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Medical News Today: Fetal alcohol syndrome: Causes, treatment, and symptoms

Drinking alcohol whilst pregnant.
Drinking alcohol whilst pregnant can affect the development of the fetus, and may potentially cause fetal alcohol syndrome.
Fetal alcohol syndrome is one of several conditions, known as fetal alcohol spectrum disorders (FASDs), that cause a wide range of different physical, behavioral, and learning symptoms.

It can be difficult to determine the exact prevalence of FASDs, but according to the Centers for Disease Control (CDC), “experts estimate that the full range of FASDs in the United States and some Western European countries might number as high as 2 to 5 per 100 school children (or 2% to 5 % of the population).”

Fetal alcohol spectrum disorders are caused by alcohol use during pregnancy; however, the relationship between alcohol, pregnancy, and FASDs is complicated, with researchers unsure about the exact number of drinks needed to cause the disorder.

Fast facts on fetal alcohol syndrome

Here are some key points about fetal alcohol syndrome. More detail and supporting information is in the main article.

  • The FASD spectrum includes several different conditions, each with different signs and symptoms.
  • Not drinking any alcohol during the entire pregnancy is the best way to prevent the development of FASDs.
  • Symptoms are physical, neurological, and behavioral.
  • There is no cure for fetal alcohol syndrome.

What causes fetal alcohol syndrome?

When a pregnant woman drinks alcohol, it passes to the baby through blood flow in the umbilical cord and placenta. Alcohol can cause problems even before a woman knows that she is pregnant. Because a developing baby is much smaller than an adult woman, a baby metabolizes the alcohol much more slowly. The presence of alcohol in baby’s blood can interfere with oxygen and nutrient delivery to the body tissues and can harm their development.

Fetal alcohol spectrum disorders

These conditions include:

  • Alcohol-related neurodevelopmental disorder refers to the behavioral and learning disabilities associated with alcohol use in pregnancy.
  • Alcohol-related birth defects are physical disabilities that can occur with prenatal alcohol exposure.
  • Neurobehavioral disorder associated with prenatal alcohol exposure refers to neurological problems that develop in children who were exposed to alcohol in utero.
  • Partial fetal alcohol syndrome refers to people who have some of the signs and symptoms of fetal alcohol syndrome but do not meet the full criteria for diagnosis.
  • Fetal alcohol syndrome is the most severe condition on the FASD spectrum. People with this condition often have neurological and developmental issues, as well as the physical disabilities associated with alcohol use during pregnancy.

What are the treatments?

Child playing with blocks.
Treatment for FASD may include various types of therapy to help with mental and physical health.

Treatment focuses on controlling symptoms, improving quality of life, and fostering independence. Early intervention programs are essential in reducing some of the effects of FASDs and preventing some of the secondary problems that arise with FASD.

A team approach, including a special education teacher, speech therapist, psychologist, and physical and occupational therapists, is often required to ensure comprehensive care.

Other services that can be effective include:

  • medication to address symptoms
  • services in school to help with learning disabilities and problematic behaviors
  • mental health care
  • medical care for physical health problems
  • training for vocational and life skills
  • family counseling to help parents and other family members
  • alcohol treatment as necessary

It is also important to address the mother’s alcohol problem as early as possible into the pregnancy. A woman who has or suspects that she has a drinking problem should speak with her obstetrician and seek help for alcohol or substance abuse.

Symptoms of FASDs

Fetal alcohol spectrum disorders have many different types of symptoms. Physical signs may include:

  • small eyes
  • thin upper lip
  • upturned nose
  • joint deformities
  • hearing problems
  • poor physical growth
  • heart, kidney, and bone problems

Brain and neurological problems can include:

  • poor coordination or balance
  • learning disorders
  • poor memory
  • hyperactivity or attention problems
  • moodiness
  • poor judgment, decision-making, or problem-solving skills

Behavioral problems can include:

  • poor social skills
  • difficulty with behavior and impulse control
  • poor concept of time
  • difficulty in school or in getting along with others
  • inability to set or work towards goals

Adults with FASDs also suffer from many of these problems, which may cause additional challenges. Many people with FASDs develop mental health disorders and may have problems with the law or with holding down a job. They may struggle with managing money and may be unable to live independently.

The National Organization on Fetal Alcohol Syndrome has a list of resources available to help adults, or their caregivers, who are dealing with this disorder.

How can fetal alcohol syndrome be prevented?

Pregnant woman with tea cup.
It is often suggested that pregnant woman avoid alcohol entirely. It may help to replace habitual drinks with alternatives, such as replacing a glass of wine in the evening with a hot drink instead.

The best method of prevention is abstaining from alcohol during pregnancy.

While one review of studies claimed that occasional, light drinking might be safe, the American College of Obstetricians and Gynecologists (ACOG) is very vocal in its position that women should not drink any amount of alcohol during pregnancy, due to the risk for FASDs.

Women who may be trying to get pregnant should also consider completely abstaining from alcohol to prevent prenatal alcohol exposure.

Though some midwives or obstetricians will suggest the occasional glass of wine at the end of pregnancy to help improve sleep, no one has established how much alcohol is safe for a pregnant woman to drink. The American Academy of Pediatrics (AAP) also advise against any alcohol consumption during pregnancy and note that prenatal alcohol exposure is the most common preventable cause of congenital disabilities and developmental delays in children.

Is fetal alcohol syndrome common?

The Behavioral Risk Factor Surveillance System (BRFSS) is a large, state-based organization that carries out phone surveys of the American population. Between 2011-2013, the BFRSS interviewed over 200,000 women between the ages of 18-44 about their drinking habits. Of these women, 4 percent were pregnant at the time of the interview.

The BRFSS researchers noted several significant findings that were related to alcohol use and pregnancy.

  • 1 in 5 women who were not pregnant reported binge drinking on an average of 3.1 occasions.
  • 1 in 10 pregnant women reported alcohol use.
  • 1 in 33 pregnant women reported binge drinking within the last 30 days, with an average of 4.6 episodes of binge drinking, which is higher than the figure reported by non-pregnant women.

The study highlighted just how common alcohol use during pregnancy is.

Outlook

The outlook for a child or adult with FASD varies according to its severity. Some people have a mild form of this condition and are able to live independently with minimal issues. Other people will never be able to live alone, hold down a job, or care for themself. These disabilities will last a lifetime, as there is no cure or medical treatment for people with this condition. Early initiation of counseling and other therapies can help to improve development and functioning.

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