Alcohol in pregnancy
Key points
- Fetal alcohol syndrome is the manifestation of specific growth, mental, and physical birth defects associated with the mother's high levels of alcohol use during pregnancy.
- Alcohol use or abuse by the pregnant woman subjects her to the same range of risks that alcohol has in the general population.
- Consumption of alcohol by a pregnant woman may be the first indicator of potential fetal alcohol syndrome.
- Examination of the baby may show a heart murmur or other evidence of cardiac anomalies.
Alternative names
Fetal alcohol syndrome; At risk for fetal alcohol syndrome; Drinking alcohol during pregnancy
Definition
Fetal alcohol syndrome is the manifestation of specific growth, mental, and physical birth defects associated with the mother's high levels of alcohol use during pregnancy.
Causes, incidence, and risk factors
Alcohol use or abuse by the pregnant woman subjects her to the same range of risks that alcohol has in the general population. However, it poses extreme and unique risks to the fetus and is associated with fetal alcohol syndrome (FAS).
Timing of alcohol use during pregnancy is also of importance. Alcohol use during the first trimester is more damaging than during the second trimester, which is, in turn, more damaging than use in the third trimester.
Alcohol ingested by a pregnant woman easily passes across the placental barrier to the fetus. Because of this, drinking alcohol can adversely affect the development of the baby.
A pregnant woman who drinks any amount of alcohol is at risk, since a "safe" level of alcohol ingestion during pregnancy has not been established. However, larger amounts appear to cause increased problems. Multiple birth defects associated with "classical" fetal alcohol syndrome are more commonly associated with heavy alcohol use or alcoholism.
Fetal alcohol syndrome consists of the following abnormalities:
- Intrauterine growth retardation: growth deficiency in the fetus and newborn in all parameters - head circumference, weight, height
- Delayed development with decreased mental functioning (mild to severe)
- Facial abnormalities including small head (microcephaly); small maxilla (upper jaw); short, up-turned nose; smooth philtrum (groove in upper lip); smooth and thin upper lip; and narrow, small, and unusual-appearing eyes with prominent epicanthal folds
- Heart defects such as ventricular septal defect (VSD) or atrial septal defect (ASD)
- Limb abnormalities of joints, hands, feet, fingers, and toes
Symptoms
Consumption of alcohol by a pregnant woman may be the first indicator of potential fetal alcohol syndrome.
Others:
- Slow intrauterine and neonatal growth with occasional diagnosis of failure to thrive
- Delayed development and evidence of mild to moderate mental retardation (IQ range from 50 to 85 with reported average in the mid 60s)
Written and revised by
David Cohen, M.D.
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