When a pregnant woman drinks alcohol, it crosses the placenta and reaches the fetus. The amniotic fluid surrounding the fetus will also contain alcohol. Prenatal alcohol exposure puts the fetus at risk for physical and mental damage. Fetal alcohol spectrum disorder (FASD) describes children who have a disorder or disability related to prenatal alcohol exposure. There are many disorders that fall within this spectrum, with fetal alcohol syndrome (FAS) being the most severe.
Fetal alcohol syndrome
Fetal alcohol syndrome is the leading known cause of mental retardation. Its effects are permanent, and it has lifelong consequences. Fetal alcohol syndrome affects all socioeconomic groups and people of all ethnic backgrounds. In the United States, 1-2 infants are born with FAS per 1,000 live births.
Infants who should be evaluated for FAS
According to the U.S. Centers for Disease Control and Prevention (CDC), if it is known that the pregnant mother abused alcohol during pregnancy, her infant should be evaluated for fetal alcohol syndrome. (Alcohol abuse is defined as seven or more alcohol drinks per week or three or more alcohol drinks on multiple occasions, or both.) If it is not known how much the mother drank during pregnancy, an infant should be evaluated for FAS if he/she has any of the symptoms of FAS.
Diagnosis
There are three symptoms that should be present for a diagnosis of fetal alcohol syndrome:
- Dysmorphic facial features – specific facial features that include thin edge of the lips (thin vermilion border), smooth area between the nose and upper lip (smooth philtrum), and small opening for the eyes between the eyelids (small palpebral fissures)
- Inadequate growth in height or weight before or after birth
- Central nervous system abnormality – this may be structural (such as a small head), neurological (such as seizures), or functional (poor test performance).
Treatment
The infant born with fetal alcohol syndrome may need hospitalization in a neonatal intensive care unit immediately after birth. Tests will be done to determine what physical abnormalities the infant has, and this will help determine what specific treatments will be needed. For example, the child may need antiseizure medications if having seizures. Hearing will be tested in infancy and as needed.
Intervention services will be tailored to each child’s individual needs. The child may need help with improving communication and social skills, emotional development, or language development. He or she may need special education services or speech therapy. Some children with FAS have problems with hyperactivity, impulsivity, oppositional behavior, or sleep disorders, and may require medication or other types of therapy.
Prevention
It is important to remember that fetal alcohol syndrome is a preventable disorder. Research studies have not been able to determine what exactly is a “completely safe” level of alcohol intake for a pregnant woman, one that would definitely not cause harm to her fetus. Therefore, the CDC recommends that women who are pregnant, planning to become pregnant, or at risk for pregnancy should be advised not to drink alcohol.
Last updated 11/18/05
Information for this article was taken from:
- Centers for Disease Control and Prevention. (2005). Guidelines for identifying and referring persons with fetal alcohol syndrome. Morbidity and Mortality Weekly Report, August 28, 2005.
- Dittmer, C., & Lentz-Kapua, S.L. (2005). Fetal alcohol syndrome. eMedicine, accessed at http://www.emedicine.com/ped/topic767.htm
- Carter et al. (2005). Effects of prenatal alcohol exposure on infant visual acuity. Journal of Pediatrics, vol. 147, pp. 473-479.
