Fetal Alcohol Syndrome is a series of birth defects such as physical, mental, behavioral and learning problems caused by the mother drinking alcohol during pregnancy. Kenneth Jones and David Smith at the University of Washington in Seattle officially identified Fetal Alcohol Syndrome in 1973 (Golden 1). The exact reasons certain fetuses are affected and others are not, is not fully understood. CDC reports state that 0.2 to 1.5 per 1000 babies are born each year in the United States with alcohol related birth defects (CDC 1).
Fetal Alcohol Syndrome can be prevented with education. Even small changes in education and behavior can reduce the risk of women giving birth to babies with fetal alcohol syndrome. Women have been drinking for years not knowing or understanding the effects that alcohol had on their babies. Some women that drink do not even know they are pregnant and may unknowingly and unintentionally cause damage to the unborn and developing baby. Then there are the women that are addicted to alcohol. The drive can be stronger for the alcohol than for the health of herself or her unborn baby. Education, behavior modification and detoxification are areas of change needed to help with prevention of Fetal Alcohol Syndrome.
When alcohol is consumed it is absorbed into the mother’s bloodstream and passed through the placenta and into the central nervous system of the fetus. Alcohol depresses the central nervous system of the fetus. Alcohol is a potent teratogen. A teratogen is any substance which has been proven to cause birth defects. It is not fully known if it is the alcohol or acetaldehyde, which is a breakdown product from alcohol, which causes birth defects. How the damage occurs is not completely understood, but alcohol does create a glucose and oxygen deficit for the fetus (Spong 1).
There is increased risk for miscarriage, stillbirth, and birth defects in women that drink, especially in the first trimester. Also, the amount of alcohol intake can multiply the chances of these effects. The organs of the fetus begin developing between three to ten weeks. Alcohol may affect the developing organs such as the heart, brain and central nervous system. Because of the effect on the brain, alcohol can cause mental retardation. Damage to the brain can happen anytime during the pregnancy since the brain develops for all nine months and beyond birth (Belfort 2006).
The effects of the alcohol can vary in range of severity and parts of the anantomy. Some babies are born with growth deficiencies due to the alcohol consumption during pregnancy. They are short in length, under weight, and have small heads (Wong). Facial abnormalities include small eye openings, drooping eyelids, skin folds across the inner corners of the eyes, a flattened or missing bridge of the nose, underdeveloped philtrum, thin upper lip, cleft lip, and cleft palate (Wong). There are major organ defects, especially of the heart such as septal defects, tetralogy of Fallot, and patent ductus arteriosus (Wong). They may have problems with their respiratory system such as apnea, pulmonary hypertension and SIDS. Renal abnormalities include aplastic, dysplastic, hypoplastic kidneys, horseshoe kidneys, ureteral duplications, and hydronephrosis (Wong 844). They may have joint and limb abnormalities. Some of the skeletal abnormalities are restriction of movement, altered palmar crease patterns, hypoplastic nails, shortened digits, radionulnar synostosis, flexion contractures, pectus excavaum and carinatum, Klippei-Feil syndrome, hemivertebrae, and scoliosis (Fry-Johnson 42) . Malformation of the Eustachian tube, conductive hearing loss and nuerosensory hearing loss are some auditory defects. They tend to have chronic ear infections. They have a tendency to be more susceptible to infections (Wong 844).
Malnutrition is a risk factor for women that drink and can lead to birth defects. Malnutrition can cause low birth weight, growth retardation, fetal damage, and is an increased risk for spontaneous abortion and stillbirth. There are several reasons for the malnutrition. First, alcoholics prefer alcohol over food therefore the intake of needed nutrients is poor. Then there is reduce absorption and metabolism of nutrients.
Women that drink can be deficient in many vitamins and minerals such as vitamin B6, folic acid, riboflavin, thiamine, vitamin K, iron, magnesium and zinc. Deficiency in vitamin B6 can result in a clubfoot, cleft lip and palate. Folate acid deficiencies are related to neural tube defects and orofacial defects. Riboflavin deficiency may affect failure to grow, thrive and develop. Lack of thiamine has been found to cause heart defects. Deformities related to vitamin K deficiency are shortened fingers, cupped ears, flat nasal bridges, and underdeveloped nose, mouth and mid face. Babies that are born iron deficient are often smaller and shorter. Deficiency in zinc has been linked to impaired growth and development. Zinc deficiency has been related to lower immunity in infants and abnormalities of the nervous system that lead to learning difficulties and mental retardation (Anderson 3).
According to an article by Mary J. O’Connor in the American Journal of Drug and Alcohol abuse, children with fetal alcohol syndrome may show cognitive and attention deficits, increased activity levels, problems in inhibition and state regulation, perseverative behavior, and expressive language and motor problems. These problems may last into and throughout adulthood. They may have difficulties such as bonding in infants and depression in 4-6 year olds. There have been reports of depression, anxiety, psychosis, somatic complaints, delinquency, hyperactivity and sleep disorders. O’Connor also reports in a study done on 473 people that were prenatally exposed to alcohol 44% were diagnosed with major depressive disorder, 40% had psychotic disorders, and 20% had bipolar disorders(Women’s Health1). Studies on prenatal alcohol exposure and relation to IQ show varying severities. It was noted that some children for unknown reasons are more susceptible than others to the effects of alcohol. An article in Journal of School Health by Jennifer H. Green reports on a review of studies done showing an average IQ for people with fetal alcohol syndrome at 65.73 with a range of 20-120 (Green 1).
Fetal alcohol syndrome is a preventable problem. The public needs to be educated on the effects alcohol can have on an unborn child and that no amount of alcohol is safe during pregnancy. The effects from alcohol ingestion during pregnancy can range in severity and last a lifetime. Healthcare worker must educate and advise all females within childbearing years of the potential harm to the fetus. During pregnancy it is never too late to stop and reduce the risk to the fetus. Ultimately it is up to the mother to follow through with these warnings and advice.
Anderson, Mark. Historical Perspective Prenatal Nutrition and Birth Defects. Selen River Press, 2008. World Wide Web. July 24, 2008.
Belfort, Mandy. Department of Neonatal-Perinatal Medicine, Children’s Hospital Boston, Boston, MA. , Healthline Pregnancy Guide, February 2006
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Center for Diease Control and Prevention.(2006) Fetal Alcohol Spectrum Disorder. World Wide Web: July 24, 2008.http://www.cdc.gov/ncbddd/fas/fasask.htm#how
Fry-Johnson, Yvonne W. M.D.(2005). Fetal Alcohol Syndrome “It’s a Faith Walk…” World Wide Web: July 25, 2008.
Golden, Janet. 2005. Message in a Bottle The Making of Fetal Alcohol Syndrome. Cambridge: Harvard University Press.
Green, Jennifer H. “Fetal alcohol spectrum disorders: understanding the effects of prenatal alcohol exposure and supporting students.”Journal of School Health77.3 (March 2007): 103(6).General OneFile. Gale. BREVARD COUNTY LIBRARY SYSTEM. 24 July 2008
Prenatal alcohol exposure has effects far beyond fetal alcohol syndrome.”Women’s Health Weekly(Dec 9, 2004): 75.General OneFile. Gale. BREVARD COUNTY LIBRARY SYSTEM. 24 July 2008
Spong CY (2006) Protection against Prenatal Alcohol-Induced Damage. PLoS Med 3(4): e196 doi:10.1371/journal.pmed.0030196
Wong, Donna L., Hockenberry, Marilyn J., Perry, Shannon E., and Lowdermilk, Deitra Leonard. (2006). Maternal Child Nursing Care (3rd edition). St. Louis: Mosby Elsevier.