Fas Fetal Alcohol Syndrome

Overview, Causes, & Risk Factors

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. Fetal alcohol effects, or FAE, is the term for a condition in which the baby has symptoms of FAS, but they are less severe. Alcohol-related neurodevelopmental disorder, or ARND, refers to children who exhibit only the behavioral and emotional problems of FAS. They don’t show any developmental delay or growth problems.

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 can’t eliminate the alcohol as well as the mother can. Because of this, the fetus 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 broad range of defects. The severity of the disorder also can vary widely. Physical problems can range from many defects to none. communication\ \education, including reading, writing, and basic math\ \motor function\ \personal care, such as bathing, dressing, eating, and toileting\ \social skills\ \thinking skills, such as decision making, problem solving, and self-direction\ \working\Mental retardation can vary from severe disability to subtle learning problems. How the fetus is affected depends on when in 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 not known.

Symptoms & Signs

What are the signs and symptoms of the condition?

Following are some of the classic effects of FAS:

  • abnormalities of the face, including a poorly developed jaw and upper lip and a flattened bridge of the nose
  • behavioral problems, such as a short attention span and hyperactivity
  • developmental delays or communication\ \education, including reading, writing, and basic math\ \motor function\ \personal care, such as bathing, dressing, eating, and toileting\ \social skills\ \thinking skills, such as decision making, problem solving, and self-direction\ \working\mental retardation
  • epilepsy, or seizures
  • failure to thrive, or delayed physical growth
  • learning difficulties, such as difficulties understanding certain problem solving concepts
  • low birth weight and small head circumference
  • minor malformations of the arms and legs
  • organ defects, including congenital heart disease that may require surgery
  • poor coordination and fine motor skills
  • poor memory
  • poor socialization skills and lack of imagination
  • Diagnosis & Tests

    How is the condition diagnosed?

    Diagnosis of FAS begins with a medical history and physical exam. The diagnosis is based on defects in three areas. These are growth, physical development, and mental development. To make the diagnosis, defects in all three areas have to be noted.

    A thorough diagnostic procedure is important. This is best done by a doctor familiar with the disorder. An FAS team at a children’s hospital can help with the diagnosis as well.

    Prevention & Expectations

    What can be done to prevent the condition?

    Fetal alcohol syndrome is preventable. A woman should avoid alcohol during pregnancy. She should also avoid alcohol if she is trying to get pregnant. 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, the fetus’s brain continues to develop throughout pregnancy. This development can be disrupted by alcohol at any stage.

    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. communication\ \education, including reading, writing, and basic math\ \motor function\ \personal care, such as bathing, dressing, eating, and toileting\ \social skills\ \thinking skills, such as decision making, problem solving, and self-direction\ \working\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.

    Treatment & Monitoring

    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 communication\ \education, including reading, writing, and basic math\ \motor function\ \personal care, such as bathing, dressing, eating, and toileting\ \social skills\ \thinking skills, such as decision making, problem solving, and self-direction\ \working\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.

    Article type: xmedgeneral