Fetal Alcohol Spectrum Disorders

What are FAS and FASDs? Prenatal exposure to alcohol can cause a range of disorders, known as fetal alcohol spectrum disorders (FASDs). One of the most severe effects of drinking during pregnancy is fetal alcohol syndrome (FAS). FAS is one of the leading known preventable causes of mental retardation and birth defects. If a woman drinks alcohol during her pregnancy, her baby can be born with FAS, a lifelong condition that causes physical and mental disabilities. FAS is characterized by abnormal facial features, growth deficiencies, and central nervous system (CNS) problems. People with FAS might have problems with learning, memory, attention span, communication, vision, hearing, or a combination of these. These problems often lead to difficulties in school and problems getting along with others. FAS is a permanent condition. It affects every aspect of an individual’s life and the lives of his or her family.

Fetal alcohol spectrum disorders (FASDs) is an umbrella term describing the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. These effects include physical, mental, behavioral, and/or learning disabilities with possible lifelong implications. The term FASDs is not intended for use as a clinical diagnosis.

FASDs include FAS as well as other conditions in which individuals have some, but not all, of the clinical signs of FAS. Three terms often used are fetal alcohol effects (FAE), alcohol-related neurodevelopmental disorder (ARND), and alcohol-related birth defects (ARBD). The term FAE has been used to describe behavioral and cognitive problems in children who were prenatally exposed to alcohol, but who do not have all of the typical diagnostic features of FAS. In 1996, the Institute of Medicine (IOM) replaced FAE with the terms ARND and ARBD. Children with ARND might have functional or mental problems linked to prenatal alcohol exposure. These include behavioral or cognitive abnormalities or a combination of both. Children with ARBD might have problems with the heart, kidneys, bones, and/or hearing.

All FASDs are 100% preventable—if a woman does not drink alcohol while she is pregnant.

How common are FAS and FASDs? The reported rates of FAS vary widely. These different rates depend on the population studied and the surveillance methods used. CDC studies show FAS rates ranging from 0.2 to 1.5 per 1,000 live births in different areas of the United States. Other FASDs are believed to occur approximately three times as often as FAS.

What are the characteristics of children with FAS and other FASDs?FAS is the severe end of a spectrum of effects that can occur when a woman drinks during pregnancy. Fetal death is the most extreme outcome. FAS is a disorder characterized by abnormal facial features and growth and central nervous system (CNS) problems. If a pregnant woman drinks alcohol but her child does not have all of the symptoms of FAS, it is possible that her child has another FASD, such as alcohol-related neurodevelopmental disorder (ARND). Children with ARND do not have full FAS but might demonstrate learning and behavioral problems caused by prenatal exposure to alcohol. Examples of these problems are difficulties with mathematical skills, difficulties with memory or attention, poor school performance, and poor impulse control and/or judgment.

Children with FASDs might have the following characteristics or exhibit the following behaviors:

• Small size for gestational age or small stature in relation to peers
• Facial abnormalities such as small eye openings
• Poor coordination
• Hyperactive behavior
• Learning disabilities
• Developmental disabilities (e.g., speech and language delays)
• Mental retardation or low IQ
• Problems with daily living
• Poor reasoning and judgment skills
• Sleep and sucking disturbances in infancy

Children with FASDs are at risk for psychiatric problems, criminal behavior, unemployment, and incomplete education. These are secondary conditions that an individual is not born with but might acquire as a result of FAS or a related disorder. These conditions can be very serious, but there are protective factors that have been found to help individuals with FASDs. For example, a child who is diagnosed early in life can be placed in appropriate educational classes and given access to social services that can help the child and his or her family. Children with FASDs who receive special education are more likely to achieve their developmental and educational potential. In addition, children with FASDs need a loving, nurturing, and stable home life to avoid disruptions, transient lifestyles, or harmful relationships. Children with FASDs who live in abusive or unstable homes or who become involved in youth violence are much more likely than those who do not have such negative experiences to develop secondary conditions.

If you think your child might have an FASD, contact your doctor who might be able to refer you to a specialist who can assess your child.

How can we prevent FASDs? FASDs are completely preventable—if a woman does not drink alcohol while she is pregnant or could become pregnant. If a woman is drinking during pregnancy, it is never too late for her to stop. The sooner a woman stops drinking, the better it will be for both her baby and herself. If a woman is not able to stop drinking, she should contact her doctor, local Alcoholics Anonymous, or local alcohol treatment center. The Substance Abuse and Mental Health Services Administration has a Substance Abuse Treatment Facility locator. This locator helps people find drug and alcohol treatment programs in their area. If a woman is sexually active and is not using an effective form of birth control, she should not drink alcohol. She could become pregnant and not know it for several weeks or more.

Mothers are not the only ones who can prevent FASDs. The father’s role is also important in helping the mother abstain from drinking alcohol during pregnancy. He can encourage her not drinking alcohol by avoiding social situations that involve drinking and by not drinking alcohol himself. Significant others, family members, schools, health and social service organizations, and communities can also help prevent FASDs through education and intervention.

In February 2005, the U.S. Surgeon General issued an Advisory on Alcohol Use in Pregnancy to raise public awareness about this important health concern. To reduce prenatal alcohol exposure, prevention efforts should target not only pregnant women who are currently drinking, but also women who could become pregnant, are drinking at high-risk levels, and are having unprotected sex.

Click here to learn more about CDC’s FAS Prevention Activities. Content source: National Center on Birth Defects and Developmental Disabilities