Overview of Fetal Alcohol Syndrome
Alcohol in normal person can induce several effects to the body that can be dangerous and life-threatening. That is why pregnant women is not allowed consuming alcohol since no amount of alcohol is safe to them. Alcohol can affect any development stage of fetus even at the stage when woman herself still do not realize that she is pregnant. There are group of conditions that occur in baby with alcoholic mother and those group of conditions is called Fetal Alcohol Spectrum Disorders (FASD). FASD is divided into few types and the most severe from all types is called Fetal Alcohol Syndrome. Shortly, we will find out about physical and mental effects of fetal alcohol syndrome. But before we go to those topic, let’s find out about the types of FASD.
Types of FASD
- Fetal Alcohol Syndrome (FAS). This is most severe conditions from all types of FASD. The baby with FAS has distinctive facial abnormalities, birth defects and neurodevelopmental abnormalities.
- Partial Fetal Alcohol Syndrome (pFAS). The baby is known or highly suspected that he/she got history of prenatal alcohol exposure. He/she has physical feature and neurodevelopmental abnormalities like FAS baby though it is not completely meet full criteria.
- Alcohol-related Neurodevelopmental Disorder (ARND) and Alcohol-related Birth Defects (ARBD). ARBD refers to physical abnormalities associated with prenatal alcohol exposure. While ARND refers to individual who is known having history of prenatal alcohol exposure and exhibit neurodevelopmental and cognitive abnormalities that cannot be explained by other factors and suspected related to alcohol.
Physical and mental effects of Fetal Alcohol Syndrome
Diagnosis of FAS is made when three main features are present in one individual. Those features are:
- Distinctive facial abnormalities
- Growth deficiency
- Central nervous system abnormalities (It could be each structural, neurological or behavioral abnormalities and it could be combination from them).
Distinctive facial abnormalities
Several facial abnormalities that people with FAS have are believed to be caused in the first term of pregnancy especially during the 10th and 20th weeks of pregnancy. The three distinctive facial abnormalities of FAS are:
- Smooth philtrum. Philtrum is an area between nose and upper lips. In normal people the philtrum is divided into two or has some groove. While in people with FAS, the philtrum is smooth and flatten.
- Thin vermillion or upper lip.
- Small palpebral fissures or small eyes opening.
Other facial abnormalities that are associated to prenatal alcohol exposure are:
- Epicanthal folds. There are skin fold at the corner of the eyes.
- Short nose
- Low nasal bridge
- Small and flatten midface
- Minor ear abnormalities
- Small head circumference
People with FAS have low average height and low birth weight. The birth height and weight are documented if they are at or below the 10th percentile of standardized growth charts.
Central Nervous System Abnormalities
In observing the central nervous system abnormalities, doctor will measure brain’s structure, neurological impairment in central nervous system and cognitive function impairment. The first to be observed is the brain’s structure since it is observable than the other two. Prenatal alcohol exposure can cause damage in brain’s structure. Microcephaly or small head circumference often happened to people with FAS. Doctor will measure occipital-frontal circumference (OFC). If OFC measurement results at 2 or more standard deviation below normal OFC than the individual is diagnosed with microcephaly. Microcephaly or the impairment of brain’s structure is highly caused the impairment of hippocampus, the part of the brain which is responsible to memory, learning ability, emotion, capability to encode vision and auditory information. We can say that CNS neurological and functional are impaired as well.
The next observation is neurological impairment. Prenatal alcohol exposure can cause damage not only to central nervous system but also to peripheral nervous system and autonomic nervous system. If there are neurological problems in central nervous system than individuals can be diagnosed with FAS. Neurological problems are divided into two signs, hard sign and soft sign. Hard sign is like epilepsy and any other seizure disorder or otherwise diagnosable disorders. While soft signs are much broader and sometimes not specific to neurological impairment. The examples of soft signs are clumsiness, impairment of fine motor skills, bad coordination of eye and hand. Because of the broader signs, the observation of neurological impairment has to be done by trained physician, pediatric neurologist or pediatric neuropsychologist.
Functional impairment is diagnosed by observing behavior or cognitive abnormalities. The cognitive function and behavior which observed are learning abilities, academic achievement, memory, communication, ADHD, adaptive behavior, social skills and communication.
There are other physical signs that may occur in people with FAS and are not included in the criteria of FAS.
- Heart defects like ventricular septal defect most commonly occur in people with FAS and followed by atrial septal defects. Heart murmur also happen at birth but frequently disappear when baby turn into one year old.
- Bones joint often occur in abnormal position and function. Small fifth fingernails or altered palmar crease pattern are the examples of bones abnormalities that may occur in people with FAS.
- Renal aplasia (a kidney that do not develop), renal dysplasia and hypoplasia.
- Optic nerve hypoplasia that can cause involuntary eye movement, light sensitivity and decreased visual sharpness.
Fetal alcohol syndrome often happened because the mother consumes liquor more than 4 drinks per day. Milder symptoms of FAS are occurred in babies with alcoholic mother who consumer liquor up to 2 drinks per day in the early term of pregnancy.
FAS cannot be cured but there are treatment to improve the CNS damage though the treatment may be different to each patients since disabilities and needs of each patients are varied from one another. The best way to prevent FAS occur into baby is abstinence from any alcohol. The abstinence of drinking is starting from the day woman had sexual intercourse since alcohol will influence any stages of fetal development. Many women do not aware that they had conceived that is why they have to avoid drinking as soon as possible or their baby will have higher risk getting physical and mental effects of fetal alcohol syndrome.