Fetal Alcohol Syndrome: Causes, Symptoms & Impacts

What is Fetal Alcohol Syndrome?

Fetal alcohol syndrome (FAS) is a condition that can occur in a person whose mother drank alcohol during pregnancy. FAS causes brain damage in the developing fetus and is the most common non-hereditary cause of intellectual disability.¹

Symptoms of Fetal Alcohol Syndrome

It is also commonly characterized by abnormal facial characteristics, including small eye openings, a thin upper lip, a low nasal bridge, and a smooth groove between nose and upper lip. Depending on the timing and frequency of maternal alcohol consumption, other physical and behavioral problems associated with FAS may include:²

• Birth defects (heart, lung, bone, and kidney)
• Vision problems
• Hearing loss
• Growth problems
• Delayed development
• Cognitive impairment
• Poor memory
• Coordination difficulties
• Learning disabilities
• Attention deficits
• Hyperactivity
• Impulse control issues
• Language deficits

Pregnancy and Alcohol abuse

No amount of alcohol consumption is ever safe for a developing baby before birth. Any amount of alcohol will pass directly from the mother to the baby. The liver of developing babies is not fully formed, and it lacks the ability to process alcohol. Because brain growth takes place throughout pregnancy, the presence of alcohol is a risk to the baby for the duration of the pregnancy. In a report to Congress, the National Academy of Medicine noted that “of all the substances of abuse (including cocaine, heroin, and marijuana), alcohol produces by far the most serious neurobehavioral effects in the fetus.”³

FAS Statistics

When considering the effects of prenatal alcohol exposure, the number of women who consume alcohol during pregnancy is frightening. According to the Centers for Disease Control and Prevention, more than 1 in 10 pregnant women consume alcohol while 3% of pregnant women report binge drinking (four or more alcoholic beverages at once).⁴ These concerning statistics help to explain the high prevalence of FAS, which is around 2 cases per 1,000 births in the United States.⁵

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FAS Treatment & Prevention

FAS is completely preventable in children whose mothers do not drink during pregnancy. Consider giving up alcohol if you are trying to get pregnant, and stop drinking immediately if you find out that you are pregnant. It is never too late to stop drinking during your pregnancy, and the sooner you stop the better it will be for you and your baby. If you have an alcohol problem, please seek treatment immediately. An addiction professional can determine your level of dependence on alcohol and help to develop a treatment plan.

There are currently 3 medications approved by the Food and Drug Administration for the treatment of alcohol use disorders in the United States: naltrexone, disulfiram, and acamprosate. Unfortunately, studies have shown that some of these drugs have the potential to cause adverse effects on the fetus.^6-7 Your doctor must carefully evaluate the risks of these medications before prescribing any of them to you.

It is recommended to undergo detox in a medical detox facility or hospital. Pregnant women are especially vulnerable to the harmful effects of alcohol withdrawal and will require intensive monitoring and ongoing evaluation by an obstetrician. Some people going through detox may be administered benzodiazepines to treat the uncomfortable symptoms of alcohol withdrawal. However, there is a lack of conclusive evidence regarding the fetal risks associated with exposure to benzodiazepines. Your clinician must determine whether the use of this medication is worth the potential risks.

Treatment for pregnant women with alcohol abuse issues should include behavioral therapy, which teaches important coping skills and is essential to long-term recovery.

Sources

1. Denny, L., Coles, S., & Blitz, R. (2017). Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorders. American Family Physician. 96(8), 515-522.
2. Centers for Disease Control and Prevention (2019). Facts about FASDs.
3. Institute of Medicine (1996). Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment. Washington, DC: The National Academies Press.
4. Tan, C.H., Denny, C.H., Cheal, N.E., Sniezek, J.E., & Kanny, D. (2015). Alcohol use and binge drinking among women of childbearing age—United States, 2011–2013. Morbidity and Mortality Weekly Report, 64(37),1042–1046.
5. National Institutes of Health. (2018). Fetal Alcohol Spectrum Disorders.
6. Mylan pharmaceuticals ULC. (2011). Product monograph, Campral Acamprosate calcium, delayed release tablets 333mg, alcohol abstinence aid.
7. Helmbrecht, G.D., & Hoskins, I.A. (1993). First trimester disulfiram exposure: report of two cases. American Journal of Perinatology, 10(1), 5-7.