Fetal alcohol spectrum disorder
| Fetal alcohol spectrum disorders | |
|---|---|
| Other names | Foetal alcohol spectrum disorders, Foetal alcohol syndrome, Fetal alcohol syndrome, FASD, FAS, PAE, Prenatal alcohol exposure, Prenatal substance exposure, PSE |
| Only 10% of individuals with FASD have associated facial features. | |
| Specialty | Embryology, toxicology, psychiatry, neurology, gynaecology, obstetrics, neonatology, pediatrics |
| Symptoms | Varied; Craniofacial abnormality, short height, low body weight, small head size, poor coordination, behavior problems similar to ADHD, learning and speech problems, intellectual disability |
| Complications |
|
| Usual onset | Prenatal |
| Duration | Lifelong |
| Types | Fetal alcohol syndrome, partial fetal alcohol syndrome, alcohol-related neurodevelopmental disorder, static encephalopathy, alcohol-related birth defects |
| Causes | Drinking alcohol during pregnancy |
| Diagnostic method | Based on symptoms and prenatal alcohol exposure |
| Differential diagnosis | ADHD, autism, bipolar disorder, conduct disorder, learning disability, oppositional defiant disorder |
| Prevention | Avoiding drinking alcohol during pregnancy |
| Treatment | Parent-child interaction therapy, efforts to modify child behavior, possibly medications |
| Prognosis | Varies based on severity with FAS having a life expectancy of 34 years old without interventions. Unconfirmed (other types) |
| Frequency | Unconfirmed; between 1 in 20 (~390 million) and 1 in 13 (~600 million) (all types) 0.2 and 9 per 1,000 (FAS) |
Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a person who is exposed to alcohol during gestation. In the United States FASD affects 1 in 20 Americans, but is highly misdiagnosed and underdiagnosed.
The several forms of the condition (in order of most severe to least severe) are: fetal alcohol syndrome (FAS), partial fetal alcohol syndrome (pFAS), alcohol-related neurodevelopmental disorder (ARND), and neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE). Other terms used are fetal alcohol effects (FAE), partial fetal alcohol effects (PFAE), alcohol-related birth defects (ARBD), and static encephalopathy, but these terms have fallen out of favor and are no longer considered part of the spectrum.
Not all infants exposed to alcohol in utero will have detectable FASD or pregnancy complications. The risk of FASD increases with the amount consumed, the frequency of consumption, and the longer duration of alcohol consumption during pregnancy, particularly binge drinking. The variance seen in outcomes of alcohol consumption during pregnancy is poorly understood. Diagnosis is based on an assessment of growth, facial features, central nervous system, and alcohol exposure by a multidisciplinary team of professionals. The main criteria for diagnosis of FASD are nervous system damage and alcohol exposure, with FAS including congenital malformations of the lips and growth deficiency. FASD is often misdiagnosed as or comorbid with ADHD.
Almost all experts recommend that the mother abstain from alcohol use during pregnancy to prevent FASDs. As the woman may not become aware that she has conceived until several weeks into the pregnancy, it is also recommended to abstain while attempting to become pregnant. Although the condition has no known cure, treatment can improve outcomes. Treatment needs vary but include psychoactive medications, behavioral interventions, tailored accommodations, case management, and public resources.