Alcohol and Pregnancy

18th February 2011

Here is an article you may be interested in in relation to Foetal Alchol Syndrome.

'There is no safe level of alcohol consumption in pregnancy.' Dr. Siobhán Barry, Ireland

Pregnancy and Alcohol

The general consensus amongst doctors and health care professionals is that alcohol is best avoided during pregnancy. Research suggests that excessive drinking and in particular binge drinking can cause irreparable harm to the foetus. That said, many women find themselves pregnant when they have been drinking socially. The advice would be to abstain from drinking once you discover you are pregnant to minimise the risk of damage to the foetus and potential life long problems for the child. The avoidance of all alcohol in pregnancy prevents any risk of foetal alcohol-related problems.

Alcohol use or abuse by a pregnant woman poses unique risks to the foetus. Alcohol ingested by a pregnant woman easily passes across the placental barrier to the foetus. This can cause damage throughout the pregnancy; however the earlier in the pregnancy that heavy drinking occurs, the more severe the damage. Increasing amounts of alcohol cause increased problems. Multiple birth defects are more common with heavy alcohol use or alcoholism.

Foetal Alcohol Syndrome

The exact amount of alcohol that causes this condition is unknown, although binge drinking is known to be particularly harmful. Between 177 and 354 babies are born each year in Ireland with Foetal Alcohol Syndrome and this figure increases to 1,770 if we include all alcohol-related neurological disorders, according to Professor Susan Ryan. She claims that Foetal Alcohol Syndrome is the biggest cause of non-genetic intellectual disability in the western world and the only one that is 100% preventable.

Prevention
The effects of Foetal Alcohol Syndrome are totally preventable by avoiding alcohol during pregnancy.

Features of Babies Born with FAS

Newborns can be irritable, floppy, experience severe tremors and show other signs of alcohol withdrawal. Children may exhibit effects from one or more of the following signs and symptoms depending on the amount and duration of foetal alcohol exposure.

Abnormal facial features - including small head (microcephaly); small upper jaw; short upturned nose; smooth philtrum (groove in upper lip); smooth and thin upper lip, and small and unusual appearing eyes with prominent epicanthic folds.
Growth retardation - Babies born with FAS often have low birth weight (less than 5.5lb).
Central nervous system abnormalities - Exposure to large amounts of alcohol during foetal development can affect the child’s brain and spinal cord in, for example, small brain size, impaired fine motor skills and poor eye-hand coordination.
Developmental delay - Children with FAS often have a mild to moderate learning disability (estimated to cause 10-20% of mild learning disability (IQ 50-80)).
Other birth defects - Between 20 and 50% of children with FAS have eye, ear or heart anomalies.

Behavioural Issues for Older Children with FAS

Children with FAS often have difficulties in their behaviour and learning. These may include:

problems with reasoning
difficulties with arithmetic
problems with abstract ideas and in generalising from one situation to another
inattentiveness and poor concentration
impulsivity and poor judgement
subtle memory difficulties.

These children may be given diagnoses of Oppositional Defiant Disorder and Conduct Disorder later in childhood.

Treatment

Unfortunately, the damage caused by alcohol exposure in the foetus cannot be reversed. Foetal alcohol syndrome is not just a childhood disorder; the cognitive and behavioural effects and psychosocial problems may persist through adolescence and into adulthood. Although the facial features are not as distinctive after puberty and the growth deficiency is not as apparent as in the younger child, the central nervous system effects do persist throughout life.

Classification of Alcohol Effects in Children

The American Academy of Paediatrics uses the following criteria for diagnosing alcohol-related effects in children. For a child to be diagnosed with these conditions, alcohol abuse during pregnancy must be confirmed.

Foetal Alcohol Syndrome (FAS). This condition may occur when a woman drinks large amounts of alcohol (4 to 5 drinks per day).
Foetal Alcohol Effects (FAE) Children with FAE have defects in more than one, but not all, of the FAS areas.
Alcohol-related neurodevelopmental disorder (ARND). Children with ARND have central nervous system abnormalities and behaviour and cognitive abnormalities. They do not have the facial features and growth retardation that can be caused by foetal alcohol exposure. ARND can occur either alone or in combination with FAS or FAE.
Alcohol related birth defects (ARBD). Alcohol may cause one or more birth defects of the eyes, ears, heart, kidney and bones. ARBD can occur either alone or with FAS or FAE.

Useful Websites:

www.fasstar.com/UK/ (This is the website of FAS-UK. It offers a wide range of information about the syndrome, with research reports, an awareness poster, and a 1992 story (with an Irish connection) by George Steinmetz in National Geographic (v.181:2).

www.fetalalcoholsyndrome.org (US)

www.fetalalcohol.com (Canadian)

http://hsc.uwe.ac.uk/fas-info/