Fetal Alcohol Syndrome

Fetal Alcohol Syndrome

Fetal Alcohol Syndrome (FAS) was found, named and treated in the late 1960's. The term "Fetal Alcohol Syndrome" is used to describe a lifelong set of physical, mental and neurobehavioral birth defects associated with alcohol consumption during pregnancy.

Most women are not aware of the many complications that can occur during pregnancy. Many pregnant women continue drinking right throughout their pregnancy, ignoring the fact that they could damage, and pose problems to themselves and well as there fetus. According to many physicians FAS is a leading cause of mental retardation and birth defects. In the United States, one in 500 children reported are diagnosed with FAS. On the Indian reservations the numbers are much higher, they are one in 99 children. Approximately one-half of the cases of Fetal Alcohol Syndrome go unrecognized. FAS affects more newborns every year than Down syndrome, cystic fibrosis, spina bifida, and Sudden Infant Death Syndrome combined. This completely preventable birth defect is found in all ethnic groups and socioeconomic classes around the world, however it does occur 30 times more in Native Americans than it does in whites, and is six times more common in blacks.

Alcohol is a teratogen, a substance capable of producing fetal abnormalities. When a pregnant woman drinks, so does her baby; through the blood vessels in the placenta, the mother's blood supplies the developing baby with nourishment and oxygen. In the fetus, the metabolism of alcohol is immature and very slow. While the mother is drinking, the levels continue to build and will remain high for long periods. Binge drinking is more harmful to the fetus because the high alcohol levels are reached rapidly and remain high. Periodic alcohol consumption keeps the blood alcohol levels low in the mother and gives the fetus time to metabolize some of the alcohol. Alcohol produces more significant neurobehavioral effects in the fetus than other drugs, including cocaine, heroin and marijuana.

Fetal Alcohol Syndrome consists of characteristic patterns of abnormalities resulting from the exposure that the fetus has had with alcohol during early development. Children with FAS have a range of problems and are not easy to care for. They are born with a compilation of disorders that affect their life and the lives of people whom they come in contact with. Many of these children end up in foster care being shuttled back and forth between families, due to behavioral and physical problems, some of which are;

Ð'* Deficiency in growth

Ð'* Patterns of malformation affecting the face, heart and urinary tract

Ð'* Central nervous system dysfunction

Ð'* Mental retardation

Ð'* Neurological deficits (poor motor skills and hand-eye coordination)

Ð'* Complex pattern of behavioral and learning problems (difficulties with memory, attention and judgment)

Many factors play a role in the development of FAS in an infant. The most prominent among these are the frequency and the quantity of alcohol consumption during the pregnancy. The timing of the gestation of alcohol is what determines the level of abnormalities that occur. If the mother drank during the first trimester, more physical anomalies are present and if during the third trimester, growth deficiency is noticed. Drinking during any and/or all trimesters will result in a lower IQ. The average IQ is 63 in a child with FAS. Each child with FAS is affected differently. These children can have either low birth weights or normal birth weights with slow postnatal growth. They range below the third percentile in height, weight, and head circumference through adolescence and will not be able to catch up in growth. Many studies have found that if the amount of alcohol consumed is reduced or stopped during the third trimester, the growth is improved.

When diagnosing there are specifics doctors look for in treating a patient for FAS. First, the eyes are the most common sign of FAS, the eyelids especially. Children often appear to have widely spaced eyes and small eye openings. The next common facial defect is slow growth in the center of the face. This produces an underdeveloped mid-face and the area between the eye and the mouth may seem to be flattened and the nose is often very low and tends to point forward and downward. While these anomalies make an FAS child very recognizable, the child is not grossly malformed and the anomalies become less pronounced as the child matures. While the face abnormalities are very obvious the orthopedic anomalies are common. Some examples are:

Ð'* spina bifida

Ð'* club foot

Ð'* congenital hip dislocation

Ð'* delayed skeletal maturation

Ð'* small joints of the hands

Ð'* incomplete rotation at the elbow

Ð'* small fifth fingernail

About 50% of FAS children will have genital and renal malformations, and 29-41% have cardiac anomalies. Microencephaly (small brain size) occurs in 80% of affected children. Anencephaly (born with no brain) occurs more frequently with FAS than in the normal population. Another factor affected in performance is fine motor dysfunction, which is manifested by weak grasp, poor hand/eye coordination, and/or tremulousness, irritability in infancy, and hyperactivity in childhood. Behavior and social problems are common and will persist throughout life. Finally, Cardiac abnormalities include, heart murmurs and ventricular septal defect. Dental, oral, vision and hearing disorders also occur frequently.