Fetal Alcohol Syndrome: Causes, Signs, Symptoms, Treatment, Effects, Prognosis, Prevention

Pregnant women are often chastised for consuming alcohol as it is said to be harmful for the fetus in the mother’s womb. Consumption of alcohol at this stage leads to a wide spectrum of conditions in the child that leads to complications in their normal development – both physiological and psychological. This wide spectrum of conditions in the child which may be indicated by short height, smaller head with respect to the body, low body weight, poor coordination issues, behavioral and learning issues at school, visual and/or hearing impairments and the like can be termed as Fetal Alcohol Spectrum Disorders or FASD. While there are many variations of FASD, Fetal Alcohol Syndrome or FAS is the most severe form.

Simply put, Fetal Alcohol Syndrome can be defined as the physiological and psychological damage occurring in a child due to exposure to alcohol while it is in the womb. Fetal Alcohol Syndrome is characterized by a class of symptoms involving brain impairment, impaired physiological growth and abnormalities in the formation of facial features.

Alcohol consumption by women during pregnancy has been found to be the causative factor behind Fetal Alcohol Syndrome. It has been found to be one of the dominant reasons behind birth deformities in the United States with as many as 5000 to 12000 babies being born every year with this condition, also popularly known as Fetal Alcohol Abuse Syndrome.

Fetal Alcohol Syndrome or FAS is usually characterized by both physiological and behavioral abnormalities. However, diagnosis of Fetal Alcohol Syndrome is only possible when the child manifests the associated major symptoms of the disease which are as follows-

• Retarded Physiological Growth in Child with Fetal Alcohol Syndrome – The child is likely to possess retarded growth in terms of physiology in relation to the growth index considered normal for children of the contemporary age group.
• Fetal Alcohol Syndrome Facial Features or Characteristics– The facial features of children suffering from Fetal Alcohol Syndrome are likely to be different from the normal index with small eyes, upturned and short nose, thin upper lip, flattened philtrum.
• Fetal Alcohol Syndrome and the Problems in the Central Nervous System– The complications in the Central Nervous System caused by Fetal Alcohol Syndrome is characterized by mental retardation, impairment in language development, retarded rate of development of motor activities- both gross and fine, impulsiveness, hyperactivity and seizures.

Apart from the aforementioned symptoms, Fetal Alcohol Syndrome can also lead to certain secondary conditions in the child which may be listed as follows-

• Psychological Issues in Child with Fetal Alcohol Syndrome – Fetal Alcohol Syndrome child may suffer from problems such as ADD or Attention Deficit Disorder, depression, conduct disorder and the like.
• Problems Maintaining Law and Order– Children with Fetal Alcohol Syndrome often grow up to be truant teenagers and adults, unable to adhere to the social and legal norms, rules and regulations, thereby facing severe behavioral issues, such as, anger management issues, frustration and similar other problems. This leads to high rates of suspension and expulsion from educational institutions, drug abuse, inability to hold on to a job and live independently etc.

Like a number of other diseases, Fetal Alcohol Syndrome does not have a fixed set of universal outcome- they vary from one child to another. However, one of the most common outcomes that can be observed is that none of the children suffering from Fetal Alcohol Syndrome will have a normal development of the brain. The best course that can be taken is to go for an early diagnosis and take appropriate measures in order to work out certain behavioral and educational strategies that fit the needs of the child. However, it should be understood that Fetal Alcohol Syndrome is an irreversible condition; the impact can be controlled to an extent by means of early intervention programs but cannot be completely eradicated.

Among the many substances that cause damage to the human physiological and psychological system, alcohol definitely comes near the top of the list with it being the most common tetragon with adverse effects. Though harmful for people at all stages, pregnant women are perhaps at a greater risk as the alcohol easily travels via the placenta to the fetus’s system. It is difficult to record an accurate figure of the number of people suffering from Fetal Alcohol Syndrome due to number of factors, viz, varying definitions, reluctance in diagnosis, scarcity of reliable data collection methods and tools and the like. About 0.5 – 2 out of 1000 live births are affected by Fetal Alcohol Syndrome in the USA. However, this number varies greatly with the communities, food, culture and lifestyle habits, traditions and similar factors. This has been proven by the figures of Italy and West Cape Province in South Africa where the numbers range from 40 per 1000 children and 89 per 1000 children respectively.

The major cause behind Fetal Alcohol Syndrome is the consumption of alcohol by women who are pregnant or are planning for a baby. Though alcohol proves to be fatal for pregnant woman and her child at all stages, the first trimester (3 months) are the most crucial. However, this does not mean that pregnant women can have alcohol after this phase. There is no safe level of alcohol consumption for pregnant women, with the risk factor increasing with the level of the alcohol.

Development of the heart and other organs, bones, central nervous system and facial characteristics are the most important phase of development during the first trimester. Hence, alcohol consumption at this stage leads to deformities with the risk increasing with the levels of alcohol and phases of pregnancy.

A clear, conclusive and universal mechanism for the development of Fetal Alcohol Syndrome has not been identified due to the existence of the various different ways in which alcohol could penetrate the system of the fetus after its consumption by the pregnant mother.

Alcohol enters the bloodstream and reaches the fetus in the womb by means of the placenta. This results in higher levels of accumulation of alcohol in the blood of the fetus resulting in abnormal development. This is because fetuses have a slower metabolism system. The intervention of the alcohol in the transmission of oxygen and the optimal levels of nutrition to the tissues, various organs of the body and the brain leads to deformity.

Liver, which is the dominant organ for detoxifying ethanol in adults, is incapable of doing so in case of fetuses since the ALDH and ADH enzymes are not yet functional. This ensures the exposure of the fetus to the ethanol in the amniotic fluid for a longer period of time, thereby, leading to convulsions.

It is important to introduce a child having Fetal Alcohol Syndrome to intervention therapies at the earliest possible instance in order to gain a certain amount of control over their condition and this is possible only by means of proper diagnosis. There are four key criteria that must be taken into account when diagnosing a child with Fetal Alcohol Syndrome –

• Deficiency in terms of growth- the height and weight of the child, both prenatal and postnatal will be lower than the normal index.
• Facial features, such as small eyes, upturned nose, smaller head and the like will be present.
• Damage in the Central nervous system
• Prenatal exposure to alcohol by means of the pregnant mother.

It is important to do evaluations based on multi-disciplinary approach in order to completely assess the four criteria and come to a conclusion. While many physicians simply take growth defalcation and the characteristic facial features into account, some physicians also take abnormalities in the Central Nervous System structure into account.

At the very onset, it needs to be understood that Fetal Alcohol Syndrome is an irreversible process. Though the disease is incurable by itself, some of the associated symptoms can be treated and for this it is necessary to diagnose Fetal Alcohol Syndrome at the earliest possible stage.

Fetal Alcohol Syndrome children may face psychological issues. Indulging such children in special education activities and social activities can help them to a considerable extent. Since, children suffering from Fetal Alcohol Syndrome face behavioral issues; they can be provided special training that helps them to become more sociable. Speech problems can also be taken care of by means of language therapies and such other measures.

Although no medication is prescribed for Fetal Alcohol Syndrome, there are certain medicines that address the symptoms, such as, antidepressants, anti-anxiety drugs and neuroleptics. Various kinds of therapy sessions, like physiotherapy, speech and language therapy etc. can also help children with Fetal Alcohol Syndrome.

There is only one way of preventing Fetal Alcohol Syndrome from occurring in children and that preventive measure has to begin right from the time when parents begin planning for a baby. The pregnant mother or the women who are planning to have a baby need to refrain from alcohol consumption which is the root of the entire problem. Hence, giving up alcohol during pregnancy completely is the only way preventing children from having Fetal Alcohol Syndrome.

In order to spare children from this medical condition, it is very useful that the mothers keep themselves from their drinking habit. Since Fetal Alcohol Syndrome has no treatment or cure, it is always better that the mothers are careful enough to give the child a healthy life ahead by preventing the disorder.