Fetal alcohol spectrum disorders (FASDs) are a group of potentially disabling congenital conditions that occur due to alcohol consumption by the mother during pregnancy, with fetal alcohol syndrome or FAS being the most severe among them . Problems and complications associated with it include mental retardation, physical and facial deformities and learning difficulties .
Drinking alcohol during pregnancy is the principal cause responsible for this disorder in newborn infants. No safe amount of alcohol to drink during pregnancy has been determined. So, it is advisable to avoid drinking altogether to eliminate any risk . However, researchers show that binge drinking is likely to result in more serious problems compared to drinking a glass of wine now and then .
FAS mainly affects the facial features, bones, heart and central nervous system. So, it is believed that drinking during the first trimester may affect the fetus most as these organs and body parts develop in the initial three months. But, drinking during any trimester is harmful for the baby .
When you drink alcohol during pregnancy, it reaches the developing fetus, crossing the placenta through your bloodstream . The fetus cannot metabolize the alcohol as fast as you can. As a result, the blood alcohol concentration in the baby becomes higher than that in your body, causing developmental problems . Alcohol also prevents ample amount of oxygen and necessary nutrients from reaching the baby’s developing organs and tissues, such as heart and brain.
According to a research performed on primates, newborns carrying a specific gene variant are believed to be more likely to develop the symptoms of FAS .
Being one of the most common causes of congenital mental retardation , it is also characterized by a wide range of physical, mental and behavioral symptoms.
Problems associated with FAS tend to worsen as an affected individual reaches adulthood. Long term effects may include problems associated with growth retardation and intellectual development, inability to live alone, difficulty in abiding by the law  and increased risk of being suicidal .
It is easily preventable by avoiding drinking alcohol while pregnant. It is recommended to give up drinking as soon as you plan to have a baby to eliminate any risks. Women with drinking problems should consult a health care practitioner regarding the best ways to refrain from alcohol throughout pregnancy .
It is not possible to confirm the diagnosis of FAS before birth . But, tests and exams performed for fetal health assessment (e.g. pregnancy ultrasound) often enables doctors to suspect the condition. Women unable to give up alcohol during pregnancy should consult their doctor to help detect the problems as soon as possible . Brain imaging exams (MRI, CT scan) as well as tests for determining the blood alcohol levels in the mother help to evaluate the chances of FAS for the unborn baby.
Diagnosis after birth includes a thorough physical examination to look for characteristic symptoms such as heart murmur and other cardiac defects . A child may have to remain under observation for weeks, months and even years after birth as the doctor assesses the following:
The facial and other physical signs present in babies born with FAS help with the detection at the early stage. However, it is possible for a healthy baby to have a few facial characteristics that resemble those described in FAS patients . So, proper assessment by an expert physician is essential for confirming the diagnosis.
Genetic testing may be necessary to rule out any hereditary condition with similar symptoms .
Possible environmental causes (abuse, neglect etc.) responsible for the CNS abnormalities should also be considered in the differential diagnosis . It also includes ruling out other FASDs such as ARND (alcohol-related neurodevelopmental disorder) and ARBD (alcohol-related birth defects) that often leads to similar physical symptoms.
Despite being an incurable disorder, the quality of life of the patients may be improved by proper management that generally continues throughout their lives .
Children with FAS should be provided with a stable routine to follow at home as they are often highly sensitive to disorders and disruptions in their daily routine. Being exposed to abuse and violence at home increases their chances of developing problems with substance abuse and violence as adults . A regular routine with simple rules and rewards for proper behaviour help these children to lead as normal a life as possible. The following measures can also help with the management:
Its exact prevalence is still not known. But according to statistics, the overall incidence is estimated to be 0.97 in every 1000 live births and 43 in every 1000 births among babies born to heavy drinkers. Although FAS is seen among all races, babies having a Native American origin are found to be more susceptible to the condition. In Canada, it has a higher prevalence among Inuit communities and certain First Nations .
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The ICD-9 code used for indicating FAS is 760.71  while its ICD-10 code is Q86.0 .