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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia [Internet].

Fetal alcohol syndrome

Alcohol in pregnancy; Alcohol-related birth defects; Fetal alcohol effects; FAS

Last reviewed: August 30, 2014.

Fetal alcohol syndrome is growth, mental, and physical problems that may occur in a baby when a mother drinks alcohol during pregnancy.

Causes

Using alcohol during pregnancy can cause the same risks as using alcohol in general. But it poses extra risks to the unborn baby. When a pregnant woman drinks alcohol, it easily passes across the placenta to the fetus. Because of this, drinking alcohol can harm the baby's development.

A pregnant woman who drinks any amount of alcohol is at risk for having a child with fetal alcohol syndrome. There is no "safe" level of alcohol use during pregnancy. Larger amounts of alcohol appear to increase the problems. Binge drinking is more harmful than drinking small amounts of alcohol.

Timing of alcohol use during pregnancy is also important. Drinking alcohol is likely most harmful during the first 3 months of pregnancy. But drinking alcohol any time during pregnancy can be harmful.

Symptoms

A baby with fetal alcohol syndrome may have the following symptoms:

  • Poor growth while the baby is in the womb and after birth
  • Decreased muscle tone and poor coordination
  • Delayed development and problems in three or more major areas: thinking, speech, movement, or social skills
  • Problems with the face, including narrow and small eyes with large epicanthal folds, small head, small upper jaw, smooth groove in upper lip, and smooth and thin upper lip

Exams and Tests

A physical exam of the baby may show a heart murmur or other heart problems. As the baby grows, there may be signs of delayed mental development. There also may be problems with the face and bones.

Tests include:

  • Blood alcohol level in pregnant women who show signs of being drunk (intoxicated)
  • Brain imaging studies (CT or MRI) after the child is born

Treatment

Women who are pregnant or who are trying to get pregnant should not drink any amount of alcohol. Pregnant women with alcohol use disorder should join a rehabilitation program and be checked closely by a health care provider throughout pregnancy.

Support Groups

The following organizations may offer assistance:

  • National Council on Alcoholism and Drug Dependency | www.ncadd.org
  • SAMHSA National Helpline | 1-800-662-4357

The following organizations are good resources for information on alcoholism:

Outlook (Prognosis)

The outcome for infants with fetal alcohol syndrome varies. Almost none of these babies have normal brain development.

Infants and children with fetal alcohol syndrome have many different problems, which can be difficult to manage. Children do best if they are diagnosed early and referred to a team of health care providers who can work on educational and behavioral strategies that fit the child's needs.

When to Contact a Medical Professional

Call for an appointment with your health care provider if you are drinking alcohol regularly or heavily, and are finding it difficult to cut back or stop. Also, call if you are drinking alcohol in any amount while you are pregnant or trying to get pregnant.

Prevention

Avoiding alcohol during pregnancy prevents fetal alcohol syndrome. Counseling can help women who have already had a child with fetal alcohol syndrome.

Sexually active women who drink heavily should use birth control and control their drinking behaviors, or stop using alcohol before trying to get pregnant.

 

References

  1. Carlo WA. Fetal alcohol syndrome. In: Kliegman RM, Stanton BF, St. Geme JW III, et al., eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 100.2.
  2. Cunningham FG, Leveno KJ, Bloom SL, et al. Teratology and medications that affect the fetus. In: Cunningham FG, Leveno KJ, Bloom SL, et al, eds. Williams Obstetrics. 23rd ed. New York, NY: McGraw-Hill; 2010:chap 14.
  3. Wallen LD, Gleason CA. Perinatal substance abuse. In: Gleason CA, Devaskar SU, eds. Avery's Diseases of the Newborn. 9th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 12.

Review Date: 8/30/2014.

Reviewed by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • Psychosocial interventions for women enrolled in alcohol treatment during pregnancyPsychosocial interventions for women enrolled in alcohol treatment during pregnancy
    Pregnancy can be seen as a window of opportunity where women may seek treatment for their addictions out of concern for their unborn child. Worldwide estimates of alcohol usage report that a large proportion of women continue to drink during their pregnancy. Light alcohol consumption has not been associated with adverse effects on a woman's baby, while excessive consumption of alcohol has been shown to cause a number of birth defects as well as foetal alcohol syndrome. Alcohol consumption during pregnancy is the most widely recognized cause of severe mental and developmental delay in the baby. Therefore pregnancy is an important point in time to treat women for their alcohol dependence. This review sought to find all trials which compared any psychosocial intervention to other treatment or no treatment for pregnant or postpartum women in alcohol treatment. No articles were found which fit our inclusion criteria; most trials assessed psychosocial interventions to reduce alcohol consumption in pregnant or reproductive age women, not pregnant or post‐partum women in alcohol treatment. We defined alcohol treatment as when the authors stated the women were in alcohol treatment or any validated psychosocial intervention for the treatment of alcohol dependence. Control trials need to be performed on this population of women to determine the most effective therapy for pregnant women seeking treatment for their alcohol dependence.
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