Fetal Alcohol Syndrome

General Illness Information

Medical Term:
FETAL ALCOHOL SYNDROME

Common Name: None Specified

Description: Fetal alcohol syndrome (FAS) is a condition that affects some infants born to mothers who drank alcohol during pregnancy.

FAS is the leading cause of mental retardation in the Western world and has a worldwide incidence of 1.9 in 1000 live births.

Fetal alcohol syndrome occurs in all racial groups according to alcohol abusing mothers.

Approximately one third to one half of mothers  who drink heavily  during pregnancy have babies with FAS.

Causes: Alcohol consumption during pregnancy can cause birth defects, especially if the mother consumes large amounts of alcohol or drinks in binges. Although only 30 to 40% of the women who drink heavily have babies with the full fetal alcohol syndrome, other studies have shown that children born to mothers who drink socially (one to two drinks per day or occasionally five drinks are a time) are at increased risk for learning disabilities and other cognitive problems. This suggests that there is no safe level of alcohol consumption during pregnancy.

Prevention: Fetal alcohol syndrome can be prevented by abstaining from drinking alcohol during pregnancy. There is no safe amount of alcohol that can be consumed by expectant mothers.

Signs & Symptoms

FAS exhibits a specific pattern of malformation seen only in babies of women who consume alcohol during their pregnancy. Severity of these defects are proportional to the amount of alcohol consumed during pregnancy. Fetal alcohol effects (FAE) are characterized by less severe physical effects than seen in FAS.

Growth deficiency- low weight and short length at birth and continuing during childhood.

A characteristic pattern of facial features- abnormal smallness of the head (microcephaly), flat and elongated mid-face, the indentation in the middle of the upper lip is diminished or absent and some eye abnormalities.

Skeletal abnormalities- scoliosis (abnormal curvature of the spine), pectus excavatum (depression in the chest wall), congenital hip dislocation, altered palmar crease and short fifth finger.

Heart abnormalities in 30 to 40% of FAS babies.

Central nervous system dysfunction- manifested as microcephaly and/or neurobehavioral dysfunction (e.g. hyperactivity, motor problems, attention deficits, cognitive disabilities).

Intellectual/ academic- average IQ is about 65 ( there is a wide range of IQ scores from low average to mild to moderate retardation). Average reading level is fourth grade; average spelling level is third grade; average math level is grade two.

Behavioral\ CNS dysfunction- presents as follows:

Infancy:  Tremulousness, irritability, feeding difficulties (weak suck), failure to thrive, and development delays

Preschool:  hyperactive, alert, outgoing, excessively friendly, increased need for body contact, lacks richness of speech, thought, and grammatical complexity, problems with coordination.

Early school age:  increasing difficulty with math, (reading and writing may be equal to other children), attention deficit disorder (ADD), emotional liability, social intrusiveness,  and hostility and destructiveness. 

Middle school age and adolescence:  poor attention, good verbal skills (often masks seriousness of the situation), decreased motivation and attendance, problems with abstract learning, memory difficulties, lack of social inhibition, and increase risk of sexual abuse and pregnancy.   

Risk Factors

 Alcohol consumption during pregnancy.

Diagnosis & Treatment

Diagnosis is based on history and clinical findings. Clinical findings are as mentioned  under signs and symptoms.
There are no specific laboratory tests for diagnosing fetal alcohol syndrome. However, psychological and neurological tests may be helpful to determine the extent of neurological dysfunction.

Other causes of failure to thrive must be ruled out.

Accurate and early diagnosis of FAS is essential for optimal treatment.

General Measures:

Early intervention for special education needs- such as infant stimulation programs, preschool language programs and vocational training.

Compete periodic physical examinations for follow- up of associated birth defects.

Complete psychological testing  including professional intervention for depression, drug abuse, and behavior management.

Counseling- individual, family and group.

Increased adolescent services due to difficulties with onset of puberty.

Caregiver considerations: education concerning FAS,  arrangement for respite care, access to local support groups and agencies and counseling.

Appropriate alcohol- abuse treatment if caregiver is the birth mother, including counseling to reduce maternal guilt.

Medications:

May need medication for treatment of ADD.

Activity:

No restrictions.

Diet:

No special diet.

Possible Complications :

Failure to thrive.

Alcohol and substance abuse.

Increased risk of sexual abuse and pregnancy.

Depression.

Point #

Prognosis

With early diagnosis and early intervention , these individual can attain their maximal potential and can lead productive lives.

Other

 ‘Nothing Specified’.

   

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