Fetal Alcohol Syndrome (FAS) is a group of physical malformations and neurodevelopmental alterations in children born to women who consumed alcohol during pregnancy. It is the most common congenital malformation in industrialized countries and one of the most frequent causes of mental retardation.
Alcohol induces the death of neurons during fetal brain development. This damage occurs mainly during the period in which the connections between neurons are established, which will make later intellectual development possible. Alcohol also alters placental function by decreasing the transfer of oxygen and various essential nutrients, affecting cellular energy metabolism, protein synthesis and cell migration. In short, alcohol alters the correct development of all cells of the fetal organism.
Clinical features
Of children born with alcohol-related disorders, 25% have “complete” FAS, i.e. characterized by prenatal and/or postnatal growth retardation, central nervous system developmental impairment, and a characteristic pattern of dysmorphic craniofacial features. Many of them also present congenital anomalies in other organs. The remaining 75% are born with less severe physical and/or neurodevelopmental abnormalities, belonging to “partial” FAS.
Diagnosis and treatment
Diagnosis of FAS is not easy, as there are no complementary and laboratory tests that can confirm it. Diagnosis is based on the existence of a maternal history of alcohol consumption during gestation and the presence of clinical features in the child. There is no curative or specific treatment. The alterations are permanent and irreversible. These children may have multiple disabilities and must receive early intervention with special family, social, health and educational care.
International adoption and FAS
Children placed for international adoption, especially those from Eastern European countries, are at increased risk for FAS. When socio-health information and the pre-adoption medical report raise suspicion of this disorder, it is advisable to perform a telemedicine evaluation of the child’s clinical characteristics, so that the prospective parents, once advised, can make informed decisions.