Fetal Alcohol Syndrome
- The four major features of classic fetal alcohol syndrome (FAS) are as follows:
- CNS neurodevelopmental abnormalities
- Facial dysmorphisms
- Growth retardation
- Maternal alcohol use during pregnancy.
- First described in 1973; classic FAS has since been recognized as one of the fetal alcohol spectrum disorders (FASDs), which include the following:
- FAS, partial FAS (pFAS), alcohol-related neurodevelopmental disorder (ARND), and alcohol-related birth defects (ARBD)
- Taken together, FASDs are three times more common than classic FAS, and the effects range from very mild symptoms to very severe.
- Classic FAS: 3.1 per 1,000 live births
- FASDs: 9.1 per 1,000 live births
- Binge drinking seems to be the primary risk factor.
- The highest prevalence of reported alcohol use during pregnancy are among those who are aged 35–44 years, white, college graduates, or employed.
- Poor maternal nutrition appears to increase risk in the presence of maternal binge drinking.
- Maternal polymorphisms of the alcohol dehydrogenase gene (ADH): The presence of the ADH1B*3 allele appears to protect the fetus.
- Concordance of FAS is higher in monozygotic than in dizygotic twins.
- Women who are pregnant or may become pregnant should avoid alcohol. No “safe” level of alcohol consumption has been determined during pregnancy.
- Women with alcohol addiction who are or may become pregnant should enter a treatment program.
- According to the Centers for Disease Control and Prevention (CDC), 7.6% of pregnant women reported alcohol use during the month prior to being surveyed and 1.4% reported binge drinking.
- The highest risk for FAS occurs in children whose mothers consume ≥4 drinks per occasion per week (peak blood alcohol level is more important than a lower sustained blood alcohol level).
- In the United States, Alcoholic Beverage Labeling Act passed in 1998 requires heath warning labels, including risk of alcohol consumption during pregnancy.
- Malformation of the developing brain is the primary pathophysiologic event resulting in secondary neurodevelopmental pathology and facial dysmorphisms in classic FAS.
- May involve increased susceptibility to cell damage by free radicals in the developing fetus, especially in the first trimester
- Alcohol and its metabolite acetaldehyde are teratogens.
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Cabana, Michael D., editor. "Fetal Alcohol Syndrome." Select 5-Minute Pediatrics Topics, 7th ed., Wolters Kluwer Health, 2015. 5-Minute Clinical Consult, www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14151/all/Fetal_Alcohol_Syndrome.
Fetal Alcohol Syndrome. In: Cabana MDM, ed. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. https://www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14151/all/Fetal_Alcohol_Syndrome. Accessed June 10, 2023.
Fetal Alcohol Syndrome. (2015). In Cabana, M. D. (Ed.), Select 5-Minute Pediatrics Topics (7th ed.). Wolters Kluwer Health. https://www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14151/all/Fetal_Alcohol_Syndrome
Fetal Alcohol Syndrome [Internet]. In: Cabana MDM, editors. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. [cited 2023 June 10]. Available from: https://www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14151/all/Fetal_Alcohol_Syndrome.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Fetal Alcohol Syndrome ID - 14151 ED - Cabana,Michael D, BT - Select 5-Minute Pediatrics Topics UR - https://www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14151/all/Fetal_Alcohol_Syndrome PB - Wolters Kluwer Health ET - 7 DB - 5-Minute Clinical Consult DP - Unbound Medicine ER -