Fetal alcohol syndrome (FAS) is a severe developmental disorder caused by exposure to alcohol before birth. FAS is characterized by a pattern of physical and mental disorders. These disorders include growth deficiencies, facial abnormalities, and brain damage. Pregnant women who drink alcohol several days per week and have many drinks on each occasion are at the highest risk of having a child with FAS. However, physicians do not know what amount of alcohol is necessary to cause FAS. Health experts recommend that women avoid all alcohol use during pregnancy to ensure the safety of their unborn babies.
Many cases of FAS go undetected. This happens because the variable pattern of disorders makes the syndrome difficult to diagnose. Scientists estimate that FAS affects 1 to 3 babies out of every 1,000 live births worldwide. But the rate is much higher in some populations. It is especially high among groups with high rates of alcohol abuse. Scientists estimate that other, less severe, alcohol-related birth defects occur about three to five times as often as FAS.
Symptoms.
Physicians diagnose FAS if they observe a pattern of abnormalities in association with known or suspected exposure to alcohol before birth. Symptoms of FAS include small body size and low birth weight. Babies born with FAS also have characteristic facial features. These features include small eyes, a thin upper lip, and an absent or indistinct philtrum. The philtrum is the vertical groove on the outside of the upper lip, between the mouth and the nose. Some children with FAS have a short, slightly upturned nose and small folds on the side of each eye close to the nose.
Brain damage is usually the most critical feature of FAS. The brain damage often causes intellectual disability. Such disability ranges from mild to moderate in most cases but may be severe. Fetal alcohol exposure can also cause a highly variable pattern of behavioral problems. Such problems include delayed behavioral development, sleep disturbances, attention deficit disorder, hyperactivity, learning disabilities, and vision and hearing disorders. Some people with FAS also have other birth defects that affect the eyes, heart, kidney, or skeleton.
Cause.
Alcohol consumed by a pregnant woman easily crosses from the mother’s bloodstream to enter the bloodstream of the developing fetus (unborn baby). There, alcohol interferes with the normal growth and development of the brain and other organs. This interference leads to the characteristic symptoms of FAS. However, the effects of alcohol exposure on a fetus vary. The effects depend on the level of alcohol consumption, when alcohol is consumed during pregnancy, and other factors, such as smoking by the mother and prenatal nutrition.
Prevention and treatment.
There is no cure for FAS. However, encouraging women to avoid alcohol when they are pregnant or may become pregnant is an effective means of preventing FAS. Screening programs that identify women with alcohol abuse disorders prior to pregnancy are also effective. Women who drink during pregnancy and cannot stop should receive medical treatment for alcoholism immediately.
Treatment for people with FAS depends on the age of the person and on the individual disorders of the child or adult patient. Some individuals born with FAS require long-term care. However, many other people with FAS can achieve a normal life with proper medical care and family support.
See also Alcoholism ; Birth defect ; Intellectual disability .
