You can avoid fetal alcohol syndrome by not drinking alcohol during pregnancy. If you’re a woman with a drinking problem who wants to get pregnant, seek help from a doctor. If you’re a light or social drinker, don’t drink if you think you might become pregnant anytime soon. Remember, the effects of alcohol can make a mark during the first few weeks of a pregnancy. Visit these blogs for more tips and information about fetal alcohol syndrome.
What is the outlook of a child with fetal alcohol syndrome?
These conditions affect infants’ physical, mental, and behavioral development, and the effects can last a lifetime. Babies with fetal alcohol syndrome do not appear to cry in a specific way. They can be irritable or jittery, but the most noticeable sign of the condition will be the shape of the baby’s face.
Box 3 Resources on alcohol use in pregnancy and fetal alcohol spectrum disorders
C, The normal features in a control mouse fetus (not prenatally exposed to alcohol). Prenatal alcohol exposure and central nervous system (CNS) involvement are factors common to the disorders encompassing FASD. Evidence of CNS involvement can be structural (e.g., small brain size, alterations in specific brain regions) or functional (e.g., cognitive and behavioral deficits, motor and coordination problems). For fetal alcohol syndrome—which is also characterized by growth deficiencies, distinct facial features, and other physical factors in addition to CNS involvement—confirmation of prenatal alcohol exposure is not required. Fetal alcohol spectrum disorder (FASD) is considered a spectrum of disorders that includes FASD with and without sentinel facial features, fetal alcohol syndrome, partial fetal alcohol syndrome, alcohol-related neurodevelopmental disorder, and alcohol-related birth defects.
What to do if you think your child has fetal alcohol spectrum disorder (FASD)
- Most often, FASDs are diagnosed based on the mother’s history and the appearance of the baby, based on a physical examination by a doctor.
- They estimate that around 1 baby in every 1,000 born in the United States may be affected.
- Alcohol consumption and binge drinking are increasing among women of childbearing age in many countries, particularly in the most populous countries such as China and India26.
Following cholinergic stimulation of cultured astrocytes, we observed increases in ECM protein expression (fibronectin and laminin) both intracellularly and in the media and upregulation of factors that prevent degradation of the ECM (Guizzetti et al., 2008). Astrocyte-released proteins also play a major role in the regulation of synaptogenesis (reviewed in Guizzetti et al., 2014), the maintenance of brain homeostasis, neuroimmune function and blood-brain barrier development (Obermeier et al., 2013; Engelhardt and Liebner, 2014). A shift from a deficit-based to a strength-based management approach emphasizes the need to harness the abilities of individuals with FASD to improve their QOL and well-being.
- Indeed, attention deficit hyperactivity disorder (ADHD) is often diagnosed in FASD individuals with concordance rates ranging from 65–95% (Coles et al., 2002; Fryer et al., 2007; Rasmussen et al., 2010).
- Acetyl-CoA, a metabolite of acetic acid, acetylates histones and, therefore, modifies gene expression.
- If you’re currently pregnant and drinking alcohol, stop immediately to try to lower the risk of FAS.
- FASD are the most common preventable cause of neurodevelopmental impairment and congenital anomalies164.
Fetal Alcohol Spectrum Disorders: An Overview from the Glia Perspective
Alcohol was not viewed as dangerous for pregnant people until 1973 when the diagnosis of FAS was first implemented. However, the Food and Drug Administration (FDA) did not make a public awareness announcement about the side effects of alcohol use during pregnancy until 1977. Unfortunately, people with FAS are more likely to experience legal troubles, have secondary mental health diagnoses, and have higher rates of suicide. People with FAS have better outcomes if they experience a supportive and loving environment during childhood. Once the condition has been diagnosed, a team of healthcare professionals can assess your child’s needs and offer appropriate educational and behavioural strategies.
Caregiver burden
- FASD affect all strata of society, with enormous personal, social and economic effects across the lifespan.
- People with FASDs can have lifelong effects, including problems with behavior and learning as well as physical problems.
- Thus, before establishing a diagnosis of FASD, it is important to ask whether the family history suggests a genetic disorder, whether other teratogenic exposures occurred during pregnancy and whether the patient has features not previously described in FASD.
- If you’ve consumed alcohol during pregnancy, talk to your healthcare provider.
Further research is required to determine how effects of PAE on the gut microbiota influence development and later health. GABAergic interneurons comprise the principal inhibitory network of the brain. Alcohol enhances GABAA receptor-mediated depolarization of migrating GABAergic interneurons through activation of L-type voltage-gated calcium channels, thereby accelerating tangential migration63. Dysfunction of GABAergic interneurons drunken baby syndrome may impair inhibitory control of brain networks. In mice, PAE during corticogenesis also disrupts radial migration and pyramidal cell development in the somatosensory cortex, which could be linked to decreased tactile sensitivity during adolescence140. Most often, FASDs are diagnosed based on the mother’s history and the appearance of the baby, based on a physical examination by a doctor.
With the direction of radial glia fibers, neurons of the cerebral cortex migrate from the germinal zone (Nadarajah and Parnavelas, 2002). Attempts have been made to understand the individual and combined effects of PAE and postnatal events on individual behaviours in FASD263. One model of complex trauma (Supplementary Fig. 1) displays neurodevelopmental variation as a complex interplay between prenatal and postnatal events and improves understanding of their interactions and association with outcomes. Child maltreatment viewed through a neurodevelopmental lens highlights the benefit of a sequential model of therapeutics rather than a focus on specific therapeutic techniques264. Children with FASD and ADHD have a different pattern of neurocognitive and behavioural abnormalities than children with ADHD alone254, suggesting the need for a tailored therapeutic approach. Expert consensus approaches for the management of ADHD in FASD have been developed.
How Boston Children’s approaches FAS
A hierarchy of strategies can be used to prevent fetal alcohol spectrum disorder (FASD), ranging from awareness campaigns for the whole population to health, educational and social support for women and children. The strategies are placed in the context of cultural, political and environmental factors that influence access to, use of and attitudes towards alcohol use in pregnant women. Even a single, clinician-directed question about alcohol use may reduce PAE207,208; however, successful screening requires that practitioners understand the importance of preventing PAE and providing non-judgmental screening and brief interventions196. Preliminary evidence suggests that web-based or app-based mobile health interventions may mitigate patient stigma and reluctance to report alcohol use and might circumvent barriers related to clinician time constraints, training and motivation209. Similarly, mobile health approaches may reduce alcohol and substance use in the preconception, prenatal, and postnatal periods209 and improve access to interventions for families in rural and remote settings.