Fetal Alcohol Syndrome is the set of signs and symptoms that occur as a consequence of alcohol consumption during pregnancy and last throughout life. These symptoms are characterized by a delay in physical and mental development, as well as craniofacial alterations. It is the leading cause of birth defects and preventable mental retardation during pregnancy and is a serious public health problem.
In the 19th century, alcohol consumption during pregnancy was directly associated with malformations in the newborn. Fetal Alcohol Syndrome (FAS) was first described in 1968 by Lemoine. Currently, the term fetal alcohol spectrum disorder (FASD) is used, referring to a set of presentations and disabilities resulting from alcohol exposure in utero. This disorder encompasses Fetal Alcohol Syndrome, Partial Fetal Alcohol Syndrome, alcohol related neurodevelopmental disorders, neurobehavioral disorder associated with prenatal alcohol exposure and alcohol related birth defects.
Alcohol is a teratogen with severe developmental impairments in several systems, especially in the development of the central nervous system.
Alcohol crosses the placenta freely and rapidly reaches the fetus. The elimination time of alcohol by the fetus is longer than that of the mother, which makes the fetus more vulnerable. It also acts as a cellular toxicant and can cause cell death, alterations in cell growth and/or interference in cell differentiation or other morphogenic processes. All these functions constitute basic characteristics of cell growth and the development of the organism, so it affects both the form (congenital malformations) and function (growth, learning and behavioral alterations), as well as embryonic and/or fetal death.
Its adverse effects are more serious especially when its consumption occurs during the first trimester of gestation, which is the most vulnerable due to cellular differentiation.
Fetal Alcohol Syndrome: what dose of alcohol is toxic?
Pediatric specialists state that no amount of alcohol consumption during pregnancy can be considered safe. In fact, there is no safe trimester for drinking alcohol. All types of alcohol pose a similar risk and excessive alcohol consumption poses a dose-related risk to the fetus. Depending on the time of pregnancy and the mother’s metabolism, moderate or infrequent alcohol consumption may also generate Fetal Alcohol Syndrome.
Prevalence of Fetal Alcohol Syndrome
It is difficult to know the prevalence of Fetal Alcohol Syndrome because the intake of alcohol by the pregnant woman is unknown and because in many children it is diagnosed late due to the wide variety of clinical manifestations at the time of birth. Despite this, it is estimated that between 4 and 15% of children born to women who consume alcohol in large quantities during pregnancy suffer from Fetal Alcohol Syndrome.
The clinical manifestations of Fetal Alcohol Spectrum Disorder (FASD) are:
- There is a specific pattern of facial anomalies: short palpebral fissures, thin upper lip and flat nasolabial fold.
- Prenatal and postnatal growth retardation. They usually have lower height and weight, at least, until puberty.
- Central nervous system dysfunction. This dysfunction can be physical, such as microcephaly (small cranial circumference), or behavioral, such as attention deficit.
There may also be other clinical manifestations such as strabismus, cardiac and skeletal anomalies, among others.
Fetal Alcohol Syndrome: treatment
An early diagnosis is very important in order to initiate early treatment by specialized professionals, offering support to the child, the family and the school, since these children present certain behaviors that alter their social relationships, substance abuse, school performance and mental health, which in many cases makes them unable to live independently.
The main treatment is based on early intervention programs of psycho-pedagogical treatment, both to help children with self-regulation and to support teachers and caregivers in the management of behavior at school and at home.
Prevention of this pathology consists of total abstinence from alcohol by the mother. This is the most effective measure.