Fetal alcohol syndrome

Causes and Risks:

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. 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.

The incidence of fetal alcohol syndrome varies from 1 out of 1,500 to 1 out of 600 live births. This wide range is related to differences in drinking practices. 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, increasing amounts appear to cause increased problems in a linear fashion. Multiple birth defects associated with "classical" fetal alcohol syndrome more commonly are 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, upturned 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.



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.

Symptoms:

Consumption of alcohol by a pregnant woman may be the first indicator of potential fetal alcohol syndrome.

Others:



Signs and Tests:
Examination of the baby may show a heart murmur or other evidence of cardiac anomalies. As the baby grows, there may be evidence of delayed mental development.

Tests include:



Treatment:

Women trying to conceive and pregnant women 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.

Support groups can benefit the woman by providing interaction with members who share common experiences and problems. For this condition, see alcoholism - support group .

For free information on how to stop drinking contact:

  • The National Alcohol Abuse Hotline at 1-800-662-HELP
  • The National Council on Alcoholism at 1-800-NCA-CALL

Sedatives may be given to the newborn to combat the effects of withdrawal.

Prognosis:

Outcome for infants with fetal alcohol syndrome is considered to be poor.

The problems of the infant and child with fetal alcohol syndrome are diverse and difficult to manage. Cardiac defects may necessitate surgery.
There is no effective therapy for the mental retardation.

Complications:

Alcohol consumption during pregnancy may result in:

  • miscarriage or stillbirth
  • premature delivery
  • a mentally retarded baby
  • a baby who is small for gestational age
  • a baby who may die in infancy
  • a baby with a small head and defects, or malformations of the eyes, nose, or mouth
  • a baby with malformation of the heart or other vital organ
  • a baby with slow growth and poor coordination
  • a restless , overactive baby that may later exhibit hyperactive behavior and learning disabilities



Call Your Healthcare Provider:

Call for an appointment with your health care provider if you are drinking alcohol regularly or heavily and are finding it difficult to cut back or stop, or if you are drinking alcohol in any quantity while pregnant or contemplating becoming pregnant.


This is an illustration of the different landmarks of the face. These landmarks may be referred to when answering questions in the Symptom Analysis section.