Fetal Alcohol Syndrome

Abstract

Although suspected for centuries, the detrimental effects of ethyl alcohol on the unborn fetus were not systematically documented and given the name fetal alcohol syndrome (FAS) until the early 1970s. The characteristics of FAS are central nervous system (CNS) dysfunction, prenatal and postnatal growth retardation, and dysmorphology of the mid-facial region. The appearance of these children resembles those born with Down’s syndrome (trisomy 21) because of the short palpebral fissures and prominent epicanthic folds. This facial resemblance may have contributed to the lack of recognition of FAS as a separate condition by the medical profession and the general population; in addition, FAS children are frequently microcephalic and mildly to moderately mentally retarded. The common practice of heavy drinkers to underestimate their alcohol consumption and their reluctance to recognize the contribution of their drinking behavior to their child’s condition makes it difficult to assess the quantity of alcohol ingested during pregnancy by mothers of FAS children. Nevertheless, it is clear that FAS children are the offspring of excessive drinkers, many of them alcoholics. What is not clear is whether there is a range of effects on the fetus caused by a corresponding range of alcohol intake. However, danger from moderate use of alcohol (less than 1 ounce absolute alcohol per day) has not been demonstrated and should not be overstated. FAS is now the third leading cause of birth defects (after Down’s syndrome and spina bifida) and is, of course, the leading preventable cause.