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Fetal Alcohol Spectrum Disorders |
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Fetal Alcohol Spectrum Disorders |
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Frequently Asked Questions
FAS and Other Prenatal Alcohol-Related Conditions
Q. What is FAS?
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FAS stands for fetal alcohol
syndrome. It is one of the leading known preventable causes of mental
retardation and birth defects. FAS represents the severe end of a
spectrum of effects that can occur when a woman drinks alcohol during
pregnancy. Fetal death is the most extreme outcome. FAS is characterized
by abnormal facial features, growth deficiency, and central nervous
system (CNS) problems. People with FAS can have problems with learning,
memory, attention span, communication, vision, hearing, or a combination
of these things. These problems often lead to difficulties in school and
problems getting along with others. FAS is a permanent condition. It
affects every aspect of an individual’s life and the lives of his or her
family. However, FAS is 100% preventable—if a woman does not drink
alcohol while she is pregnant.
Q. What are FAE, ARND, and ARBD?
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Prenatal exposure to alcohol can
cause a spectrum of disorders. Many terms have been used to describe
children who have some, but not all, of the clinical signs of FAS. Three
terms are fetal alcohol effects (FAE), alcohol-related neurodevelopmental
disorder (ARND), and alcohol-related birth defects (ARBD). The term FAE
has been used to describe behavioral and cognitive problems in children
who were prenatally exposed to alcohol, but who do not have all of the
typical diagnostic features of FAS. In 1996, the Institute of Medicine
(IOM) replaced FAE with the terms ARND and ARBD. People with ARND can
have functional or mental problems linked to prenatal alcohol exposure.
These include behavioral or cognitive deficits, or both. Examples are
learning difficulties, poor school performance, and poor impulse control.
They can have difficulties with mathematical skills, memory, attention,
judgment, or a combination of these. People with ARBD can have problems
with the heart, kidneys, bones, hearing, or a combination of these.
Q. What are FASDs?
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The term fetal alcohol spectrum
disorders (FASDs) has emerged to address the need to describe the
spectrum of disorders related to fetal alcohol exposure. It is an
umbrella term describing the range of effects that can occur in an
individual whose mother drank alcohol during pregnancy. These effects can
include physical, mental, behavioral, learning disabilities, or a
combination of these, with possible lifelong implications. The term FASDs
is not intended for use as a clinical diagnosis. Unlike people with FAS,
those with other prenatal alcohol-related conditions under the umbrella
of FASDs do not show the identifying physical characteristics of FAS and,
as a result, they often go undiagnosed.
Q. How common are fetal alcohol
syndrome (FAS) and other prenatal alcohol-related conditions (known
collectively as FASDs)?
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The reported rates of FAS vary
widely. These different rates depend on the population studied and the
surveillance methods used. CDC studies show FAS rates ranging from 0.2 to
1.5 cases per 1,000 live births in different areas of the United States.
Other prenatal alcohol-related conditions, such as ARND and ARBD, are
believed to occur about three times as often as FAS.
Q. How do I know if my child
has been affected by maternal alcohol use?
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Children with FAS have evidence
of growth deficiency, CNS problems, and a distinct pattern of facial
characteristics such as a thin upper lip, smooth philtrum (the groove
running vertically between the nose and lips), and small eye openings.
For more detail about the diagnostic criteria for FAS, visit
http://www.cdc.gov/ncbddd/fas/documents/
FAS_guidelines_accessible.pdf.
Children with different FASDs have CNS problems like children with FAS
and/or a pattern of behavior or cognitive abnormalities such as learning
difficulties and poor school performance. People with FASDs can have poor
coordination or hyperactive behavior. They can have developmental
disabilities such as speech and language delays, learning disabilities,
mental retardation, or low IQ. They can have problems with self-care such
as tying shoes or organizing one’s day. People with FASDs can have poor
reasoning and judgment skills. Infants with FASDs have sleep and sucking
disturbances. People with FASDs often have problems as they get older.
These might include mental health problems, disrupted school experiences,
trouble with the law, unemployment, inappropriate sexual behavior, or a
combination of these. For more information about these secondary
problems, please visit
http://www.cdc.gov/ncbddd/fas/secondary.htm.
Q. I suspect my child, or a
child in my care, might have FAS. What should I do?
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If you think a child might have
FAS or another prenatal alcohol-related disorder, contact the National
Organization on Fetal Alcohol Syndrome (NOFAS). NOFAS has a directory of
national and state services such as diagnostic and treatment services and
family support groups. Go to
http://www.nofas.org/. At the home page, click on “Resources”. From
there, click on “National & State Resource Directory”. From the map,
click on your state for a list of services near you.
Q. Can FASDs be treated?
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FASDs are permanent conditions.
They last a lifetime and affect every aspect of a child’s life and the
lives of his or her family members. There is no cure for these
conditions. However, FASDs can be completely prevented—if a woman does
not drink alcohol while she is pregnant. With early identification and
diagnosis, a child with an FASD can get services that can help him or her
lead a more productive life
Q. If a woman has an FASD, but
does not drink during pregnancy, can her child have an FASD? Are FASDs
hereditary?
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FASDs are not genetic or
hereditary. If a woman drinks alcohol during her pregnancy, her baby can
be born with an FASD. But if a woman has an FASD, her own child cannot
have an FASD, unless she drinks alcohol during pregnancy.
Q. What are the economic
consequences of FAS?
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The 10th Special Report to the
U.S. Congress on Alcohol and Health estimated the annual cost of FAS in
1998 to be $2.8 billion. A recent report estimates that the lifetime cost
for one individual with FAS in 2002 was $2 million. This is an average
for all people with FAS. People with severe problems, such as profound
mental retardation, have much higher costs.*
Pregnancy and Alcohol Use
Q. Is there any safe amount of
alcohol to drink during pregnancy? Is there a safe time during pregnancy to
drink alcohol?
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When a pregnant woman drinks
alcohol, so does her unborn baby. There is no known safe amount of
alcohol that a woman can drink during pregnancy. There is also no safe
time during pregnancy to drink alcohol. Alcohol can have negative effects
on a fetus in every trimester of pregnancy. Therefore, women should not
drink if they are pregnant, planning to become pregnant, or could become
pregnant (that is, sexually active and not using an effective form of
birth control).
Q. What is a "drink"? What if I
drink only beer or wine coolers?
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All drinks containing alcohol
can hurt an unborn baby. A standard drink is defined as .60 ounces of
pure alcohol. This is equivalent to one 12-ounce beer or wine cooler,
one 5-ounce glass of wine, or 1.5 ounces of 80 proof distilled spirits
(hard liquor). Some alcoholic drinks have high alcohol concentrations
and come in larger containers (22-45 ounce containers). There is no safe
kind of alcohol. If you have any questions about your alcohol use and
its risks to your health, talk to your health care provider. The
American College of Obstetricians and Gynecologists (ACOG, 2006) has
developed a physician’s guide illustrating standard-sized drinks for a
number of beverages in a recent publication entitled,
Drinking and
Reproductive Health: A Fetal Alcohol Spectrum Disorders Prevention Tool
Kit. Click
here to see standard-sized drinks.
Q. How does alcohol cause these
problems?
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Alcohol in the mother’s blood
crosses the placenta freely and enters the embryo or fetus through the
umbilical cord. Alcohol exposure in the first 3 months of pregnancy can
cause structural defects (e.g., facial changes). Growth and CNS problems
can occur from drinking alcohol any time during pregnancy. The brain is
developing throughout pregnancy. It can be damaged at any time. It is
unlikely that one mechanism can explain the harmful effects of alcohol on
the developing fetus. For example, brain images of some people with FAS
show that certain areas have not developed normally. The images show that
certain cells are not in their proper place and tissues have died in some
areas.
Q. Is there anything I can do
now to decrease the chances of having a child with an FASD?
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If a woman is drinking during
pregnancy, it is never too late for her to stop. The sooner a woman stops
drinking, the better it will be for her baby. A woman should use an
effective form of birth control until her drinking is under control. If a
woman is not able to stop drinking, she should contact her physician,
local Alcoholics Anonymous, or local alcohol treatment center, if needed.
The Substance Abuse and Mental Health Services Administration has a
Substance Abuse Treatment Facility locator. This locator helps
people find drug and alcohol treatment programs in their area.
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If a woman is sexually active
and not using an effective form of birth control, she should not drink
alcohol. She could be pregnant and not know it for several weeks or more.
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Mothers are not the only ones
who can prevent FASDs. Spouses, partners, family members, friends,
schools, health and social service organizations, and communities can
help prevent FASDs through education and support.
Q. I just found out I am
pregnant. I have stopped drinking now, but I was drinking in the first few
weeks of my pregnancy, before I knew I was pregnant. Could my baby have an
FASD? What should I do now?
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The most important thing is that
you have completely stopped drinking after learning of your pregnancy. It
is never too late to stop drinking. The sooner you stop, the better the
chances for your baby’s health. It is not possible to know what harm
might have been done already. Some women can drink heavily during
pregnancy and their babies do not seem to have any problems. Others drink
less and their babies show various signs of alcohol exposure. Many body
parts and organs are developing in the embryonic stage (weeks 3 to 8 of
the pregnancy). This is the time when most women do not know they are
pregnant. There is no known safe amount of alcohol or safe time to drink
alcohol during pregnancy. It is recommended not to drink at all if one is
pregnant or planning to become pregnant. Also, if a woman is sexually
active and not using an effective form of birth control, she should avoid
alcohol. The best advice is to try not to be alarmed, talk to your doctor
about this, and be sure to receive routine prenatal care throughout your
pregnancy.
Q. Can a father’s drinking
cause FASDs?
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How alcohol affects the male
sperm is currently being studied. Whatever the effects are found to be,
they are not FASDs. FASDs are caused specifically by the mother’s alcohol
use during pregnancy. However, the father’s role is important. He can
help the woman avoid drinking alcohol during pregnancy. He can encourage
her abstinence from alcohol by avoiding social situations that involve
drinking. He can also help her by avoiding alcohol himself.
*Source: Lupton C, Burd L, Harwood
R. Cost of fetal alcohol spectrum disorders. American Journal of Medical
Genetics Part C (Seminars in Medical Genetics) 2004;127C:42–50.
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Date: May 2, 2006
Content source: National Center on Birth Defects and Developmental
Disabilities
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