Definition: Fetal alcohol syndrome refers to the signs and symptoms manifested in the fetus due to fetal injury resulting from alcohol consumption by the mother.
Cause
Alcohol consumption by mother. Effects are related to:
- Type of alcohol consumed.
- Quantity of alcohol consumed.
- Maternal age.
- Trimester in which fetus is exposed.
- Other drugs and environmental exposure.
- Threshold dose for mother.
- Pregnancy complications.
- Binge drinking.
- Threshold – 0.5 oz. of absolute alcohol per day is the threshold below which no alcohol related effects occur.
Prevalence
Alcohol use during pregnancy varies but has been reported to be 1 to 2 percent. It is one of the most recognizable causes of mental retardation in United States.
Symptoms: Fetal alcohol syndrome cannot be diagnosed prenatally. The effects of alcohol appear to be biphasic as a linear dose response is observed only once a threshold of six drinks per occasion is met. Women ingesting eight or more drinks daily throughout pregnancy have a 30 to 50 % risk of having a child with all features of fetal alcohol syndrome.
Features include:
- Growth restriction
- Behavioral disturbance
- Brain defects
- Cardiac defects
- Spinal defects
- Craniofacial anomalies
- Absent to hypoplastic philtrum
- Broad upper lip
- Flattened nasal bridge
- Hypoplastic upper lip vermilion
- Micrognathia
- Microphthalmia
- Short nose
- Short palpebral tissues
Diagnosis:
- History of alcohol consumption by mother.
- Ultrasound may help in diagnosis of only some defects like cleft lip or cardiac defects.
- The affected child typically has hyperreactivity and persistent irritability in early years followed by development delay, growth deficiency, a variable degree of mental retardation, hyperactivity, poor coordination and distinctive facial features.
Treatment:
- Early cessation of alcohol consumption results in amelioration of some effects.
- Prenatal exposure should also be avoided as it increases the risk of brain hemorrhage and white matter brain damage in preterm babies.
