Fetal Alcohol Syndrome

(Alcohol in Pregnancy; Drinking Alcohol During Pregnancy; FAS)

Definition

Fetal alcohol syndrome (FAS) belongs to a group of health problems called fetal alcohol spectrum disorder (FASD). It happens when a woman drinks alcohol during pregnancy. The alcohol can cause birth and growth defects in the baby. These defects make up FAS.

Causes

Alcohol can cross from the mother's blood to the baby's blood. Even a small amount of any type can harm a growing baby.

Blood Traveling Through Mother's Placenta to Baby
baby fetus placenta

Alcohol travels through this path and affects the baby's development, particularly the heart and brain.

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Risk Factors

Things that raise a baby's chance of FAS are:

  • Unplanned pregnancy or not knowing you are pregnant and still drinking
  • Alcohol use disorder in the mother

Symptoms

Birth and growth problems depend on when the exposure happened and how much was consumed.

Babies with FAS may have:

  • Low birth weight
  • Small size and slowed growth
  • Small head
  • Small eyes
  • Short, flat nose
  • Flat cheeks
  • Small jaws
  • Misshapen ears
  • Thin upper lip
  • Shaking
  • Sight and hearing problems
  • Problems seeing

As the infant grows, other symptoms may develop, such as:

  • Problems eating and sleeping
  • Delayed speech
  • Learning problems
  • Poor coordination
  • Behavior problems
  • Lack of impulse control
  • Problems getting along with other children

Children do not outgrow these problems. Teens and adults often have social and emotional problems. They may also have:

  • Problems at school
  • Problems keeping a job
  • Trouble living on one's own
  • Mental health problems
  • Alcohol or substance abuse disorder
  • Anxiety problems
  • Anger problems
  • Legal problems

Diagnosis

The doctor will ask about your alcohol intake while pregnant. You will also be asked about your child's symptoms and health history. A physical exam will be done. This is often enough to make the diagnosis.

Treatment

There is no cure. The goal is to manage symptoms. Choices are:

  • Social services to teach parents how to care for and support a child with special needs
  • Special education services to help with learning

Prevention

Women should not drink alcohol while pregnant or trying to become pregnant.

RESOURCES:

Kids Health—Nemours Foundation
http://www.kidshealth.org

March of Dimes
https://www.marchofdimes.org

CANADIAN RESOURCES:

Greater Toronto Area Intergroup
http://aatoronto.org

Women's Health Matters
http://www.womenshealthmatters.ca

REFERENCES:

Cook JL, Green CR, et al; Canada Fetal Alcohol Spectrum Disorder Research Network. Fetal alcohol spectrum disorder: a guideline for diagnosis across the lifespan. CMAJ. 2016 Feb 16;188(3):191-197.

Drinking and your pregnancy. National Institute on Alcohol Abuse and Alcoholism website. Available at: http://pubs.niaaa.nih.gov/publications/DrinkingPregnancy_HTML/pregnancy.htm. Accessed November 4, 2020.

Fetal alcohol spectrum disorder. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/fetal-alcohol-spectrum-disorder. Accessed November 4, 2020.

Last reviewed September 2020 by EBSCO Medical Review Board Kari Kassir, MD  Last Updated: 5/7/2021