FAS is a varying group of symptoms that can affect an infant born to a mother who consumes alcohol during pregnancy. The most serious consequence is severe mental retardation due to impaired brain development. Other possible outcomes might be :
- mild to moderate mental retardation,
- central nervous system problems,
- small size, low birth weight or growth retardation
- facial or cranial (skull) abnormalities such as: small head size, small eyes and/or short eye openings, under-development of the upper lip with flat upper lip ridges, thin upper lip and flat maxillary jaw) area.
FAE is thought to be a milder form of FAS. It may include some of the features in cases where there is a history of prenatal alcohol exposure. Learning/behavior difficulties can be as severe as FAS. In both FAS and FAE, studies show a positive relationship between degree of prenatal alcohol exposure and physical birth defects, growth, brain and behavioral deficiencies.
Follow-up assessments have shown that, in less severe cases, although some of the physical characteristics of FAS may lessen with maturity, abnormalities of the upper lip and small eye openings, short stature,and small head continue. Brain and behavioral deficits also continue including lower IQ and a number of behavioral disorders.
Children with FAS/FAE are frequently described as hyperactive, distractible, or impulsive. They often have short attention spans similar to attention deficit disorder, but with lower IQ's, particularly in the FAS individual. In addition to attention deficits, problems with judgment, comprehension, and abstract thinking are common.
RISK FACTORS FOR FAS/FAE
Along with amount and timing of prenatal alcohol intake, there are other biological and environmental factors which add to the risk for alcohol-caused birth defects. Biologic factors may include increasing age, number of children, or individual differences in metabolism of alcohol. There may also be genetic differences which make some more vulnerable to alcohol exposure.
OTHER CONSEQUENCES OF ALCOHOL TO THE DEVELOPING INFANT
Newborns exposed to alcohol before birth may have a weak sucking response and irregular sucking patterns early in life. Some describe them as easily distracted and fatigued when sucking. Sleep disturbance, and jitteriness have also been reported in infants exposed to alcohol before birth.
Some studies also suggest that a higher incidence of impaired vision and hearing, motor incoordination, and problems with balance are possibly attributed to alcohol use by the mother before birth of the infant. Fetal exposure to alcohol can also result in abnormal thyroid function and some decrease in the immune system effectiveness.
HOW DOES ALCOHOL CAUSE THESE EFFECTS ON A FETUS?
Although the role alcohol plays in FAS/FAE is not clear, possible factors may include
- Acetaldehyde (ACH) which is the primary product when alcohol is metabolized;
- fetal malnutrition especially if the mother is undernourished. Even when she has eaten the proper foods, the placenta (structure that nourishes the fetus) may not be able to carry these vitamins, minerals and other nutrients which are so important to the developing fetus;
- lack of oxygen due to less blood flow to the fetus through the placenta; and
- disturbance of prostaglandins (PG's) which control normal blood flow to the placenta.
Since questions about how much alcohol is too much, and when the fetus is at greatest risk are difficult to answer at this time, women are advised to abstain from alcohol during pregnancy in order to prevent the risk of alcohol-related injuries to the developing fetus.
PREVENTION OF FAS/FAE
The safest choice for a pregnant woman is to avoid alcohol, tobacco, and other drugs.
The brain is unique--it is one of the first to begin to develop and the last to be completed--and it is particularly sensitive to the effects of alcohol throughout its development--that is, throughout all three trimesters.
Questions about how much alcohol is too much and when the fetus is at greatest risk are difficult to answer at this time since a period of greatest susceptibility and a dose-response relationship have not been established. Not all women who drink alcohol during pregnancy have babies with FAS or FAE, and women who abuse alcohol frequently, eat poorly, smoke and consume other drugs, which also put them and their developing infant at risk.
In summary, babies whose mothers drink during pregnancy may be born with Fetal Alcohol Syndrome or Fetal Alcohol Effects. These effects last a lifetime for the infant and for their families.
IMPORTANCE OF DIAGNOSIS
FAS/FAE may have clear-cut signs that are very easily diagnosed. When symptoms are mild, a child is often overlooked and early intervention does not take place. This can lead to early school failure, whether it is due to attention deficit or hyperactivity, poor vision, hearing, inability to think clearly or other factors. Early diagnosis gives the individual every opportunity to function at an optimal level.
WHERE CAN I GET HELP IF I THINK MY CHILD HAS FAS/FAE?
There are a number of agencies that can help evaluate your child. Talk to your physician or midwife if you have one. Other suggestions might include your county health department, a nurse or a social worker. The National Organization on Fetal Alcohol Syndrome with support from The Centers for Disease Control provides a directory of treatment centers, prevention programs and support groups nationwide.
