Fetal Alcohol Syndrome (FAS) describes changes in a baby born to a mother whose pregnancy was complicated by alcohol consumption. The changes depend on the amount, frequency and the timing of the consumption of alcohol during pregnancy. The first three months of pregnancy is the time in which vital organs like the heart and the kidney are developing. Drinking alcoholic beverages in that time period can be especially harmful. Another term for the wide range of findings is FASD (Fetal Alcohol Spectrum Disorder).
The alcohol in the blood of the mother moves to the blood of the fetus. Because the ability of the fetus to get rid of the alcohol is much less than the mother, the alcohol concentration in the blood of the fetus becomes much higher than that of the mother. In other words, the intoxication of the fetus is much more than the mother. Alcohol interferes with the ability of the fetus to use oxygen.
Children with FAS tend to have a larger than normal fold of skin near the inner corner of the eye (epicanthal fold) and a shorter than average eyelid opening. High refractive errors (near-sightedness and far-sightedness) that require glasses and eye crossing (strabismus) are common. Abnormalities of the cornea and anterior chamber of the eye have been described. The optic nerve may not fully develop (optic nerve hypoplasia) resulting in sub-normal vision. Nystagmus, or shaking of the eyes, may be the first sign of optic nerve hypoplasia.
The upper lip may appear wide and thin with a flat surface. Growth and developmental delays, learning disabilities and mental retardation (mild to severe) occur in association with FAS. Abnormalities of the heart and skeletal system have been reported [See figure 1]. The effects of FAS extend beyond childhood. The changes caused by alcohol consumption can cause lifelong disabilities.
Each year, between 5000 and 12000 American babies are born with FAS. The estimated incidence of FAS is 1-2 per 1,000 births. Milder findings may be seen in 3-5 per 1,000 births.
Strabismus, amblyopia, and the need for glasses (refractive error) can be treated. Some eye conditions, such as strabismus, may require surgery. Impairment of visual acuity caused by optic nerve hypoplasia cannot be treated. However, the pediatric ophthalmologist can help the family and school personnel optimize the child’s learning experience.
Yes. Since there is no known "safe" amount of alcohol that can be consumed during pregnancy, the recommendation is to abstain. The U.S. Surgeon General has given the following advice about alcohol use during pregnancy:
• A pregnant woman should not drink alcohol.
• A woman who is trying to get pregnant should not drink alcohol because she will not know she is pregnant for the first few weeks of the pregnancy.
• A pregnant woman who has already used alcohol during her pregnancy should stop right away.
• Because nearly half of all pregnancies in the United States are unplanned, women of childbearing age should talk with their doctor about how to prevent an alcohol-exposed pregnancy.
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