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Fetal Alcohol Syndrome

Alcohol As A Teratogen

Infants, young children, and young adults who were exposed to alcohol during pregnancy often have lower than average birth weight and height. Cardinal clinical manifestations include physical abnormalities such as hypotonia (low muscle tone), smaller than normal skull, irregularities of the face including small eye sockets, mid-face hypoplasia (arrested development of the nose, or "flat-face" syndrome), and a very thin upper lip with either an elongated or absent lip indentation. Neurological or central nervous system disorders such as hyperactivity, learning and intellectual deficits, temper tantrums, short attention and memory span, perceptual problems, impulsive behavior, seizures, and abnormal electroencephalogram (EEG, or brain wave patterns) become apparent after the infant stage. Usually, the severity of the physical manifestations correlates with the severity of the intellectual deficits. Children exposed to alcohol during pregnancy may lack the typical physical features that characterize FAS, but manifest behavioral and neurological defects known as alcohol-related birth defects (ARBD).

Even for FAS-affected children with almost normal intelligence, learning problems become evident by the second grade. By third and fourth grade, affected children experience increasing difficulty with arithmetic, organizational skills, and abstract thinking. By the time they reach middle or junior high school, children with FAS display a delayed level of independence and self-control leading to persistent social adjustment problems. Impaired judgment and decision-making abilities often results in an inability to sustain independent living later in life.

The affects of FAS range from severe to mild and correlate to the amount and frequency of alcohol consumed by the pregnant woman and the stage of pregnancy in which drinking takes place. Also, drinking in the first three months of pregnancy may have more serious consequences than drinking the same quantities later in the pregnancy. The recurrence risk in the case of a woman who has had one child with FAS is approximately 25% higher than the general population, increasing as she continues to reproduce. The most severe cases seem to be children of long-term, chronic alcoholic mothers.

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