Pediatric Fetal Alcohol Syndrome and Other Teratogens

What is fetal alcohol syndrome (FAS)?

Fetal alcohol syndrome (FAS) is a group of abnormalities in babies born to mothers who consume alcohol during pregnancy. It is the most common known non-genetic (non-inherited) cause of mental disabilities in the United States. According to the Centers for Disease Control and Prevention (CDC), between 1,200 and 8,8,00 babies are born with FAS each year. Even more are born with alcohol-related neurodevelopmental disorder (ARND).

Fetal alcohol syndrome includes a characteristic group of defects including small head and brain, facial abnormalities, and defects of other organs. Infants with FAS also have neurodevelopmental abnormalities including impaired fine motor skills, abnormal walking, neurosensory hearing loss, and poor eye-hand coordination.

What causes fetal alcohol syndrome?

Many drugs can pass from the mother's blood stream through the placenta to the fetus. Alcohol is no exception. Alcohol is broken down more slowly in the immature body of the fetus than in an adult's body. This can cause the alcohol levels to remain high and stay in the baby's body longer.

The full picture of FAS usually occurs in babies born to mothers who have an alcohol problem, or those who drink regularly or binge-drink. However, no amount of alcohol is safe. Even light or moderate drinking can affect the developing fetus.

Why is fetal alcohol syndrome a concern?

Alcohol use in pregnancy has significant effects on the fetus and the baby. Dependence and addiction to alcohol in the mother also cause the fetus to become addicted. At birth, the baby's dependence on alcohol continues. But since the alcohol is no longer available, the baby's central nervous system becomes overstimulated causing the symptoms of withdrawal. Alcohol withdrawal may begin within a few hours after birth and symptoms may last up to 18 months.

In addition to the acute effects of withdrawal, babies often suffer the teratogenic (causing abnormalities in formation) effects of alcohol. Specific deformities of the head and face, heart defects, and mental disabilities are seen with fetal alcohol syndrome (FAS).

What are the symptoms of fetal alcohol syndrome?

The following are the most common symptoms of FAS. However, each baby may experience symptoms differently. Symptoms may include:

• small head, small jaw, and small, flat cheeks
• malformed ears
• small eyes, poor development of optic nerve
• crossed-eyes
• upturned nose, low bridge
• small upper mouth structure and teeth
• caved-in chest wall
• umbilical or diaphragmatic hernia
• limited movement of finders and elbows
• extra fingers, abnormal palm creases
• excessive hair
• undergrown nails
• incomplete or lack of development of brain structures
• heart murmurs, heart defects, abnormalities of large vessels
• incomplete development of genitalia
• growth, motor, and mental disabilities     
• irritability in infancy and hyperactivity in childhood
• poor coordination

The symptoms of FAS may resemble other medical conditions or problems. Consult a physician for a diagnosis.

How is fetal alcohol syndrome diagnosed?

Most often, FAS is diagnosed based on the mother's history and the appearance of the baby, based on a physician examination by a physician.

Treatment for fetal alcohol syndrome:

The US Food and Drug Administration (FDA) has designated specific drugs for treating the symptoms of withdrawal from alcohol in babies. However, there is no treatment for life-long birth defects and disabilities. Babies and children with alcohol-related damage often need developmental follow-up and, possibly, long-term treatment and care.

Prevention of fetal alcohol syndrome:

Fetal alcohol syndrome is 100 percent preventable. However, it requires that a mother stop using alcohol before becoming pregnant. Because no amount of alcohol is proven safe, women should stop drinking immediately if pregnancy is suspected.