical birth defects associated with the mother's high levels of alcohol use during pregnancy.
Causes, incidence, and risk factors
Alcohol use or abuse by the pregnant woman subjects her to the same range of risks that alcohol has in the general population. However, it poses extreme and unique risks to the fetus and is associated with fetal alcohol syndrome (FAS). Timing of alcohol use during pregnancy is also of importance. Alcohol use during the first trimester is more damaging than during the second trimester, which is, in turn, more damaging than use in the third trimester. Alcohol ingested by a pregnant woman easily passes across the placental barrier to the fetus. Because of this, drinking alcohol can adversely affect the development of the baby. A pregnant woman who drinks any amount of alcohol is at risk, since a "safe" level of alcohol ingestion during pregnancy has not been established. However, larger amounts appear to cause increased problems. Multiple birth defects associated with "classical" fetal alcohol syndrome are more commonly associated with heavy alcohol use or alcoholism.
Fetal alcohol syndrome consists of the following abnormalities:
- Intrauterine growth retardation: growth deficiency in the fetus and newborn in all parameters -- head circumference, weight, height
- Delayed development with decreased mental functioning (mild to severe)
- Facial abnormalities including small head (microcephaly); small maxilla (upper jaw); short, up-turned nose; smooth philtrum (groove in upper lip); smooth and thin upper lip; and narrow, small, and unusual-appearing eyes with prominent epicanthal folds
- Heart defects such as ventricular septal defect (VSD) or atrial septal defect (ASD)
- Limb abnormalities of joints, hands, feet, fingers, and toes.
Consumption of alcohol by a pregnant woman may be the first indicator of potential fetal alcohol syndrome. Others indicators may be:
- Slow intrauterine and neonatal growth with occasional diagnosis of failure to thrive
- Delayed development and evidence of mild to moderate mental retardation (IQ range from 50 to 85 with reported average in the mid 60s)
- Facial abnormalities, skeletal limb abnormalities, tremors (in the newborn infant), agitation and crying (in the newborn infant)
Pregnant women, or women trying to conceive, are encouraged to avoid drinking alcohol in any quantity. Pregnant alcoholic women should be involved in alcohol abuse rehabilitation programs, and monitored closely throughout pregnancy.
Prevention
Abstinence from alcohol during pregnancy absolutely prevents fetal alcohol syndrome. Counseling is indicated to help prevent recurrence in women who have previously delivered a child with fetal alcohol syndrome. Sexually active women who drink heavily or are alcoholics should use highly effective contraceptive measures and control drinking behaviors, or discontinue the use of alcohol prior to attempting to conceive.
Credit: National Institute of Health.