Fetal Alcohol Spectrum Disorders (FASD)

The role of ethanol as a teratogenic agent has been widely recognized for decades; in fact, it is considered to be the main identifiable and preventable cause of cognitive deficits and congenital malformations directly involving the central nervous system.

In this regard, prenatal alcohol exposure can give rise to a group of conditions known collectively under the name “fetal alcohol spectrum disorders” or FASD. This generic term conceptually groups together a wide variety or spectrum of physical, mental, behavioral and cognitive alterations resulting from the damage caused by alcohol exposure in intrauterine life.

It should be taken into account that alcohol ingested by the mother passes easily through the placenta and, given that the fetus metabolizes alcohol much more slowly and inefficiently, its concentration in the blood is significantly higher than that of the pregnant woman. This implies a significant increase in the exposure time of the fetal nervous system to this teratogen (at times when the brain structures and other organs are forming and developing), increasing the risk of irreversible damage. For example, the involvement of the basal nuclei and their connections with the frontal lobe would cause a series of executive-attentional control difficulties (producing behaviors typical of attention deficit disorder and hyperactivity), and the involvement of the hippocampus would be directly related to memory problems. Or the involvement of the cerebellum (a structure involved in balance, coordination and learning), would underlie the difficulties that these children demonstrate in these particular areas.

However, the damage caused by alcohol consumption during pregnancy can be modulated by multiple factors (both genetic and environmental). Thus, while in some cases the clinical expression may be severe, in others all the symptoms may not be present, or may be much milder (to the point of not being recognized as a direct consequence of alcohol intake in the embryonic stage). Thus, the identification of these disorders requires an exhaustive pediatric and neurological evaluation, which must be carried out by a professional with training and experience in this type of disorders, in order to be able to identify the children suffering from them early and help them to improve their abilities and reach their maximum potential.

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Finally, we would like to emphasize that the intrauterine damage caused by prenatal exposure to alcohol is irreversible, that fetal alcohol spectrum disorders only occur when a pregnant woman consumes alcoholic beverages during gestation and that, given that there is currently no amount of alcohol that is considered safe in this period, it is of fundamental importance that all women who are pregnant or planning a pregnancy abstain from consuming any type of alcoholic beverage during pregnancy.

Although different brain areas of fundamental importance in the cognitive-behavioral and emotional control of the individual may be affected, early follow-up and treatment prevents the appearance of complications or secondary disorders, and improves the medium and long-term prognosis.