Fetal alcohol syndrome (FAS) refers to physical, mental, or developmental disorders that affect babies born of alcohol-exposed mothers during pregnancy. Such anomalies include behavioral, learning, and physical problems. There may be developmental issues affecting the face, heart, bones, central nervous system, etc. The more the consumption of alcohol during pregnancy, the more the changes.
Changes also depend on timing and frequency of alcohol consumption. For instance, a mother who consumes alcohol in the first three months of pregnancy risks giving birth to a child with FAS. This is because the vital body organs such as the kidneys and heart develop in that period.
Some literature indicates that alcohol consumption at all stages of pregnancy predisposes an infant to FAS.
Causes & Risk Factors
FAS develops in a fetus when the alcohol moves from the mother’s blood into the fetus’ blood through the placenta. The fetus cannot eliminate the alcohol as fast as the mother leading to high alcohol concentrations in the fetus. Alcohol disrupts the fetus’ ability to use oxygen properly, leading to abnormal development and possibly permanent brain damage. This can lead to the loss of the fetus, and survivors may be faced with life-long irreversible challenges. Children may develop eye problems such as a decrease in vision.
FAS may damage the fetus during the early pregnancy phase, especially when the woman is unaware of her state. Heavy drinkers expose their children to more risk. Any alcohol amounts and all alcohol types are harmful, and these include strong spirits, beer, or wine.
Signs & Symptoms
The signs and symptoms include physical, cognitive, social, and intellectual problems.
- Eyelid abnormality signs include a narrow eyelid opening, abnormal skin folds near the eye’s inner corner, a large distance between the eye’s inner corners, and droopy eyelids.
- Abnormalities may affect the cornea, anterior chamber, and lens (where a cataract can form).
- Abnormalities in the optic nerve can cause irreversible visual acuity problems.
- Eye movement disorders such as strabismus (eye misalignment), nystagmus (shaking of the eyes), refractive errors (hyperopia, myopia, astigmatism), and amblyopia may manifest.
- The lips, heart, kidneys, head (small head), and skeletal system may undergo abnormal development.
- Neurological disorders, learning disabilities, and growth and delays in development may result.
- Other problems include low weight, hearing problems, below average height, and social/behavioral issues such as lack of concentration, attention, or hyperactivity.
Early diagnosis can help arrest some of the symptoms associated with FAS. A diagnosis may be made through a physical examination. The doctor looks for physical defects like a heart problem, the primary indication of FAS. S/he may also look for a slow growth rate, abnormalities of bone growth and facial features, and visual and hearing problems. Others include the small size of the head, slow development of speech or language, and poor coordination.
Treatment of FAS is aimed at relieving the patient of the symptoms. It may involve efforts by various specialists such as an ophthalmologist, neurologists, speech therapists, etc.
Some drugs can address the symptoms associated with FAS. They include antidepressants to address mood swing issues, medicine to treat anxiety and aggression, and stimulants to treat hyperactivity, behavioral issues, and lack of focus. Glasses can treat refractive errors, amblyopia, and strabismus.
FAS Children with strabismus may require eye muscle surgery where the affected muscles are repositioned to allow proper alignment of the eyes.
Studies indicate that children with FAS can be violent and substance abusers if exposed to violence and drugs at home. Parents or caregivers should create a homely environment for these children. Such children are easily irritated and disruptive and can do well with a routine containing simple follow-up rules.
Children with FAS can also benefit from behavioral training by behavior experts. The children are taught social skills such as reasoning, self-control, and so on. Such children can also benefit from academic help. Parents and caregivers can get training on how to deal with FAS children. Support and talk therapy groups designed for parents may go a long way to make a child with FAS live a comfortable life.
Prognosis & Long-Term Outlook
The damage caused by FAS to the structures of the body is irreversible. If FAS affects the optic nerve and leads to optic nerve hypoplasia, vision loss is permanent. However, with good management of some of the symptoms, a child should lead a normal life.
Prevention & Follow Up
The best preventive measure is total abstinence from alcohol. Women who are pregnant or intending to get pregnant should avoid alcohol. Those who discover they are pregnant after consuming alcohol should stop immediately. Women who struggle with alcohol and find out they are pregnant should consult the doctor right away. They can join support groups to assist them in stopping the habit. Those of childbearing age may consider pausing or stopping alcohol consumption altogether.