Fetal alcohol syndrome

Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a person whose mother drank alcohol during pregnancy. Problems may include an abnormal appearance, short height, low body weight, small head size, poor coordination, low intelligence, behavior problems, and problems with hearing or seeing. Those affected are more likely to have trouble in school, legal problems, participate in high-risk behaviors, and have trouble with alcohol or other drugs. The most severe form of the condition is known as fetal alcohol syndrome (FAS). Other types include partial fetal alcohol syndrome (pFAS), alcohol-related neurodevelopmental disorder (ARND) and alcohol-related birth defects (ARBD). Some accept only FAS as a diagnosis, seeing the evidence as inconclusive with respect to other types. Fetal alcohol spectrum disorders are caused by drinking alcohol during pregnancy. Surveys from the United States have found about 10% of pregnant women have drunk alcohol in the last month, and 20% to 30% drank at some point during the pregnancy. About 4.7% of North American women who are pregnant are alcoholics. The risk of problems depends on the amount consumed and the frequency of consumption as well as when during pregnancy the alcohol is consumed. Other risk factors include an older mother, smoking, and poor diet. There is no known safe amount or safe time to drink during pregnancy. While drinking small amounts of alcohol does not cause abnormalities in the face, it may cause behavioral issues. Alcohol crosses the blood brain barrier and both directly and indirectly affects a developing baby. Diagnosis is based on signs and symptoms in the person. Fetal alcohol spectrum disorders are preventable by avoiding alcohol. For this reason, medical authorities recommend no alcohol during pregnancy or while trying to become pregnant. While the condition is permanent, treatment can improve outcomes. Interventions may include parent-child interaction therapy, efforts to modify child behavior, and possibly medications. FASD is estimated to affect between 2% and 5% of people in the United States and Western Europe. FAS is believed to occur in between 0.2 and 9 per 1000 live births in the United States. In South Africa, some populations have rates as high as 9%. The negative effects of alcohol during pregnancy have been described since ancient times. The lifetime cost per child with FAS was $2,000,000 in 2002 in the US. The term fetal alcohol syndrome was first used in 1973. FASDs encompass a range of physical and neurodevelopmental problems that can result from prenatal alcohol exposure. The most severe condition is called fetal alcohol syndrome (FAS), which refers to individuals who have a specific set of birth defects and neurodevelopmental disorders characteristic of the diagnosis. Some accept only FAS as a diagnosis, seeing the evidence as inconclusive with respect to other types. Partial fetal alcohol syndrome (pFAS) refers to individuals with a known, or highly suspected, history of prenatal alcohol exposure who have alcohol-related physical and neurodevelopmental deficits that do not meet the full criteria for FAS. The subtypes of pFAS are alcohol-related neurodevelopmental disorder (ARND) and alcohol-related birth defects (ARBD). In addition to FAS, pFAS, ARND, and ARBD, any other conditions believed to be related to prenatal alcohol exposure, such as spontaneous abortion and sudden infant death syndrome (SIDS), are also considered to be on the spectrum of related disorders. It is unclear as of 2017 if identifying a FASD-related conditions benefits the individual. The key of FASD can vary between individuals exposed to alcohol during pregnancy. While consensus exists for the definition and diagnosis of FAS, minor variations among the systems lead to differences in definitions and diagnostic cut-off criteria for other diagnoses across the FASD continuum. The central nervous system damage criteria particularly lack clear consensus. A working knowledge of the key features is helpful in understanding FASD diagnoses and conditions, and each is reviewed with attention to similarities and differences across the four diagnostic systems. More than 400 problems, however, can occur with FASD. In terms of FASD, growth deficiency is defined as significantly below average height, weight or both due to prenatal alcohol exposure, and can be assessed at any point in the lifespan. Growth measurements must be adjusted for parental height, gestational age (for a premature infant), and other postnatal insults (e.g., poor nutrition), although birth height and weight are the preferred measurements. Deficiencies are documented when height or weight falls at or below the 10th percentile of standardized growth charts appropriate to the population. Prenatal or postnatal presentation of growth deficits can occur, but are most often postnatal.