Fetal Alcohol Syndrome



Fetal alcohol syndrome is a set of physical, mental, and behavioral problems that may develop in a child whose mother drank alcohol during pregnancy. It is the most common known cause of mental retardation in the United States.

KEYWORDS

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Alcoholism

Obstetrics

Pediatrics

Sarah, Child of Alcohol

Sarah was always very quiet and never caused any trouble in elementary school, but she had few friends and never did fit in. Although she got fair grades, the teachers never knew how difficult the lessons were for her. When Sarah got to high school, however, she stopped trying to learn the lessons that were difficult for her, and she just barely graduated. Sarah had "fetal alcohol effects," which were the result of her mother's drinking during pregnancy.

* syndrome means a group or pattern of symptoms and/or signs that occur together.

A person with fetal alcohol effects (FAE) has some of the symptoms of fetal alcohol syndrome (FAS), but not enough to be diagnosed with the full syndrome * . Many of Sarah's teenage friends outgrew their immaturity, forgetfulness, and learning problems, but Sarah did not. The effects of her mother's drinking while she was pregnant with Sarah continue to follow Sarah throughout her life.

Not everyone with FAS or FAE has been identified, and researchers estimate that one in every 300 to 350 children born may have FAE or FAS. FAE and FAS are not contagious.

What Causes Fetal Alcohol Syndrome?

Alcohol use during pregnancy can cause fetal alcohol syndrome. When a woman drinks alcohol during pregnancy, it can cause a range of effects on the fetus * , from subtle symptoms, such as Sarah had, to full fetal alcohol syndrome. Fetal alcohol syndrome is a grouping of similar characteristics found in affected babies. These characteristics may include low birth weight, distinctive facial features, learning problems, and mental retardation.

Like most drugs, alcohol passes through the mother's placenta * directly into the fetal bloodstream. In the fetus, alcohol slows down the central nervous system and is broken down by the immature liver of the fetus, which cannot handle this poisonous substance effectively. Alcohol stays in the fetus for a long period of time—even after it has left the mother's body.

The more the mother-to-be drinks, the greater the danger to the unborn baby. Women who have three or more alcoholic drinks a day, and women who are binge drinkers (drinking heavily but not every day), are likelier to have children with fetal alcohol syndrome. All types of alcohol can cause damage. The same amount of alcohol is found in one beer, one glass of wine, and one shot of hard liquor like gin, whiskey, or vodka.

* fetus (FEE-tus) is the term for an unborn human offspring during the period after it is an embryo, from 9 weeks after fertilization, until childbirth.

* placenta (pla-SEN-ta) in humans is the organ that unites the fetus to the mother's uterus.

* cleft palate is a gap or split in the roof of the mouth (the palate). It occurs when the palate of a fetus does not develop properly during the first months of pregnancy.

What Happens When Babies Have Fetal Alcohol Syndrome?

Facial characteristics

Babies with fetal alcohol syndrome have a distinctive appearance. Characteristics may include:

  • Small openings for the eyes, which appear widely spaced.
  • Flat cheekbones.
  • Ridges between the nose and upper lip tend to be flatter than usual.
  • 1 Bridge of the nose tends to be low and flat.
  • Upper lip tends to be thinner than usual.
  • Cleft palate * .
  • Epicanthal (ep-i-KAN-thal) folds, which are folds of skin at the inner corner of the eye.
  • Minor abnormalities in the shape and placement of ears.
  • Nose is shorter than usual so the child has an elf-like appearance.

2,500 Years of Warnings About Alcohol and Pregnancy

In 1973, researchers at the University of Washington named the group of symptoms that can result from alcohol use during pregnancy "fetal alcohol syndrome." In 1987, the U.S. Surgeon General said that no known safe level of alcohol use during pregnancy exists. Among those who issued earlier warnings were:

  • The Hebrew Bible and Talmud
  • Plato (c. 428-348 B.C.E.), Greek philosopher
  • Aristotle (384-322 B.C.E.), Greek philosopher
  • Plutarch (c. 46-119), Greek biographer
  • Francis Bacon (1561—1626), English philosopher
  • Dr. William Sullivan, a U.S. doctor who conducted the first scientific study of the fetal effects of alcohol (1899)
  • Taav Laitenen, a Finnish doctor who observed the low birth weight of babies born to mothers who drank alcohol during pregnancy (1910)
  • Dr. Lemoine, a French doctor who described facial features, growth retardation, and central nervous system problems resulting from alcohol use during pregnancy (1968).

Other characteristics

The general characteristics associated with fetal alcohol syndrome include:

  • Premature birth.
  • Low birth weight. Babies with FAS are small at birth and may continue to grow slowly after birth as well.
  • Possible heart defects.
  • Possible skeletal problems or differences in the hands.
  • Misaligned or misshapen teeth.
  • Central nervous system problems, which may include microcephaly (my-kro-SEPH-a-lee) (an abnormally small head) and varying degrees of brain damage.
  • Some children have mental retardation, ranging from mild to severe.
  • Children may have problems concentrating and understanding concepts like time, money, and cause and effect.
  • Children may have difficulty making friends and controlling their impulses. As a result, they may get into trouble at home and at school.

Fetal alcohol effects

Children with fetal alcohol effects may not have the facial and physical characteristics of children with fetal alcohol syndrome, but they do have many of the same behavior and learning problems related to prenatal alcohol exposure.

How Can Fetal Alcohol Syndrome Be Prevented?

Fetal alcohol syndrome is 100 percent preventable. A pregnant woman should not drink at all. Since there is no amount of alcohol that has been proven safe to drink, the best choice for the mother-to-be is not to drink at all.

See also
Alcoholism
Birth Defects
Cleft Palate
Mental Retardation
Prematurity

Resources

Books

Dorris, Michael. The Broken Cord. Demco Media, 1999. A true story about parents who adopt a boy with fetal alcohol syndrome.

Streissguth, Ann, Jonathan Kanter, and Mike Lowry, Eds. The Challenge of Fetal Alcohol Syndrome: Overcoming Secondary Disabilities. Seattle: University of Washington Press, 1997.

Organizations

U.S. National Institute on Alcohol Abuse and Alcoholism (NIAAA), 6000 Executive Boulevard, Suite 409, Bethesda, MD 20892. The NIAAA website posts the fact sheet "When You Are Pregnant, Drinking Can Hurt Your Baby" and provides referrals to other resources.
Telephone 301-443-3860
http://silk.nih.gov/silk/niaaal/publication/brochure.htm

The National Organization on Fetal Alcohol Syndrome, 418 C Street, N.E., Washington, D.C. 20002.
Telephone 800-66-NOFAS
http://www.nofas.org

March of Dimes Defects Foundation, Office of Government Affairs, 1901 L Street N.W., Suite 200, Washington, D.C. 20036.
Telephone 202-659-1800
http://www.modimes.org

Connecticut Clearinghouse, 334 Farmington Avenue, Plainville, CT 06062. Provides resources and referrals to groups dealing with fetal alcohol syndrome.
Telephone 800-232-4424
http://www.ctclearinghouse.org

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