March 21st, 2016
Fetal Alcohol Spectrum Disorders (also commonly referred to as FASD) is a multitude of disturbing health issues that are usually reported in the babies born to alcoholic mothers. Research and clinical data indicates that consumption of alcohol in any form during pregnancy may lead to deleterious side-effects in the babies. These effects may range from physical anomalies to severe behavioral changes and mental retardation in the newborn.
According to a new study reported in the peer reviewed journal Pediatrics (1), investigators suggested that the prevalence of FASD among first-graders is 2.4% to 4.8% (or 24 to 48 per 1000 pupils).
It has long known that some drugs have teratogenic potential if taken during the pregnancy and therefore the intake of such drugs should be strictly avoided. One such example is alcohol (or ethanol). Alcohol consumed by mothers during pregnancy can gain access into the fetal circulation via placental vessels; thereby leading to accumulation of alcoholic breakdown products in the fetal tissues. Unfortunately, since fetal metabolic and detoxification centers are underdeveloped, the risk of alcohol toxicity is even higher. In the absence of any management, deleterious complications in the fetus may occur even before the childbirth.
FASDs presents with various symptoms. The severity of symptoms and ensuing complications may vary from person to person, depending upon the dose, genetic factors, overall health of mother during pregnancy and exposure to other chemical or environmental toxins. Classic symptoms include:
Neurodevelopmental & Behavioral problems:
The clinical varieties of Fetal Alcohol Spectrum Disorder (FASD) are often hard to differentiate clinically on the basis of presentation alone. Study reported in the Alcoholism: Clinical and Experimental Research (3) journal suggested that the clinical accuracy of classification of FASD is approximately 71%. The prominent clinical varieties include:
It is the most frequently reported clinical variety of FASD. The infants exposed to alcohol prenatally due to maternal drinking habits can present with a multitude of symptoms including craniofacial abnormalities, cerebral retardation and organ dysfunction as well as problems with learning, language, memory and coordination. Anti-social and behavioral changes are also very common; such as, inability to deal with teachers and peers, and failure to learn new skills. At the extreme end of this disorder, death can also occur early in the infancy or childhood due to complications.
2. Alcohol Related Neurodevelopment Disorder (ARND):
People with this disorder may have problems with mental control, learning and cognitive reasoning. They may have difficulty in performing at school, especially at learning math or calculus. Memory formation, consolidation and recall may also be impaired and they may have hyperactive behavior leading to poor adjustment with coworkers.
3. Alcohol Related Birth Defects (ARBD):
Babies born with this disorder have congenital birth defects involving multi-organ, structural and functional impairment for major organ systems; for instance, cardiac defects, skeletal anomalies, renal problems or a combination of these.
Since the symptoms vary from person to person, a unique treatment approach is needed for each patient. Management should be directed to improve the quality of life as much as possible.
Steps in management of FASDs are as follows:
Any amount of alcohol can affect the well-being of mother and child during pregnancy. This occurs more often in unplanned pregnancies where women continue to consume alcohol oblivious to the fact that they have conceived. Several research studies suggests that consumption of alcohol prior to conception can also affect fertility and alter your chances of conceiving. Abstinence from drinking is the only way to protect the child from these disorders.
1. May, P. A., Baete, A., Russo, J., Elliott, A. J., Blankenship, J., Kalberg, W. O., … & Adam, M. P. (2014). Prevalence and characteristics of fetal alcohol spectrum disorders. Pediatrics, 134(5), 855-866.
2. Paolozza, A., Rasmussen, C., Pei, J., Hanlon-Dearman, A., Nikkel, S. M., Andrew, G., … & Reynolds, J. N. (2014). Working memory and visuospatial deficits correlate with oculomotor control in children with fetal alcohol spectrum disorder. Behavioural brain research, 263, 70-79.
3. Mattson, S. N., Roesch, S. C., Glass, L., Deweese, B. N., Coles, C. D., Kable, J. A., … & Jones, K. L. (2013). Further development of a neurobehavioral profile of fetal alcohol spectrum disorders. Alcoholism: Clinical and Experimental Research, 37(3), 517-528.
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