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Fetal Alcohol
Syndrome (FAS)

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Fetal alcohol syndrome (FAS) refers to growth, mental, and physical problems that may occur in a baby when a woman consumes alcohol during pregnancy. The amount of alcohol ingested during pregnancy to cause FAS is still unknown, but women are advised to avoid alcohol and drug abuse during pregnancy. In the body, alcohol crosses the placental barrier, possibly stunting fetal growth or weight, creating distinctive facial stigmata, damaging neurons and brain structures, and causing other physical, mental, or behavioral problems.

Health Effects of FAS

The main effect of FAS is permanent central nervous system damage, especially to the brain. Prenatal alcohol exposure creates a range of primary cognitive functional disabilities, including poor memory, attention deficits, impulsive behavior, and poor cause-effect reason, as well as secondary disabilities, such as mental health problems and drug addiction. These stem from underdeveloped or malformed brain cells.

Symptoms of FAS Include:

  • Growth deficiency – defined as significantly below average height, weight or both due to prenatal alcohol exposure
  • Central nervous system damage, which is the primary feature of any FAS diagnosis. CNS damage can be assessed in three areas: structural, neurological, and functional impairments
  • Structural abnormalities may include microcephaly (small head size) of two or more standard deviations below the average, or other abnormalities in brain structure
  • Neurological impairments which causes general neurological damage to the central nervous system and the peripheral nervous system. These problems are expressed as diagnosable disorders such as epilepsy or other seizure disorders, or nonspecific neurological impairments, such as impaired fine motor skills, neurosensory hearing loss, poor gait, clumsiness, poor eye-hand coordination
  • Facial features: several characteristic craniofacial abnormalities. The three FAS facial features are:
    • A smooth philtrum – The divot or groove between the nose and upper lip flattens with increased prenatal alcohol exposure.
    • Thin vermilion – The upper lip thins with increased prenatal alcohol exposure.
    • Small palpebral fissures – Eye width decreased with increased prenatal alcohol exposure.
  • Functional impairments are deficits, problems, delays, or abnormalities due to prenatal alcohol exposure, rather than hereditary causes or postnatal insults, which are observed in daily functioning, often referred to as developmental disabilities

Diagnosis of Fetal Alcohol Syndrome

The following criteria qualify FAS diagnosis:

  • Growth deficiency-Prenatal or postnatal height or weight (or both) at or below the 10th percentile
  • FAS facial features- all three FAS facial features present
  • Central nervous system damage- Clinically significant structural, neurological, or functional impairment
  • Prenatal alcohol exposure- confirmed or unknown prenatal alcohol exposure

Risk Levels for Fetal Alcohol Syndrome

The “4-Digit Diagnostic Code” distinguishes confirmed exposure as High Risk and Some Risk:

  • High Risk – Confirmed use of alcohol during pregnancy known to be at high blood alcohol levels delivered at least weekly in early pregnancy
  • Some Risk – Confirmed use of alcohol during pregnancy with use less than High Risk or unknown usage patterns
  • Unknown Risk – Unknown use of alcohol during pregnancy
  • No Risk – Confirmed absence of prenatal alcohol exposure, which rules out an FAS diagnosis

Prevention and Treatment of Fetal Alcohol Syndrome

The only certain way to prevent FAS is to avoid any drinking of alcohol during pregnancy, or while planning a pregnancy.

There is no cure for FAS due to the damage of permanent disability to the central nervous system. However, due to the range of damage, possible treatment is possible depending on the CNS damage, symptoms, secondary disabilities, and needs.

Fetal Alcohol Syndrome Prognosis

The primary disabilities are the functional difficulties due to the CNS damage. Often times, these disabilities are mistaken as behavioral problem, but the underlying CNS damage is the reason of the functional difficulty.

Some research has shown a correlation between functional problems and brain structures damaged by prenatal alcohol exposure. Examples include:

  • Learning impairments associated with impaired dendrites of the hippocampus
  • Impaired motor development and functioning associated with reduced size of the cerebellum
  • Hyperactivity which is associated with decreased size of the corpus callosum

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