Problem: Fetal Alcohol Syndrome (FAS) is a pattern of mental and physical defects which develops in some unborn babies when the mother drinks too much alcohol during pregnancy. A baby born with FAS may be seriously handicapped and require a lifetime of special care. Some babies with alcohol-related birth defects, including smaller body size, lower birth weight, and other impairments, do not have all of the classic FAS symptoms. These symptoms are sometimes referred to as Fetal Alcohol Effects (FAE). Researchers do not all agree on the precise distinctions between FAS and FAE cases.Cause of the Problem: Alcohol in a pregnant woman's bloodstream circulates to the fetus by crossing the placenta. There, the alcohol interferes with the ability of the fetus to receive sufficient oxygen and nourishment for normal cell development in the brain and other body organs.
Possible FAS Symptoms:
Size of the Problem: The incidence (number of new cases each year) of FAS and FAE are significantly under-reported. Therefore, projections are usually based on estimates of their occurrence per 1,000 live births. Recent studies by researchers Ernest Abel and Robert Sokol suggest that the incidence of FAS can conservatively be estimated at 0.33 cases per 1,000 live births. Missouri recorded 78,468 live births in 1991 and 76,005 in 1992, which would yield at least 25 new cases of FAS per year. The incidence of FAE is generally regarded to be several times the magnitude of FAS cases, perhaps in the hundreds in Missouri.
- Growth deficiencies: small body size and weight, slower than normal development and failure to catch up.
- Skeletal deformities: deformed ribs and sternum; curved spine; hip dislocations; bent, fused, webbed, or missing fingers or toes; limited movement of joints; small head.
- Facial abnormalities: small eye openings; skin webbing between eyes and base of nose; drooping eyelids; nearsightedness; failure of eyes to move in same direction; short upturned nose; sunken nasal bridge; flat or absent groove between nose and upper lip; thin upper lip; opening in roof of mouth; small jaw; low-set or poorly formed ears.
- Organ deformities: heart defects; heart murmurs; genital malformations; kidney and urinary defects.
- Central nervous system handicaps: small brain; faulty arrangement of brain cells and connective tissue; mental retardation -- usually mild to moderate but occasionally severe; learning disabilities; short attention span; irritability in infancy; hyperactivity in childhood; poor body, hand, and finger coordination.
Recommendations: Studies suggest that drinking a large amount of alcohol at any one time may be more dangerous to the fetus than drinking small amounts more frequently. The fetus is most vulnerable to various types of injuries depending on the stage of development in which alcohol is encountered. A safe amount of drinking during pregnancy has not been determined, and all major authorities agree that women should not drink at all during pregnancy. Unfortunately, women sometimes wait until a pregnancy is confirmed before they stop drinking. By then, the embryo/fetus has gone through several weeks of critical development, a period during which exposure to alcohol can be very damaging. Therefore, the Division of Alcohol and Drug Abuse urges women who are pregnant or anticipating a pregnancy to abstain from drinking alcoholic beverages.
Sources: National Institute on Alcohol Abuse and Alcoholism
Missouri Department of Health, State Center for Health Statistics
Abel, Ernest; and Sokol, Robert. A revised conservative estimate of the incidence of FAS and its economic impact. Alcoholism: Clinical and Experimental Research 15(3), 1992.
Food and Drug Administration
National Council on Alcoholism
United States Surgeon General
United States Department of Health and Human Services