What is Fetal Alcohol Spectrum Disorder?

Fetal alcohol spectrum disorder (FASD) is the clinical term for a group of disorders that can occur when a fetus is exposed to alcohol while in utero. Women who consume alcohol while pregnant place their unborn child at risk for FASD-related permanent birth defects and developmental impairment. There is no cure for any form of fetal alcohol spectrum disorder.

While in utero, a fetus is unable to metabolize substances at the same rate as the mother. The effects of a mother's alcohol consumption can adversely affect a fetus’ development as early as the first trimester. Although any alcohol use can place a fetus at risk for fetal alcohol spectrum disorder, the chance for alcohol-related birth defects increases with the mother's alcohol consumption.

A diagnosis of any classification of fetal alcohol spectrum disorder may only be made following the infant’s birth. Women who drink while pregnant are encouraged to be forthcoming about their alcohol consumption so that their obstetrician may assess the fetus’ risk for FASD. Once the child is born, knowledge of the mother's alcohol use can also be valuable to the child’s pediatrician, who may detect any alcohol-related issues that may arise during the child’s development. The earlier a diagnosis is made, the better.

Fetal alcohol spectrum disorder includes three distinct diagnoses. Fetal alcohol syndrome (FAS) affects a child’s overall development. Children with this diagnosis will demonstrate impaired mental, physical and emotional development and lifelong issues that necessitate special supportive care. A diagnosis of alcohol-related birth defects (ARBD) is generally reserved for those children who present with physical deformities. Children may be diagnosed with alcohol-related neurodevelopmental disorder (ARND) if they primarily have behavioral issues and mental retardation, including a pronounced learning disability.

Children born with any diagnosis that falls within the classification of fetal alcohol spectrum disorder will exhibit a variety of signs and symptoms depending on the severity of their condition. Individuals with FASD will generally exhibit distinctive physical features and joint deformities. Most will demonstrate some degree of sensory impairment that adversely affects their vision, hearing and/or speech. It is not uncommon for children with FASD or partial fetal alcohol syndrome to exhibit impaired coordination, development, as well as learning and behavioral issues. Many children born with fetal alcohol syndrome have some presentation of congenital heart abnormality.

Treatment for any diagnosis of fetal alcohol spectrum disorder is non-specific at best. Each presentation of fetal alcohol spectrum disorder is different and so should be the treatment. Depending on the extent of one’s symptoms, behavior and cognitive impairment will generally necessitate a unique management approach coupled with supportive therapies and counseling for both child and parent. Physical therapy may be recommended for individuals with pronounced joint deformities to maintain range of motion and foster flexibility. Children born with a congenital heart defect may require corrective surgery to promote proper cardiovascular function.