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Fetal Alcohol Syndrome

Fetal alcohol syndrome (FAS) is a pattern of physical and mental defects that can develop in a fetus in association with high levels of alcohol consumption during pregnancy.

PubMed Health Glossary
(Source: Wikipedia)

About the Effect of Alcohol on the Fetus

Alcohol can disrupt fetal development at any stage during a pregnancy — including at the earliest stages and before a woman knows she is pregnant. Research shows that binge drinking, which means consuming four or more drinks per occasion, and regular heavy drinking put a fetus at the greatest risk for severe problems.

Drinking during pregnancy can cause brain damage, leading to a range of developmental, cognitive, and behavioral problems, which can appear at any time during childhood. Fetal Alcohol Spectrum Disorders (FASD) is the umbrella term for the different diagnoses, which include Fetal Alcohol Syndrome, partial Fetal Alcohol Syndrome, Alcohol-related neurodevelopmental disorder, and Alcohol-related birth defects.

People with FASD often have difficulty in the following areas:

  • Coordination
  • Emotional control
  • School work
  • Socialization
  • Holding a job

In addition, they often make bad decisions, repeat the same mistakes, trust the wrong people, and do not understand the consequences of their actions. NIH - National Institute on Alcohol Abuse and Alcoholism

What works? Research summarized

Evidence reviews

Hypertension in Pregnancy: The Management of Hypertensive Disorders During Pregnancy

This clinical guideline concerns the management of hypertensive disorders in pregnancy and their complications from preconception to the postnatal period. For the purpose of this guideline, ‘pregnancy’ includes the antenatal, intrapartum and postpartum (6 weeks after birth) periods. The guideline has been developed with the aim of providing guidance in the following areas: information and advice for women who have chronic hypertension and are pregnant or planning to become pregnant; information and advice for women who are pregnant and at increased risk of developing hypertensive disorders of pregnancy; management of pregnancy with chronic hypertension; management of pregnancy in women with gestational hypertension; management of pregnancy for women with pre-eclampsia before admission to critical care level 2 setting; management of pre-eclampsia and its complications in a critical care setting; information, advice and support for women and healthcare professionals after discharge to primary care following a pregnancy complicated by hypertension; care of the fetus during pregnancy complicated by a hypertensive disorder.

Alcohol Use Disorders: Diagnosis and Clinical Management of Alcohol-Related Physical Complications [Internet]

Alcohol is the most widely used psychotropic drug in the industrialised world; it has been used for thousands of years as a social lubricant and anxiolytic. In the UK, it is estimated that 24% of adult men and 13% of adult women drink in a hazardous or harmful way. Levels of hazardous and harmful drinking are lowest in the central and eastern regions of England (21–24% of men and 10–14% of women). They are highest in the north (26–28% of men, 16–18% of women). Hazardous and harmful drinking are commonly encountered amongst hospital attendees; 12% of emergency department attendances are directly related to alcohol whilst 20% of patients admitted to hospital for illnesses unrelated to alcohol are drinking at potentially hazardous levels. Continued hazardous and harmful drinking can result in dependence and tolerance with the consequence that an abrupt reduction in intake might result in development of a withdrawal syndrome. In addition, persistent drinking at hazardous and harmful levels can also result in damage to almost every organ or system of the body. Alcohol-attributable conditions include liver damage, pancreatitis and the Wernicke’s encephalopathy. Key areas in the investigation and management of these conditions are covered in this guideline.

Alcohol-Use Disorders: Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence

This clinical guideline on alcohol-use disorders was commissioned by NICE and developed by the National Collaborating Centre for Mental Health, and sets out the evidence for the treatment and management of harmful drinking and alcohol dependence in adults and in young people aged 10 to 17 years.

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Summaries for consumers

Psychosocial 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.

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.

Maintenance treatments for opiate‐dependent pregnant women

Some women continue to use opiates when they are pregnant, yet heroin readily crosses the placenta. Opiate‐dependent women experience a six‐fold increase in maternal obstetric complications and give birth to low‐weight babies. The newborn may experience narcotic withdrawal (neonatal abstinence syndrome) and have development problems. There is also increased neonatal mortality and a 74‐fold increase in the risk of sudden infant death syndrome. Maintenance treatment with methadone provides a steady concentration of opiate in the pregnant woman's blood and so prevents the adverse effects on the fetus of repeated withdrawals. Buprenorphine is also used. These treatments reduce illicit drug use, improve compliance with obstetric care and improve neonatal birth weight but they are still associated with neonatal abstinence syndrome.

More about Fetal Alcohol Syndrome

Photo of a pregnant woman

Also called: Foetal alcohol syndrome, FAS

Other terms to know:
Neurodevelopmental Disorder

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