Fetal Alcohol Syndrome Risks During Pregnancy

Fetal alcohol spectrum disorder (FASD) is a childhood development disability that can range from mildly to moderately to severely debilitating. Fetal alcohol syndrome is the name for the most incapacitating form of FASD, but other types do exist: an FASD that produces moderate disability is known as partial fetal alcohol syndrome, while the least severe FASD is referred to alcohol-related neurodevelopmental disorder.

At one time, fetal alcohol syndrome and related disorders were considered fairly uncommon. But the latest evidence has refuted that assumption.

A recent study in the peer reviewed Journal of the American Medical Association (JAMA) revealed that FASDs were much more common in the United States than previously believed. It is now estimated that up to five percent of all American children may be suffering the effects of a fetal alcohol spectrum disorder, all as a result of alcohol consumption by their mothers during pregnancy.

In contrast, only about 1.5 percent of American children suffer from an autism spectrum disorder, a condition that has received much publicity and has generated great fear among parents and prospective parents. The variety of intellectual, emotional, and behavioral problems associated with mild, moderate, or severe fetal alcohol spectrum disorders is at least as broad as the disabling symptoms of autism, which highlights how underpublicized these disorders have been.

Medical experts who study fetal development agree: there is no such thing as a safe level of alcohol consumption by expectant mothers. Any amount of alcohol could put the developing fetus at risk for future disabilities, and alcohol consumed in the early stages of pregnancy can be just as damaging as alcohol consumed later.

When a pregnant woman drinks, the alcohol passes directly from her bloodstream into the bloodstream of her child. Throughout the various stages of fetal growth babies are extremely vulnerable to contaminants of any sort, and alcohol can inhibit the growth and development of cells throughout the body, most destructively in the brain, spinal cord, heart, kidneys, and bones.

When expectant mothers drink in the first trimester of pregnancy, babies may be born with serious facial abnormalities. Central nervous system damage can result from alcohol consumption that occurs at any point during the pregnancy, and growth problems (low birth rate, below-normal length) are another common side effect of repeated prenatal alcohol exposures.

Babies carried by mothers who drank alcohol during pregnancy are more likely to be stillborn or to be born prematurely. Heavier alcohol use by the mother means more severe damage, and full-blown fetal alcohol syndrome may be the result if a woman drinks continuously throughout the term of her pregnancy.

Only after birth is it possible to diagnose a fetal alcohol spectrum disorder, when its physical and behavioral effects are on full display.

As children age and develop, the consequences of any prenatal exposure to alcohol will become more evident. There are multiple physical, psychological, and behavioral signs and symptoms that may eventually manifest in children suffering from fetal alcohol spectrum disorders.

• Facial abnormalities (thin upper lip, lack of a groove between the nose and upper lip, shortened eye openings, flattening in the middle of the face)
• Heart defects and ongoing cardiac problems
• Bone abnormalities (weakness, deformation)
• Small head size
• Low body weight, at birth and later
• Lack of height, at birth and later
• Nursing difficulties
• Smaller-than-average brain size
• Speech impediments
• Hearing loss
• Poor vision
• Lack of motor coordination and fine motor skills

• Developmental delays
• Hyperactivity
• Poor focus and concentration
• Inability to sleep, or excessive sleep
• Disorganization
• Underdeveloped social skills
• Learning disabilities
• Memory problems
• Naivete, inability to tell right from wrong
• Deficient reasoning skills
• Lack of judgment and poor impulse control

Unfortunately, these symptoms of fetal alcohol exposure will not disappear with time. They will instead continue to influence the lives and futures of children as they transition into adolescence and adulthood.

While in school kids with fetal alcohol syndrome may require special assistance, and even young people with a moderate FASD will usually need additional academic and psychological services as they attempt to cope with the challenges of growing up and learning.

Drinking alcohol during pregnancy presents a direct threat to the health of babies. But expectant mothers are at risk for serious consequences as well, which can indirectly impact the health of their children even as it endangers them.

Alcohol consumption is associated with a number of preventable hazards. People under the influence of alcohol are more prone to accidents, make irresponsible decisions, fail to protect themselves adequately from dangerous people or situations, and compromise their physical health. If drinking occurs during pregnancy, the impact of their behavior is magnified, since anything that damages the health of the mother can also affect the health of the baby.

For example, miscarriages can result from accidents or exposures to violence. Because alcohol impairs judgment, a pregnant woman who drinks regularly is likely to encounter more stressful situations, and that can be a problem for unborn children since maternal stress during pregnancy is known to put children at risk for anxiety issues and mental and behavioral health disorders. Malnutrition is another possible side effect for expectant mothers who drink, and that obviously affects their ability to nourish their children both during their pregnancy and after giving birth.

Up to half of all pregnancies are unplanned, and women normally do not discover they are pregnant until at least a month after conception. Therefore, medical authorities now recommend that women who are sexually active and not using birth control stop drinking alcohol completely, if they have not already done so.

If this proves difficult or impossible, it could be a sign of addiction. Women who cannot stop drinking even after learning they’re pregnant may be struggling with chemical dependency, and as a precaution they should seek evaluation from a qualified medical professional or addiction specialist—and if a substance use disorder is diagnosed, they should begin treatment immediately.

The effects of fetal alcohol syndrome and other, less severe fetal alcohol spectrum disorders will extend into adulthood. Their impact on neurological and general physiological development is significant and permanent, and sufferers may need extensive medical and/or mental health interventions to cope with their conditions as they age.

Some of the common characteristics demonstrated by adults with fetal alcohol syndrome include:

• Ongoing learning disabilities, which can make it difficult to pursue higher educational opportunities or vocational training
• Poor concentration and focus, an inability to complete tasks
• Struggles to resolve problems constructively or to think about the long-term consequences of their actions
• Difficulties in forming new relationships, or conversely a tendency to get involved with manipulative or exploitive people
• Lack of social skills and the ability to understand social norms
• Increased risk for criminal behavior, marked by frequent encounters with the legal system
• Poor impulse control, which leaves them vulnerable to substance abuse, gambling addiction, or other compulsive behaviors
• Lack of sound judgment in areas ranging from financial management to sexual behavior
• Inability to adjust or react to change, or to initiate change that can improve living circumstances
• Poor self-care skills, including a lack of grooming and hygiene and a tendency to neglect medical and emotional needs

Many adults suffering from fetal alcohol spectrum disorders end up living in residential group homes, and they may need constant help and attention to complete various survival-related tasks. Many will be forced to apply for disability, and if they work they may require close supervision at all times.

The prospects for those with milder FASDs are better, but even they may need frequent physical and psychological therapy and regular assistance from caregivers.

Alcohol and pregnancy do not mix, and any woman who drinks should stop immediately once they discover they are pregnant.

Unfortunately, this is not so easy for women who’ve developed an alcohol use disorder. This type of chemical dependency always requires treatment, but the situation is especially urgent for expectant mothers whose behavior can directly impact their unborn children.

Pregnant women with alcohol problems should seek diagnosis and treatment right away, before their addiction continues to progress and their children are exposed to any more risk. Inpatient alcohol treatment programs offered by residential addiction treatment facilities can help expectant mothers safely overcome their drinking problems, by providing access to intensive individual, group, and family therapy along with complementary healing practices that support sobriety and wellness. Medical detox and prenatal care services can also be provided as needed, to make sure mother and child are both kept healthy and protected at all times.

Unchecked drinking by expectant mothers can easily lead to fetal alcohol spectrum disorders. But with treatment pregnant women can gain control over their drinking and substantially reduce the risks to themselves and their children. Fetal alcohol spectrum disorders are preventable, but only if action is taken early enough in the pregnancy to make a difference.