Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a person who is exposed to alcohol as a result of their mother drinking during pregnancy. Symptoms can include an abnormal appearance, short height, low body weight, small head size, poor coordination, behavioral problems, learning difficulties, and problems with hearing and sight. Those affected are more likely to have trouble with school, the legal system, alcohol, other drugs, and other areas of high risk. 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 birth defects (ARBD), static encephalopathy, alcohol-related neurodevelopmental disorder (ARND) and neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE). As of 2016, the Swedish Agency for Health Technology Assessment and Assessment of Social Services accepted only FAS as a diagnosis, seeing the evidence as inconclusive with respect to other types.
Fetal alcohol spectrum disorders are caused by the mother's drinking alcohol while pregnant with the affected person. Surveys from the United States found that about 10% of pregnant women drank alcohol in the past month, and 20% to 30% drank at some point during the pregnancy. 3.6% of pregnant American women met criteria for an alcohol use disorder in a 2001 epidemiological study. The risk of FASD depends on the amount consumed, the frequency of consumption, and the points in pregnancy at which the alcohol is consumed. Other risk factors include the mother's older age, smoking, and poor diet. There is no known safe amount or time to drink alcohol during pregnancy. Although drinking small amounts does not cause facial abnormalities, it may cause behavioral problems. Alcohol crosses the blood–brain barrier and both directly and indirectly affects a developing fetus. Diagnosis is based on the signs and symptoms in the person.
Fetal alcohol spectrum disorders are preventable by the mother's avoiding alcohol during pregnancy. For this reason, medical authorities recommend that women completely avoid drinking alcohol during pregnancy and while trying to conceive. Although the condition is permanent, treatment can improve outcomes. Interventions may include parent–child interaction therapy, efforts to modify child behavior, and drugs.
FASD is estimated to affect between 1% and 5% of people in the United States and Western Europe. FAS is believed to occur in between 0.2 and 9 per 1,000 live births in the United States. In South Africa, some populations have rates as high as 9%. The negative effects of alcohol during pregnancy have been described since ancient times. The lifetime cost per child with FAS in the United States was estimated at $2 million (for an overall cost across the country of over $4 billion) by the CDC in 2002. However, a 2015 review article estimated the overall costs to Canada from FASD at $9.7 billion (including from crime, healthcare, education, etc.). The term fetal alcohol syndrome was first used in 1973.
Types
Fetal alcohol spectrum disorders encompass a range of physical and neurodevelopmental problems which can result from prenatal alcohol exposure. The most severe condition is called fetal alcohol syndrome (FAS), which refers to individuals who have a specific set of birth defects and neurodevelopmental disorders characteristic of the diagnosis.
As of 2016, the Swedish Agency for Health Technology Assessment and Assessment of Social Services accepted only FAS as a diagnosis, seeing the evidence as inconclusive with respect to other types. Fetal alcohol syndrome (FAS) Partial fetal alcohol syndrome (pFAS) refers to individuals with a known, or highly suspected, history of prenatal alcohol exposure who have alcohol-related physical and neurodevelopmental deficits that do not meet the full criteria for FAS. pFAS-subtypes: Alcohol-related neurodevelopmental disorder (ARND) Alcohol-related birth defects (ARBD). Neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE) Static encephalopathy
There are conditions believed to be related to prenatal alcohol exposure, such as spontaneous abortion and sudden infant death syndrome (SIDS), which are also considered to be on the spectrum of related disorders. The Swedish Agency for Health Technology Assessment and Assessment of Social Services feels it is unclear if identifying a FASD-related condition benefits the individual.