Fetal Alcohol Synodrome
It sounds simple: women who drink excessively while pregnant are at high risk for giving birth to children with birth defects. Therefore, to prevent these defects, women should stop drinking alcohol during all phases of pregnancy. Alternatively, women who drink alcohol should not become pregnant unless and until they can control their drinking. More than 20 years ago, when fetal alcohol syndrome (FAS) was first described in the published medical literature, there were high hopes for its prevention. In fact, this has not been simple, and the biomedical and public health communities are still struggling to eliminate a birth defect that should be absolutely preventable.
Although references to the effects of prenatal exposure to alcohol can be found in classical and biblical literature, fetal alcohol syndrome was first described in the medical literature in France by Lemoine et al. in 1968. Researchers in the United States soon also published a landmark report describing a constellation of birth defects in children born to alcoholic women (Jones and Smith, 1973). FAS has since been described in most countries of the world. Briefly, FAS refers to a constellation of physical abnormalities, most obvious in the features of the face (see Figure 1-1) and in the reduced size of the newborn, and problems of behavior and cognition. These latter features lead to the most concern.
The degree of abnormality in any one measure can vary greatly between individuals and can change with time in the same individual. For example, people diagnosed with FAS can have IQs from well within the normal range to the severely mentally retarded range. The physical anomalies can be slight or quite striking. Some people with FAS live fairly normal lives if given adequate and structured support throughout their lives, whereas others are severely impaired. The defects may or may not be apparent or easily diagnosed at birth. Although the
References: 4. Warren KR, Li TK; Genetic polymorphisms: impact on the risk of fetal alcohol spectrum disorders. Birth Defects Res A Clin Mol Teratol. 2005 Apr;73(4):195-203. 5. Antenatal care: routine care for the healthy pregnant woman; NICE Clinical Guideline (March 2008) 6 9. Astley SJ; Comparison of the 4-digit diagnostic code and the Hoyme diagnostic guidelines for fetal alcohol spectrum disorders. Pediatrics. 2006 Oct;118(4):1532-45. 10. A report on the 2011 general lifestyle survey - Chapter 2: Drinking, Office for National Statistics (March 2013) 11