What are the Fetal Alcohol Spectrum Disorders (FASD)?
What are Fetal Alcohol Spectrum Disorders (FASD)?Fetal alcohol spectrum disorders (FASD) present as a range of neurobehavioral and physical changes that can develop during gestation when a fetus is exposed to alcohol while a mother is pregnant. The spectrum can vary from person to person and can depend on the degree of prenatal alcohol exposure.
Recent studies have estimated that one to five percent of first-grade children in the United States are affected with FASD.
Types of Fetal Alcohol Spectrum Disorders
TypesFetal alcohol syndrome (FAS) is one type of disorder that falls under fetal alcohol spectrum disorders (FASD). The types of fetal alcohol spectrum disorders include:
- Fetal alcohol syndrome (FAS). Fetal alcohol syndrome is a form of FASD with findings in many areas. It affects the central nervous system, causes abnormal physical traits, impacts growth, and is associated with neurobehavioral impairment of various degrees that affects the child’s development. People with FAS can experience vision and hearing problems. They may also have issues with attention and concentration, leading to academic and social difficulties in school.
- Partial fetal alcohol syndrome (pFAS). pFAS encompasses children who have prenatal alcohol exposure but exhibit fewer symptoms than in FAS. Physical traits and neurobehavioral impairment are at a minimum.
- Alcohol-related neurodevelopmental disorder (ARND). Prenatal alcohol exposure can cause neurobehavioral impairment without any physical traits. This is the most common form of FASD observed in the United States and often the most difficult to diagnose. Children often do not present with symptoms until school age. Symptoms can include learning problems, social interaction challenges, behavioral problems, and getting along with others. Additionally, children with ARND may struggle in school, especially in math. Their judgment, impulse control, memory, and attention span are impacted.
- Alcohol-related birth defects (ARBD). Birth defects caused by a mother exposing her unborn child to alcohol can include:
- Facial abnormalities, including cleft lip and palate
- Congenital heart defects
- Kidney abnormalities
- Spine abnormalities
- Vision or hearing problems
- Neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE). The characteristics associated with ND-PAE focus on behavioral disorders rather than physical appearance, and is very similar to ARND. Neurocognitive deficits include low IQ, poor memorization skills, visual-spatial reasoning problems, lack of executive functioning, decision-making problems, and daily communication, motor, and social skills. Children affected by ND-PAE have tremendous difficulty with nearly all aspects of their behavior, learning, emotions, and impulse control. Since brain damage is permanent, children affected by ND-PAE require additional support.
Signs & Symptoms of Cystic Fibrosis
SymptomsThere is no known safe amount or type of alcohol that a woman can consume while she is pregnant. Whether it is red wine or beer, alcohol has the same effect on a fetus. Binge drinking, or having three or more drinks on one occasion, carries the greatest risk for having a child with FASD. The best way to avoid FASD is to entirely refrain from drinking any alcohol while pregnant.
A child with an FASD can exhibit any combination of the following symptoms or signs:
Physical defects
- Facial abnormalities include a smooth ridge between the upper lip and the nose (the philtrum area)
- Small eyes
- Small head size
- Lower than-average weight
- Shorter than average height
- Problems with heart, kidneys, and bones
- Deformities of the joints, limbs, and fingers
Neurological problems
- Poor body coordination
- Hyperactivity
- Poor memory function
- Difficulties in school, especially with math
- Poor reasoning skills
- Multiple learning disabilities
- Language and speech delays
- Low IQ and intelligibility
- Sleep problems
- Difficulty sucking as a baby
- Vision and hearing problems
- Oversensitivity to external stimuli such as noise, light, and sound
- Prone to anger, frustration, and tantrums for minor reasons
Behavioral issues
- Rapid and erratic mood changes
- Hyperactivity
- Difficulty controlling emotion and impulses
- Lack of understanding of inappropriate sexual behavior
- Lack of the ability to understand the consequences of their behavior
What Causes Fetal Alcohol Spectrum Disorders?
CausesFetal alcohol spectrum disorders directly result from a developing baby being exposed to alcohol while in the mother's womb. Alcohol from the mother's blood stream is absorbed through the umbilical cord into the baby's bloodstream. The alcohol absorbed by the fetus can cause miscarriage, stillbirth, or permanent physical, behavioral, and intellectual problems.
Prenatal alcohol exposure can cause effects on the brain, central nervous system, and physiological systems like the heart, kidneys, and bones. Reducing exposure to alcohol during pregnancy is an important way to prevent congenital disabilities and neurodevelopmental disorders in the United States.
Risk Factors
Risk FactorsNo amount of alcohol is safe to drink while pregnant. Fetal alcohol syndrome is more likely to occur in the setting of heavy binge drinking that creates a high blood alcohol concentration. Older mothers with multiple pregnancies and/or births with an unstable marital status who also smoke and use other drugs are more prone to giving birth to children with FASD.
Prevention
PreventionFetal alcohol spectrum disorders (FASD) can be prevented. More than half of the pregnancies in the United States are not planned. Much of the adverse effects of alcohol consumption occurs early in a pregnancy, often before a woman even realizes she is pregnant. Therefore, the Surgeon General has determined that women who intend to become pregnant should abstain from alcohol.
Consider total abstinence from alcohol during childbearing years, especially if you have unprotected sex. If you are sexually active and drink alcohol, use birth control. If a woman has a regular 28-day menstrual cycle, a home pregnancy test can detect a positive pregnancy about two weeks after ovulation—right about when the next period is due.
Trust NewYork-Presbyterian for Fetal Alcohol Spectrum Disorders Care
NewYork-Presbyterian wants you and your unborn child to receive the highest level of care during your pregnancy. If you think you might have an alcohol abuse problem, talk with your doctor before getting pregnant. Seek help from one of NewYork Presbyterian's alcoholic treatment centers located throughout the New York metropolitan area.
Caring for a child with a fetal alcohol spectrum disorder can be difficult. Preventing fetal alcohol spectrum disorders is possible if addressed prior to pregnancy and eliminating alcohol exposure during pregnancy. Call NewYork-Presbyterian to schedule an appointment for a consultation.