What is Fetal Alcohol Syndrome?
Alcoholism can harm your baby at any stage during a pregnancy. That includes the earliest stages before you even know you are pregnant. Drinking during pregnancy can cause a group of conditions called fetal alcohol spectrum disorders (FASDs). Children who are born with FASD can have a mix of problems, such as medical, behavioral, educational, and social problems. The kinds of problems they have to depend on which type of FASD they have.
The problems could include :
- Abnormal facial features, such as a smooth ridge between the nose and upper lip
- Small head size
- Shorter-than-average height
- Low body weight
- Poor coordination
- Hyperactive behavior
- Difficulty with attention and memory
- Learning disabilities and difficulty in school
- Speech and language delays
- Intellectual disability or low IQ
- Poor reasoning and judgment skills
- Sleep and sucking problems as a baby
- Vision or hearing problems
- Problems with the heart, kidneys, or bones
Fetal alcohol syndrome (FAS) is the most serious type of FASD. People with fetal alcohol syndrome have facial abnormalities, including wide-set and narrow eyes, growth problems, and nervous system abnormalities. FASDs last a lifetime. There is no cure for FASDs, but treatments can help. These include medicines to help with some symptoms, medical care for health problems, behavior and education therapy, and parent training. A good treatment plan is specific to the child’s problems. It should include close monitoring, follow-ups, and changes when needed.
Causes of Fetal Alcohol Syndrome
The cause of fetal alcohol syndrome (FAS) is a woman drinking alcoholic beverages during pregnancy. This includes not only “hard liquor” but also beer and wine. Whatever alcohol is in a pregnant woman’s bloodstream will pass through the umbilical cord to the developing baby (fetus). The fetus cannot process alcohol through the liver or other organs, so it is exposed to the same amount of alcohol as is present in the mother’s bloodstream and for a longer period of time.
Alcohol can interfere with the normal development of the fetus, particularly the brain and central nervous system. This occurs in any of the following ways:
- Alcohol can kill cells in different parts of the fetus, causing abnormal physical development.
- Alcohol interferes with the way nerve cells develop, how they travel to form different parts of the brain, and their functioning.
- Alcohol constricts blood vessels, which slows blood flow to the placenta (the fluid-filled sac in which the fetus develops). This causes a shortage of oxygen and nutrients to the fetus.
- Toxic byproducts are produced when the body processes alcohol. These may then concentrate on and damage the brain cells of the fetus.
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Risk Factors of Fetal Alcohol Syndrome
The severity of alcohol effects on a fetus primarily depends on the following:
- Quantity—how much a pregnant woman drinks per occasion
- Frequency—how often a pregnant woman drinks
- Timing—in what stage of pregnancy a woman drinks and if she drinks heavily just as the fetus develops a particular feature or brain region
Other factors can also play a role in how prenatal alcohol exposure affects children. These include:
Research demonstrates that children may be more affected by prenatal alcohol exposure if their mothers:
- Have poor nutrition
- Have had multiple pregnancies and births
- Have lower-than-average weight, height, and body mass index (BMI)
- Are older
- Are a member of a family of heavy drinkers
Research demonstrates that children can be more affected by prenatal alcohol exposure if their mothers experience adverse-living conditions and high levels of stress. These may include social isolation, living in circumstances where alcohol misuse is common and accepted, and living in a community where resources for prenatal care are limited.
The extent of fetal alcohol syndrome may depend on the mother’s genetic makeup, her child’s genetic makeup, and changes in gene activity caused by prenatal alcohol exposure.
Researchers and clinicians have developed effective learning and behavioral interventions to help people with fetal alcohol syndrome. For example, school-based interventions can help children with fetal alcohol syndrome learn more easily. School-based interventions may include specialized teaching strategies that provide a consistent routine and allow children to practice new skills repeatedly. Other promising interventions include:
- Family support groups and classes to help parents better care for a child with fetal alcohol syndrome.
- Nutritional supplements for pregnant women and postnatal supplements for their children.
- Behavioral interventions for affected children, including training in social skills, problem solving, and personal safety.
Complications of Fetal Alcohol Syndrome
Problem behaviors not present at birth that can result from having fetal alcohol syndrome (secondary disabilities) may include:
- Attention deficit/hyperactivity disorder (ADHD)
- Aggression, inappropriate social conduct, and breaking rules and laws
- Alcohol or drug misuse
- Mental health disorders, such as depression, anxiety or eating disorders
- Problems staying in or completing school
- Problems with independent living and with employment
- Inappropriate sexual behaviors
- Early death by accident, homicide or suicide
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Fetal Alcohol Syndrome Effects in Adults
Fetal alcohol syndrome is a condition that can affect an individual far beyond infancy and childhood. In fact, many people with FAS have difficulty as a result of the condition into adulthood and the rest of their lives.
Physical Signs and Effects
The physical effects of fetal alcohol syndrome in adults are one of the most prominent symptoms of this condition. For example, many people with fetal alcohol syndrome are smaller in stature and shorter than others due to development and growth problems caused by the condition.
Additional physical effects of FAS that are apparent in adulthood may include:
- Organ defects
- Bone growth issues
- Flattened philtrum (groove in the upper lip)
- Smaller head circumference
- Smaller than normal eye openings
- Small or absent palpebral fissures (the space between the corner of the eye closest to the nose)
- Thinner upper lip
- Low and short nose bridge
- Flattened cheekbones
- Small jaw
Some of these physical defects may be minor or even unnoticeable. However, some deformities in the facial area can signify brain damage in the individual.
Mental and Neurological Signs
Physical symptoms are not the only way in which fetal alcohol syndrome can impact a person’s life. Many individuals with this condition also experience significant mental and developmental problems as well.
Fetal alcohol syndrome can directly damage the central nervous system, resulting in structural and neurological deficiencies. These deficiencies can cause a number of issues as the person develops into a child and adult. In fact, many individuals with FAS require specialized care to cope with their condition.
The mental effects that may occur as a result of FAS include:
- Learning disabilities
- Poor memory
- Low IQ
- Poor social skills
- Trouble completing tasks
- Higher susceptibility to certain mental health disorders
- Increased risk of drug and alcohol use and addiction
- Mental retardation
- Hearing disorders
Some individuals with fetal alcohol syndrome may show no signs or symptoms of this condition after infancy. However, many people with FAS will struggle with this condition for the rest of their lives.
Fetal Alcohol Syndrome Face in Adults
Fetal Alcohol Syndrome (FAS) was first defined in 1973 as a condition characterized by pre-and postnatal growth deficiencies, facial abnormalities, and central nervous system defects. The pattern of facial defects resulting from ethanol exposure during development primarily affects the midline of the face, altering the morphology of the eyes, nose, and lips . Ethanol damage to cranial neural crest cells (CNCC) early in embryonic development is responsible for these minor midline abnormalities.
A linear relationship exists between ethanol exposure and the severity of expression of ethanol-induced defects. Although the intensity, duration, and timing of prenatal ethanol exposure can dramatically affect the manifestation of these abnormalities, the general trend is that as exposure to ethanol increases, the expression of abnormal facial traits increases.
Diagnostic characteristics typical of a person with FAS include:
- Smaller eye openings (palpebral fissures, the region between the upper and lower eyelid), at times, accompanied by folds of skin (epicanthal folds) at the corners of the eyes that stretch the upper lids taut and create a more oval shape.
- A general shortening of the nose occurs, often accompanied by a lowered nasal bridge. Hypoplastic (underdeveloped) expression of the philtrum also occurs, resulting in the lessened expression or absence of the bilateral raised ridges of skin that connect the nasal septum to the bow of the upper lip.
- An overall narrowing of the forehead, shortened midface, and underdevelopment of the chin also usually accompany these ethanol-induced abnormalities. These defects are generally more pronounced in infants and children and tend to become less noticeable as growth through adolescence and adulthood alters facial morphology.
Fetal Alcohol Syndrome in Adults Personality
According to the National Center for Biotechnology Information (NCBI) , adults with FASDs have high rates of psychiatric and personality disorders, problems with drugs and alcohol, and difficulties with the law. Crimes committed by individuals with FAS are often due to the developmental and mental effects of this condition. For example, a person may steal because he or she is unable to understand the concept of ownership.
Other secondary effects that a person may experience as a result of FAS include trouble maintaining a steady job, difficulty finding and keeping housing, and money management. According to a study performed by the University of Washington, an estimated 79 percent of people with FAS had difficulty with steady employment.
Many individuals with FAS require specialized care to successfully cope with life. With help, many people with FAS are able to lead productive and relatively independent lives.
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Diagnosis of FAS
Individuals are generally diagnosed with FAS in childhood. Adults can be evaluated and diagnosed as well, although there are challenges including obtaining reliable alcohol exposure histories and changes in the physical phenotype among others.
More research is necessary to define the physical phenotype in adulthood but currently, the research suggests that microcephaly, a thin upper lip, and shortened stature are persistent features. In an adult who has not previously been evaluated for FASDs, these features could alert a health care provider that such an evaluation should be considered.
No specific medical tests exist for FAS, so a diagnosis is usually made based on the presence of various factors. These include:
- Abnormal facial features, such as a smooth philtrum
- Short stature
- Low body weight
- Central nervous system problems, such as a small head size
- Problems with hyperactivity, attention and coordination
- Known alcohol intake by the mother during pregnancy
Long Term Effects of Fetal Alcohol Syndrome in Adults
The effects of FAS can be particularly challenging to navigate during adulthood when the person is expected to take care of him or herself. Adults who experience effects related to fetal alcohol exposure often need help as they try to find housing, employment, transportation, and manage daily life.
Unfortunately, a large number of those affected will never receive the resources and support they need to succeed. According to a University of Washington study of people with FAS aged 6-51, nearly 80% had employment problems. What’s more, over 60% of those over age 12 had legal troubles, and 35% had drug and alcohol use disorders.
As people with FAS reach adulthood, both they and their caregivers face additional challenges. Specialized coaches and counselors may be required to help these individuals live happily and relatively independently.
There are a number of secondary effects that most individuals with FAS encounter, such as the following:
- Mental health disorders
- Disrupted academic success
- Inability to live independently
- Difficulty raising their
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Preventing Fetal Alcohol Syndrome
When a woman drinks during pregnancy, the blood travels through her body and into the placenta to the developing fetus. Because the fetus’s body cannot break down alcohol as fast and efficiently as an adult, the alcohol will remain in their tiny bodies for much longer, which is what is believed to cause FAS.
Women who consume excessive amounts of alcohol while pregnant increase the risk of their child developing FAS, although no amount of alcohol use is considered safe. If a woman is pregnant, the only way to ensure that fetal alcohol syndrome doesn’t develop is to abstain from alcohol consumption altogether.
Treatment for Alcohol Abuse
Some individuals, depending on how profoundly they are affected by symptoms of fetal alcohol syndrome in adults, who have a substance use disorder themselves, can receive treatment at a specialized facility such as We Level Up NJ. We offer a comprehensive approach to addiction treatment that includes evidence-based services, such as cognitive behavioral therapy, essential for the recovery process.
We employ highly-skilled addiction professionals who are trained to provide clients with the resources and support they so direly need to achieve abstinence and sustain long-term wellness and sobriety. For those with co-occurring mental health disorders, such as depression, we offer dual diagnosis treatment programs that are designed to address both conditions simultaneously.
If you are suffering from addiction to drugs or alcohol, contact us today to discuss treatment options and find out how we can help you begin your journey to recovery – and guide you every step of the way!
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 NIH – https://medlineplus.gov/fetalalcoholspectrumdisorders.html
 NIAAA – https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/fetal-alcohol-exposure
 CDC – https://www.cdc.gov/ncbddd/fasd/facts.html
 NCBI – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4629517/#:~:text=Adults%20with%20FASDs%20have%20a,stable%20employment%2C%20and%20live%20independently.