Understanding Fetal Alcohol Spectrum Disorders National Institute on Alcohol Abuse and Alcoholism NIAAA

Normal development depends on numerous epigenetic changes in embryonic stem cells that facilitate their transition to fully differentiated and functional cell lineages such as neurons, muscle and fat cells120. Alcohol can disrupt development by inducing DNA methylation and histone acetylation in gene clusters and altering gene expression121. Epigenetic alterations resulting from PAE have been observed in animal models and humans, and these changes may be lifelong and inherited by future generations118,122,123,124. A pattern of DNA methylation in buccal epithelial cells was reasonably accurate (positive predictive value 90%; negative predictive value 78.6%) in discriminating children with FASD from typically developing controls or children with autism spectrum disorders125. Large replication studies in different populations are required before this approach might be considered for diagnostic purposes.

Symptoms

An estimated 50–90% of people with FASD are also diagnosed with attention deficit hyperactivity disorder (ADHD), and many other people have secondary mental health disorders such as depression and anxiety. Prenatal alcohol exposure is the leading preventable cause of congenital (present at birth) conditions in the United States. When consumed during pregnancy, alcohol crosses the placenta and enters the fetus’s bloodstream. This section provides information on evidence-based interventions, resources for clinicians, and helping families of children with an FASD access services and community supports. The challenges that occur along with fetal alcohol syndrome can be difficult to manage for the person with the condition and for the family.

What’s the difference between fetal alcohol syndrome (FAS) and fetal alcohol spectrum disorders (FASDs)?

Alcohol enhances GABAA receptor-mediated depolarization of migrating GABAergic interneurons through activation of L-type voltage-gated calcium channels, thereby accelerating tangential migration63. Dysfunction of GABAergic interneurons may impair inhibitory control of brain networks. In mice, PAE during corticogenesis also disrupts radial migration and pyramidal cell development in the somatosensory cortex, which could be linked to decreased tactile sensitivity during adolescence140. For instance, friendship training teaches kids social skills for interacting with their peers.

Alcohol also alters epigenetic gene regulation through changes in DNA methylation. Moreover, alcohol disrupts neuronal–glial interactions, induces inflammatory changes in the developing brain and causes microencephaly partly by depletion of neural stem cells. Other effects of alcohol include the disruption of Shh signalling (an effect that is potentiated by cannabinoids) and disrupted neuronal migration. The effects of alcohol on the placenta contribute to intrauterine growth retardation and adverse neurodevelopmental outcomes.

Research Centers and Consortia working on FASD

Modification of gut microbiota by alcohol may influence brain development through the action of circulating microbial by-products. Collectively, these actions of alcohol result in altered neural circuits and decreased neuronal plasticity. You can avoid fetal alcohol syndrome by not drinking alcohol during pregnancy. If you’re a woman with a drinking problem who wants to get pregnant, seek help from a doctor. If you’re a light or social drinker, don’t drink if you think you might become pregnant anytime soon.

Because brain growth takes place throughout pregnancy, stopping alcohol use will improve the baby’s health and well-being. Alcohol in the mother’s blood passes to the baby through the umbilical cord. The more you drink while pregnant, the greater the risk to your unborn baby. Your baby’s brain, heart and blood vessels begin to develop in the early weeks of pregnancy, before you may know you’re pregnant. It may be difficult not to worry if you had alcohol before knowing you were pregnant, but do your best not to dwell on the past. The CDC notes that if the pregnant person stops drinking, the baby will likely do better.

How is fetal alcohol syndrome (FAS) treated?

All alcohol, including beer, wine, ciders and hard liquor can all cause FAS. Also, don’t hesitate to talk openly with your health care provider so you can understand your real risks and what you can do if your baby does show signs of an FASD. FASDs include a range of both physical and intellectual disabilities that may not even be visible when your child is born. While there is no celebrities famous fetal alcohol syndrome adults known cure for FASDs, research shows that early intervention therapies may help improve a child’s development. FASD are the most common preventable cause of neurodevelopmental impairment and congenital anomalies164. These disorders are the legacy of readily available alcohol and societal tolerance to its widespread use, including during pregnancy.

Similarly, the Families on Track programme increases emotional regulation and self-esteem and decreases anxiety and disruptive behaviour251. However, interventions such as CFT and Families on Track are not widely available, and barriers to their use include the need to adapt to cultural context252. International partnerships and sharing of expertise may increase accessibility to these interventions252. All diagnostic systems recommend evaluating PAE, facial and non-facial dysmorphology, and CNS structure and function using an MDT approach.

1. Alcohol consumption has occurred for centuries, with harms from prenatal alcohol exposure (PAE) being mentioned in Greek and biblical verses and depicted in the art and literature of the eighteenth and nineteenth centuries1,2.
2. It can sometimes be difficult to diagnose a person with FASD because of the variety of symptoms and spectrum of severity.
3. Therapeutic approaches must be tailored to individual strengths and needs.
4. Often, children present first to family physicians, paediatricians and psychologists who lack sufficient expertise to confidently diagnose FASD.

One study found that the people with FAS had a significantly shorter life expectancy.6 With the average life span of 34 years old, a study found that 44% of the deaths were of “external cause”, with 15% of deaths being suicides. The prognosis of FASD is variable depending on the type, severity, and if treatment is issued.citation needed Prognostic disabilities are divided into primary and secondary disabilities. The most commonly used diagnostic systems for FASD are the Collaboration on FASD Prevalence (CoFASP) Clinical Diagnostic Guidelines10, the University of Washington 4-Digit Diagnostic Code165,166 and the Canadian Guidelines167 (Table 1). The Canadian Guidelines have been adapted for use in Australia168 and the UK169 and are also used in New Zealand170. Guidelines have also been recommended by the US Centers for Disease Control and Prevention171, the State Agency for Prevention of Alcohol-Related Problems (PARPA) in Poland172, and The German Federal Ministry of Health173. GABAergic interneurons comprise the principal inhibitory network of the brain.