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Fetal Alcohol Syndrome

Fetal alcohol syndrome (FAS) is a fetal alcohol spectrum disorder that affects children whose mothers consumed alcohol during pregnancy, resulting in physical and developmental abnormalities. This disorder has no cure, and the child may experience lifelong growth problems and nervous system abnormalities. The best way to prevent FAS is to avoid drinking any amount of alcohol while pregnant. Alcohol can be toxic to the unborn baby, and its exposure during pregnancy is the leading preventable cause of neurodevelopmental abnormalities and birth defects in the United States. This article provides information on the symptoms, causes, and risks of fetal alcohol syndrome.

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Fetal alcohol syndrome (FAS) is a fetal alcohol spectrum disorder (FASD) that occurs when a pregnant woman consumes alcohol during pregnancy. 

There is no known safe amount of alcohol that can be consumed while pregnant. Alcohol passes straight from the mother to the unborn baby across the umbilical cord. 

There is no cure for FAS. Growth problems and nervous system abnormalities are common and lifelong. However, there are some helpful interventions and treatment methods available to manage fetal alcohol syndrome. 

The best way to prevent FAS is to not drink during pregnancy.

What Is Fetal Alcohol Syndrome?

As there is no specific test for FAS, it is likely that there are more incidents of fetal alcohol syndrome than reported. 

Fetal alcohol syndrome is at the most extreme end of the fetal alcohol spectrum disorders (FASDs). It involves both physical and developmental abnormalities. 

Fetal alcohol syndrome is caused by exposure to alcohol prenatally, or during pregnancy. When the mother drinks alcohol, it passes to the baby through the umbilical cord and has toxic effects. 

FAS is a lifelong disorder with no cure. Children with fetal alcohol syndrome have facial abnormalities, nervous system issues, and growth problems.

Drinking alcohol during pregnancy can have an extremely detrimental effect on the unborn baby during any trimester. It can cause the following: 

  • Fetal death and spontaneous abortions 
  • Growth and development issues
  • Cognitive problems
  • Behavioral and social problems
  • A high risk for developing fetal alcohol syndrome

Key Facts About Fetal Alcohol Syndrome

It is important to understand that alcohol is toxic to an unborn baby. Again, no amount of alcohol is considered safe to drink during pregnancy. Alcohol can impact the baby during all three trimesters of pregnancy and potentially cause fetal alcohol syndrome.

  • Fetal alcohol syndrome is reported in 0.2 to 1.5 infants for every 1,000 births in the United States. It is likely that FAS is underreported, and actual rates are much higher.
  • A conservative approach surveying U.S. 1st graders found FAS was present 1.1 to 5 percent of the time
  • The lifetime cost of one person with fetal alcohol syndrome is estimated to be more than $2 million, with total annual costs for FAS in the United States reaching $4 billion.
  • Fetal alcohol syndrome is the most severe fetal alcohol spectrum disorder. It is a lifelong condition.

What Causes Fetal Alcohol Syndrome?

A fetal alcohol spectrum disorder, such as fetal alcohol syndrome, is directly caused by prenatal exposure to alcohol. This occurs when the mother consumes alcoholic beverages during pregnancy. 

Alcohol is carried through the mother’s bloodstream and the umbilical cord straight to the baby. Alcohol has a toxic effect on the baby and can impact healthy growth while in the womb. 

Alcohol disrupts fetal development at every stage of pregnancy, even before a woman knows she is pregnant. Alcohol in the baby’s bloodstream interferes with the critical development of organs, including the brain, bodily structures such as facial features, and physiological systems.

Alcohol exposure during pregnancy is the number one preventable cause of neurodevelopmental abnormalities and birth defects in the United States. Cognitive, developmental, and behavioral issues can appear at any time during childhood after prenatal exposure to alcohol, and these issues last a lifetime. One of the biggest issues with prenatal alcohol exposure is the permanent brain damage it can cause in the baby. 

Fetal alcohol syndrome is a preventable condition that can have lasting medical, emotional, behavioral, and social challenges that interfere with daily life.

Additional risk factors for the development of fetal alcohol syndrome include the following:

  • Poor nutrition
  • Women over the age of 30 with a long history of alcohol use
  • Women with a genetic susceptibility who metabolize alcohol at slower rates
  • Women who already have a child with fetal alcohol syndrome (increased risk for future children with the condition)

What Are the Symptoms of Fetal Alcohol Syndrome?

The collection of diagnoses for people exposed to alcohol during pregnancy are fetal alcohol spectrum disorders (FASDs), and fetal alcohol syndrome (FAS) falls under this umbrella. 

Symptoms can range from mild to severe for these disorders and impact each person in variable ways. These symptoms can include the following:

  • Vision and/or hearing problems
  • Issues with the heart and/or kidneys
  • Problems with bones
  • Short stature and shorter-than-average height
  • Low body weight
  • Small head size
  • Abnormal facial features, including wide-set or narrow eyes and a smooth ridge between the nose and upper lip (the ridge called the philtrum
  • Problems latching and sucking as a baby
  • Sleep issues
  • Learning disabilities
  • Low IQ or intellectual disability
  • Hyperactive behavior
  • Language and speech delays
  • Poor memory
  • Coordination issues
  • Attention problems
  • Poor judgment and reasoning skills
  • School issues, especially with math

People with fetal alcohol syndrome have social issues, trouble getting along with others, and problems in school. FAS can cause learning, memory, communication, vision, hearing, and attention span issues. 

Fetal alcohol syndrome is often underdiagnosed or misdiagnosed. It is important to have a correct diagnosis for optimal treatment and management techniques. Oftentimes, multiple medical assessments are needed.

What Are the Risks of Fetal Alcohol Syndrome?

Fetal alcohol syndrome can lead to a host of social, emotional, physical, behavioral, and developmental issues. 

People with fetal alcohol spectrum disorders are more likely to struggle in school both academically and socially and have difficulties with impulse control and attention. They are more likely to have ADHD (attention deficit hyperactivity disorder), depression, anxiety, and conduct issues. They have increased rates of alcohol and drug use and addiction. 

People with fetal alcohol syndrome have growth issues as well as problems with their central nervous system functions. They also commonly have facial feature malformations. 

Fetal alcohol syndrome can lead to bone, heart, and kidney problems. It can increase the risk for seizures and neurological issues. FAS can potentially raise the odds for chronic health problems, such as these: 

  • Diabetes
  • Cancer
  • Hypertension
  • Immune dysfunction

People with fetal alcohol syndrome are less likely to be able to live independently without issue. They often have psychiatric concerns and personality disorders. They have difficulties staying in school and obtaining a degree or maintaining stable employment. They often have drug and alcohol problems, and they commonly get in trouble with law enforcement. 

Understanding Alcohol Abuse During Pregnancy

About one out of every seven pregnant women report current drinking while pregnant, and 5 percent report binge drinking in the past month. Any amount of alcohol abuse during pregnancy can be harmful to both mother and unborn baby. 

Alcohol travels into the blood, tissues, and organs of the baby. It is much harder for the unborn baby to break down alcohol than it is for a grown adult. The blood alcohol level in a baby will remain elevated for much longer, which means that alcohol has more impact on the baby’s brain and system, as the baby will be exposed for longer. Alcohol has teratogenic effects on the development and health of the unborn baby.

Any amount of alcohol use is unsafe during pregnancy, so it is important to stop drinking as soon as you can to prevent potential issues. It is ideal to stop drinking before becoming pregnant, but women often find out several weeks or even months into their pregnancy that they are pregnant. As soon as pregnancy is discovered, alcohol use needs to stop. 

When alcohol dependence and addiction are present, a specialized alcohol abuse and addiction treatment program for expecting mothers is needed. If someone has been drinking for a long time at high levels, they should never attempt to quit drinking on their own. Medical supervision is needed to ensure safety.

In a comprehensive treatment program, professionals will work to safely control withdrawal symptoms and cravings and minimize the chances for relapse. 

How to Prevent Fetal Alcohol Syndrome

Heavy drinking is classified as engaging in five or more binge drinking episodes in a 30-day period.

The only absolute way to prevent fetal alcohol syndrome is to not drink while trying to get pregnant or while pregnant. Typically, it can be a few weeks to a month or more before a woman even knows she is pregnant. Drinking alcohol during any stage of pregnancy can be harmful to the unborn baby. 

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) warns that binge and heavy drinking in pregnant mothers present the most risk for unborn babies. They also stress that no amount of alcohol is safe during pregnancy, and even in small amounts, alcohol can cause birth defects and growth and development issues.

Binge drinking is defined as four or more drinks in a two-hour period for a woman, or any amount of drinking that brings the BAC (blood alcohol concentration) to 0.08 grams of alcohol per deciliter or higher.

Deciding to stop drinking before trying to get pregnant, and abstaining from alcohol consumption during pregnancy, is the only way to completely prevent fetal alcohol syndrome.

Treatment Options for Fetal Alcohol Syndrome

There is no specific treatment for fetal alcohol syndrome, but there are many options that can help with the symptoms and severity of the condition. Treatment plans should be individual and tailored to the specific child. 

Treatment for fetal alcohol syndrome often includes the following methods:

  • Medications for specific medical or mental health symptoms
  • Medical care for related health conditions
  • Behavioral therapies
  • Educational therapy
  • Parent involvement and training
  • Speech and language therapy
  • Physical and occupational therapies
  • Support groups for families

There are several protective features that can help to improve treatment outcomes in children with fetal alcohol syndrome, which can include early interventions (diagnosis and treatment before 6 years old). A high level of parental support and involvement in social services and special education as early as possible is very beneficial as well. 

It is important for the child to be raised in a stable, supportive, loving, calm, and nurturing home environment, particularly early in life. Absence of violence around children with fetal alcohol syndrome improves treatment outcomes.

The Bottom Line

Drinking alcohol during pregnancy can have lasting repercussions, including fetal alcohol syndrome developing in the unborn baby. A child born with FAS will need a high level of support to learn how to talk, walk, and interact properly with the world around them. They will require consistent monitoring and follow-up care to ensure that their treatment plan evolves and remains effective.

FAS is a serious condition, but it can be prevented and treated. It is essential to stop drinking as soon as possible in pregnancy to prevent significant brain damage and developmental issues in the baby. A comprehensive addiction treatment program can help that to happen.

Fetal Alcohol Syndrome FAQs

Is it okay to have one alcoholic drink when pregnant?

Alcohol is harmful to the fetus in any amount. Regular drinking can cause fetal alcohol syndrome, so it is not considered safe to drink any amount of alcohol while pregnant.

Can I have a glass of wine during pregnancy?

It is recommended to stop drinking alcohol completely during pregnancy to avoid potential complications and issues such as FAS. All forms of alcohol are harmful during pregnancy, including beer and wine. There are nonalcoholic wines that can be enjoyed on occasion.

How much alcohol is safe during pregnancy?

No amount of alcohol is safe during pregnancy as it passes directly to the baby via the umbilical cord.

What happens if I binge drink in early pregnancy?

Alcohol consumption, even early in pregnancy, can cause a variety of health issues in the baby, including FAS. Drinking in early pregnancy can cause the baby to have abnormal facial features when born.

While it’s unlikely that a single binge drinking episode will cause significant harm, consult your doctor.

Updated April 1, 2023
  1. Data & Statistics on FASDs. (January 2022). Centers for Disease Control and Prevention.
  2. Prevalence of Fetal Alcohol Spectrum Disorders in 4 US Communities. (February 2018). JAMA Network.
  3. Fetal Alcohol Spectrum Disorders FAQs. (2022). American College of Obstetrics and Gynecologists.
  4. Fetal Alcohol Exposure. (June 2021). National Institute on Alcohol Abuse and Alcoholism.
  5. Fetal Alcohol Syndrome. (June 2022). StatPearls.
  6. Basics About FASDs. (January 2022). Centers for Disease Control and Prevention.
  7. What Happens When Children with Fetal Alcohol Spectrum Disorders Become Adults? (September 2015). Current Developmental Disorders Reports.
  8. Alcohol and Pregnancy. (January 2022). National Library of Medicine.
  9. Fetal Alcohol Spectrum Disorders. (May 2022). National Library of Medicine.
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