What Are Foetal Alcohol Spectrum Disorders and How Are They Prevented?

Consuming alcohol before pregnancy can impact a woman’s fertility and reduce her chances of conceiving. It is generally advised that women who are trying to conceive or are pregnant abstain from alcohol use, as it can pose risks to the developing fetus. Consuming alcohol during pregnancy will allow the alcohol in the mother’s blood to easily pass through the placenta and enter the baby’s bloodstream. The developing foetus's inability to efficiently metabolise alcohol can result in prolonged exposure to alcohol during pregnancy interfering with the development of the baby’s brain and other critical organs. This can lead to deficits after birth and beyond. Alcohol can disrupt development at any stage, even before a woman knows that she is pregnant.

There is no known safe amount of alcohol during pregnancy and research shows that excessive drinking during pregnancy puts a developing baby at the greatest risk for severe problems. However, even lesser amounts can cause harm.

 

What Are the Types of Foetal Alcohol Spectrum Disorders?

The term foetal alcohol spectrum disorders (FASD) is an umbrella term that includes physical, cognitive, and behavioural abnormalities caused by prenatal alcohol exposure. Depending on the features identified, the disorders categorised as FASD include:

 

Foetal Alcohol Syndrome (FAS)

The most severe form of FASD, is characterised by facial abnormalities, growth deficiencies, and central nervous system problems. Some of the facial abnormalities of FAS include a smooth ridge between the nose and upper lip, a thin upper lip, and small eye openings. Children with FAS may have weight and height growth deficiencies. A range of intellectual and behavioural disabilities is common in FAS.

 

Partial Foetal alcohol Syndrome (pFAS)

Similar to FAS and shares some of the features of FAS but does not meet the diagnostic criteria for a full FAS diagnosis. An individual with pFAS may exhibit, but not all of the physical, behavioural and intellectual abnormalities associated with foetal alcohol syndrome. They have slow growth and central nervous system problems.

 

Alcohol-Related Neurodevelopmental Disorder

Central nervous system abnormalities and behavioural or cognitive impairments, however, lack the physical characteristics that are typically observed with FAS. Individuals sometimes experience impulsiveness, and inattentiveness and find it difficult to perform in school. 

 

Alcohol-Related Birth Defects

Physical abnormalities due to prenatal alcohol exposure, excluding facial features associated with FAS. Physical birth defects can affect the heart, eyes, skeletal system, ears and kidneys. 

 

Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure

Central nervous system (CNS) problems especially difficulties in thinking and memory, behavioural problems like severe tantrums and mood issues. They experience difficulty with daily tasks like bathing and social interactions. 

 

What Are the Signs and Symptoms of Foetal Alcohol Spectrum Disorders?

FASD can make it very difficult for a child to reach their developmental milestones. Individuals with FASD experience a range of challenges which may include cognitive and learning difficulties, behavioural impairments as well and secondary disabilities including medical, educational, mental health, and social challenges, throughout their lives. They are also subject to stigmatisation due to the lack of awareness and understanding of the nature of FASD. People with FASD may face challenges in the following areas:

•         Understand and follow directions
•         Short concentration span
•         Poor memory
•         Speech and language delays
•         Controlling emotions and impulsivity
•         Communicating and developing social skills
•         Experiencing depression and anxiety

 

How is FASD diagnosed?

To diagnose FASD an individual must undergo a comprehensive assessment that includes various factors. The diagnostic process includes the following steps:

 

Clinical Evaluation

A thorough clinical examination is conducted. This examination should consider physical features associated with FASD, growth parameters and any abnormalities that are observed.

 

Developmental and Behavioural Assessment

These assessments are important to help healthcare professionals and parents understand neurobehavioral strengths and limitations.

 

Why is Early Diagnosis of FASD Crucial?

Regular visits to the paediatrician are an essential part of preventive care. These visits allow healthcare providers to track your child's growth and development. The sooner FASD is identified, the better the outcomes for the affected individuals and families. Earlier identification can enable prompt access to intervention services and support. Knowledge of FASD can help individuals develop appropriate educational strategies that will enable the affected individual to optimise their educational experience. Early identification can help families gain resources, counselling and support networks that will help in navigating the challenges associated with raising a child with FASD.

 

Why are FASD Often Undiagnosed or Misdiagnosed?

Undiagnosed or misdiagnosed cases of FASD can be attributed to several factors:

Lack of Awareness

Healthcare professionals may not be aware of the signs and symptoms of FASD, resulting in oversight during assessments. This can lead to inappropriate interventions and support. 

 

Complexity of Diagnosis

FASD is a complex spectrum. Symptoms of FASD may overlap with other developmental disorders, making an accurate diagnosis very difficult.

 

Stigma and Guilt

Due to the stigma associated with drinking while pregnant, women don’t speak about it with the fear of being judged. FASD can occur even with low or moderate alcohol consumption during pregnancy. 

 

Are There Treatment Options For FASD?

FASD is a lifelong condition, with no cure. Early intervention can aid a child’s development. There are various types of medical treatments to help with symptoms, behaviour, and education. Close monitoring with regular check-ups, and adjustments to treatment plans can contribute to better results and outcomes.

Prevention is indeed better than cure, therefore treating the mother’s alcohol use problem can prevent further pregnancies from being affected with FASD. Seek medical advice if you suspect you have a problem with alcohol or substance abuse.