Fetal alcohol syndrome

Alternative names:

alcohol in pregnancy; at risk for fetal alcohol syndrome; drinking alcohol during pregnancy

Definition:

The manifestation of specific growth, mental, and physical birth defects associated with the mother's high levels of alcohol use during pregnancy.

Causes, incidence, and risk factors:

Alcohol use or abuse by the pregnant woman subjects her to the same range of risks that alcohol has in the general population. However, it poses extreme and unique risks to the fetus and is associated with fetal alcohol syndrome. Timing of alcohol use during pregnancy is also of importance. Alcohol use during the first trimester is more damaging than during the second trimester which is, in turn, more damaging than use in the third trimester.
Alcohol ingested by a pregnant woman easily passes across the placental barrier to the fetus. Because of this, drinking alcohol can adversely affect the development of the baby.

The incidence of fetal alcohol syndrome varies from 1 out of 1,500 to 1 out of 600 live births. This wide range is related to differences in drinking practices. A pregnant woman who drinks any amount of alcohol is at risk, since a "safe" level of alcohol ingestion during pregnancy has not been established. However, increasing amounts appear to cause increased problems in a linear fashion. Multiple birth defects associated with "classical" fetal alcohol syndrome more commonly are associated with heavy alcohol use or alcoholism.

Fetal alcohol syndrome consists of the following abnormalities:

• intrauterine growth retardation: growth deficiency in the fetus and newborn in all parameters head circumference, weight, height)
• delayed development with decreased mental functioning (mild to severe)
• facial abnormalities including small head (microcephaly); small maxilla (upper jaw); short, upturned nose; smooth philtrum (groove in upper lip); smooth and thin upper lip; and narrow, small, and unusual-appearing eyes with prominent epicanthal folds
• heart defects such as ventricular septal defect (VSD) or atrial septal defect (ASD)
• limb abnormalities of joints, hands, feet, fingers, and toes.