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

A.D.A.M. Medical Encyclopedia.

Fetal alcohol syndrome

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

Last reviewed: August 8, 2012.

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

Causes, incidence, and risk factors

Using or abusing alcohol during pregnancy can cause the same risks as using alcohol in general. However, 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. No "safe" level of alcohol use during pregnancy has been established. 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. Alcohol use appears to be the most harmful during the first 3 months of pregnancy; however, 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, small eyes with large epicanthal folds
    • Small head
    • Small upper jaw
    • Smooth groove in upper lip
    • Smooth and thin upper lip

Signs 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 avoid drinking any amount of alcohol. Pregnant women with alcoholism should join an alcohol abuse 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
  • National Drug and Alcohol Treatment Referral Routing Service -- 1-800-662-4357

The following organizations are good resources for information on alcoholism:

Expectations (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.

Complications

Drinking alcohol during pregnancy may result in:

Complications seen in the infant may include:

  • Abnormal heart structure
  • Behavior problems
  • Infant death
  • Intellectual disability
  • Problems in the structure of the head, eyes, nose, or mouth
  • Poor growth before birth
  • Slow growth and poor coordination after birth

Calling your health care provider

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, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007: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.

Review Date: 8/8/2012.

Reviewed by: A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, and David R. Eltz. Previously reviewed by Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine (8/15/2011).

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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?

  • Pharmacologic interventions for pregnant women enrolled in alcohol treatment programs
    Drinking alcohol during pregnancy is common. Yet no safe level of alcohol consumption is known, with no conclusive evidence on any adverse effects on the unborn child with low levels of alcohol. During pregnancy, more than two units per day or more than four units per drinking session may increase the risk of miscarriage, reduce growth, and impair mental development of the baby. Foetal alcohol syndrome is evident as neurological abnormalities, mental retardation, varying degrees of psychosocial and behavioural problems and characteristic facial dysmorphology that are apparent in adolescents and adults. In some populations alcohol use during pregnancy leads to increased child abuse and neglect or compromised mother‐infant attachment and responsiveness. Mothers who consume alcohol are more likely to have post‐natal depression and are less likely to attend health facilities for education and medical treatment.
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