Fetal Alcohol Syndrome
Fetal alcohol syndrome, or FAS, is a collection of growth and brain development problems in newborns. When the mother drinks alcohol during pregnancy, her baby is at risk for FAS.
What is going on in the body?
When a pregnant woman drinks alcohol, it passes easily through the placenta to her fetus. The developing baby gets a high concentration of alcohol. The fetus cannot eliminate the alcohol as well as the mother can and thus is subject to high alcohol levels for a longer time.
No one knows exactly how much alcohol will cause FAE or FAS. Pregnant women vary in their ability to break down the alcohol. The mother's age, time of drinking, and food ingested with the alcohol all affect the amount passed to the baby.
Alcohol causes a range of defects that vary in type and severity. Physical abnormalities can range from many defects to none. Mental retardation can vary from severe disability to subtle learning problems. How the fetus is affected depends on what part of the pregnancy alcohol use was heaviest. Use early in pregnancy is more likely to cause brain or body malformation. Use late in pregnancy is more likely to affect fetal nutrition and more subtle areas of brain function. These include personality and the ability to learn.
What are the causes and risks of the condition?
Not all women who abuse alcohol during pregnancy have children with FAS. However, the risks are clearly related to the amount of alcohol used during the pregnancy. FAS occurs in 30% to 50% of pregnancies in which the mother drinks heavily throughout the pregnancy. The impact of lesser amounts of alcohol on the fetus is harder to evaluate.
What can be done to prevent the condition?
Fetal alcohol syndrome is preventable. A woman who either is already pregnant, trying to become so, or of childbearing age, sexually active, and not using effective birth control should avoid drinking alcohol altogether.
Because a woman often does not know she is pregnant until she misses a period, damage can be done before the pregnancy is recognized. The toxic effects of alcohol are most severe in the early months of pregnancy. However, because the fetus's brain continues to develop throughout pregnancy, this development can be disrupted by alcohol at any stage.
How is the condition diagnosed?
Diagnosis of FAS begins with a medical history and physical exam. The amount and timing of alcohol consumption during pregnancy must be assessed in a careful interview. The diagnosis of the infant is based on defects in three areas: growth, physical development, and mental development. To establish the diagnosis, defects in all three areas must be noted. A thorough assessment is important, and is best done by a clinician familiar with the disorder. An FAS team at a children's hospital can help with the evaluation.
Long Term Effects
What are the long-term effects of the condition?
There are many long-term effects of FAS on the child and his or her family. The brain effects continue as the child grows. Mental retardation and learning disabilities can affect schoolwork. The most severely affected children may never be able to function independently.
Many children with FAS are unable to plan ahead. They are unable to think about the consequences of their behavior or learn from their mistakes. This defect has an impact on relationships with family and friends.
Major behavioral difficulties are common. These problems are not easily fixed. Other long-term effects include a tendency to get ear infections. This may lead to hearing loss. The movement of joints, particularly the elbows, is sometimes limited as well.
What are the risks to others?
FAS is not contagious and poses no risk to others.
What are the treatments for the condition?
There is no cure for defects caused by FAS. The problems with behavior and mental functioning may be only partly helped by medicines and special education. The child may need open heart surgery soon after birth to repair defects from congenital heart disease. Chronic ear infections may require medicines or insertion of ear tubes. Children with FAS often need long-term medical and educational help.
What are the side effects of the treatments?
Surgery may cause bleeding, infection, or allergic reaction to anesthesia. Children with behavior problems may need to be treated with medicines to control their behavior. These medicines may cause allergic reactions, stomach upset, and stunting of the child's growth.
What happens after treatment for the condition?
Treatment is often needed for long periods of time in affected children. It may never end in those with severe mental retardation or behavior problems. Others may have trouble succeeding in school, at work, or in relationships for the rest of their lives.
How is the condition monitored?
Children with FAS need careful monitoring so that treatment can be started as soon as problems are noticed. This will help to allow the highest level of functioning possible. Other monitoring depends on the specific problems a child has as a result of the mother's alcohol use. Any new or worsening symptoms should be reported to the healthcare provider.