Fetal Alcohol Synodrome Essay Example for Free

foetal alcoholic beverageic beverage Synodrome auditionIntroduction It sounds simple women who take in excessively man pregnant ar at high risk of infection for giving surrender to children with birth defects. Therefore, to bar these defects, women should stop inebriety alcoholic drinkic drinkic beverage during all phases of maternal quality. Alternatively, women who drink alcohol should not become pregnant unless and until they can control their drinking. More than 20 years ago, when fetal alcohol syndrome (FAS) was first report in the published medical literature, there were high hopes for its barroom.In fact, this has not been simple, and the biomedical and public health communities are still struggling to eliminate a birth defect that should be absolutely preventable. HISTORY Although references to the set up of antepartum exposure to alcohol can be found in classical and biblical literature, fetal alcohol syndrome was first described in the medical literat ure in France by Lemoine et al. in 1968. Researchers in the United States soon also published a landmark circulate describing a constellation of birth defects in children born(p) to alcoholic women (Jones and smith, 1973).FAS has since been described in most countries of the world. Briefly, FAS refers to a constellation of physical ab naturalities, most obvious in the features of the face (see Figure 1-1) and in the reduced coat of the newborn, and problems of behavior and cognition. These latter features lead to the most concern. The degree of abnormality in any one bank bill can vary greatly betwixt individuals and can change with time in the same individual. For instance, throng diag hooterd with FAS can let IQs from well within the normal range to the severely psychologically retarded range.The physical anomalies can be s atonic or quite striking. Some people with FAS live fair normal lives if given adequate and structured support throughout their lives, whereas othe rs are severely impaired. The defects whitethorn or may not be apparent or easily diagnosed at birth. Although the manifestations of the damage might change with age, FAS neer completely disappears and, as with many increaseal disabilities, there is no cure, although there might be just virtually amelioration in or so individuals.FAS does not refer to signs of acute alcohol exposure or coitus interruptus at birth. impertinentlyborns can have blood alcohol levels high enough to affect acutely their main(prenominal) nervous system function and not have FAS. Newborns can also have no alcohol in their bloodstream at time of deli very(prenominal) barely still have FAS. FAS is not a drunk baby. The exists of FAS and cogitate causes can be quite highfor the individual, for the family, and for society. Three hosts have well-tried to estimate these costs, and these estimates vary greatly (Bloss, 1994).These estimates are problematic, beca map of uncertainties regarding the inc idence and prevalence of FAS and uncertainties related to the full extent of health (and other) problems experienced throughout the life story of people with FAS. Estimates of the occurrence of FAS in North American communities range from 0 per 1,000 (incidence Abel and Sokol, 1987, 1991) to 120 per 1,000 (prevalence Robinson et al. , 1987), although rates in several of the most complete studies are similaron the assemble of 0. 5 to 3 cases per 1,000 births.Assuming an annual birth cohort of approximately 4 million, this translates into 2 to 12 thousand FAS births per year in this country. As described in the report, there is a lack of longitudinal data on the extent of possible problems of adults with FAS. Therefore, cost estimates for the United States range from $75 million (Abel and Sokol, 1991) to $9. 7 billion (Harwood and Napolitano, 1985). The total lifetime cost per typical case of FAS for a child born in 1980 was estimated to be $596,000 undiscounted1 (Harwood and Napoli tano, 1985).These incidence and cost figures are offered not as launch facts but they are mean to emphasize that regardless of the details, or any one specific estimate, the costs of FAS to the individual and society are high. FIGURE 1-1 Photographs of children with fetal alcohol syndrome. SOURCES Figures 4C and 4D Reprinted with permission from Jones et al. (1973). Copyright 1973 by the Lancet Ltd. Figure 4B Reprinted with permission from Clarren and Smith (1978). Copyright 1978 by the New England Journal of Medicine, Massach givetts Medical Society.Since publication of the papers by Lemoine and by Jones and Smith, the biomedical, public health, seek, and public form _or_ system of government communities have devoted much time and energy to a gripping problem of teratology (the occupy of the effects of chemical exposure on the developing fetus), neurobiology, disease prevention, and social disarray. The U. S. earth wellness Service has spent millions of dollars in interrog ation, public education, and service programs related to the topic. Important concepts have been established through research.For example, well-controlled research studies on rats, mice, and nonhuman primates have demonstrated that alcohol exposure ca engrosss FAS. However, mend alcohol is the necessary teratogen, it alone may not be sufficient to produce FAS in military man or birth defects in animals. As with most teratogens, not every fetus exposed to fundamental amounts of alcohol is affected. The outcomes might be modulated by numerous biologic and environmental factors, such as nutrition, threshold, timing, genetic susceptibility, pattern of alcohol exposure, or fetal resilience. that research is needed to fully finish up the factors that influence the expression of alcohol teratogenesis. Public education campaigns have taught many women and their partners, as well as the medical community and society at large, that excessive alcohol consumption is dangerous during pregna ncy. Reduction in the occurrence of warmness misapply during pregnancy, reduction in the incidence of FAS, and an increase in the questioning of patients by health aid providers about alcohol and other drug use are goals of the Public Health go Healthy People 2000 initiative (U. S. Department of Health and Human Services, 1991).See Table 1-1. legal community of birth defects as a salient public health goal presents some exemplary supremacy stories. A good example is the advocacy for and impact of three- daytimetime measles immunizations for children and women of childbearing age with no bill of natural rubella or rubella immunization. An outbreak in the United States in the mid-1960s resulted in an estimated 20,000 children born with congenital rubella syndrome (CRS). CRS occurs in 20 to 25 percent of babies born to mothers who get rubella in the first trimester of pregnancy and results in congenital heart disease, deafness, mental retardation, and other fetal abnormalities .An estimate of the lifetime cost of CRS is about $330,000 per case. With widespread introduction of rubella vaccines in the late 1960s and the requirement for rubella immunization prior to school entry, the number of reported cases of CRS in the United States hit a depression of 225 in 1988. As another example, new findings that folic acid deficiency during pregnancy can result in neural tube defects have led to recommendations that grain be fortified with folic acid to prevent these birth defects. Availability of effective prevention strategies led to public policy debates and recommendations for action.The emergence of crack cocaine as a major medical and public health problem in the 1980s led to worries about a generation of crack babies who would cost the medical misgiving system, primarily neonatal intensive care wards, huge amounts of money and who would overburden the education and social service systems with problems attributable to prenatal exposure to cocaine. Further r esearch has imagen that crack cocaine can lead to serious obstetrical complications and that some of the exposed newborns do have problems. TABLE 1-1 Examples of Healthy People 2000 Goals Relevant to Fetal inebriant Syndrome (FAS) Objective 1987 Baseline.Target 2000 incidence of FAS (per 1,000 live births) 0. 22 0. 12 Abstinence from alcohol during pregnancy 79% Increase by 20% Screening by obstetrician/gynecologist for alcohol use 34% 75% Referrals by obstetrician/gynecologist for alcohol treatment 24% 75% Screening by obstetrician/gynecologist for drug use 32% 75% Referrals by obstetrician/gynecologist for drug treatment 28% 75% Cocaine-exposed children have not been followed as extensively or for as long a time as alcohol-exposed children what data have been published show some effects of prenatal cocaine exposure at three years of age, but the problems do not seem to be nearly as annihilating as predicted, nor as severe as the long-term problems associated with alcohol exposu re.In fact, some of the long-term effects associated with prenatal cocaine exposure may be due in part to the concurrent use of alcohol during pregnancy. The federal government invested millions of dollars in display projects for services for substance-abusing women. Some of these programs included services for women who horror alcohol, but the emphasis was usually on drugs, particularly illegal ones, other than alcohol, or on polydrug use.The concern to crack cocaine and its effects on the fetus is curious given that the percentage of pregnant women who drink (approximately 20 percent) faraway exceeds the percentage who use cocaine (approximately 1 percent content Institute on Drug annoyance, 1994). At the time, however, the cocaine epidemic and its potential risks to unborn children led to heated public policy debates. Policies of mandatory urine testing in delivery wards, and subsequent removal of a child from the care of a mother who tested positive for illegal substances, were buildd in many places (Blume, in press Chavkin, 1990).The accidental negative consequences of these actions have led to a reconsideration and reversal of these policies more than recently. THE FEDERAL RESPONSIBILITY FOR FAS look into As will be described in many parts of this report, FAS is a complicated health and social problem, involving many different sectors of the government. The U. S. Public Health Service (USPHS) contains the agencies with primary responsibility for research in the area. The National Institute on inebriant Abuse and alcoholic drinkism (NIAAA) of the National Institutes of Health (NIH) has the lead authority in research on FAS.However, NIAAA is a relatively petite institute of NIH. The NIAAA appropriation in 1993 was $177 million, compared with more than $400 million for the National Institute on Drug Abuse (NIDA) and slightly less than $2 billion for the National Cancer Institute (U. S. Department of Health and Human Services, 1993). NIAAA pro grams related to FAS include very staple fiber animal research, which has been the mainstay of research in this area clinical and epidemiologic research on the effects of low to moderate alcohol use by pregnant women and prevention research. The alcohol and pregnancy program at NIAAA included $9.8 million to $13. 5 million for approximately 70 grants in each of fiscal years 1990-1994. Most of these research grants were RO1, investigator-initiated awards. NIAAA monetary resource one fetal alcohol research center. In addition, many research programs sponsored by NIAAA have ancillary importance to FAS, for example, the research it funds on the epidemiology of drinking by women or on general approaches to the prevention and treatment of alcohol abuse. As an example of the level of commitment by NIAAA to this issue, the prevention research program at NIAAA has ranged from $15 million to $19.8 million annually in recent years. As the lead research agency on alcohol, the institute and th e USPHS can serve as a bully pulpit for the prevention of FAS and other alcohol-related problems. In fact, this has been the case. The U. S. surgeon General first issued a warning against the dangers of alcohol during pregnancy in 1981. In addition to backup and conducting research, NIAAA publishes information for the public on FAS, sponsors research workshops on FAS, and has its staff speak at public meetings. former(a) NIH institutes fund research pertinent to, but not directly about, FAS.For example, NIDA funded a $4 million National gestation and Health Survey on substance abuse, including alcohol, during pregnancy. The data on alcohol were a small part of the full project. In addition, NIDA funds epidemiologic and clinical research on the effects of substance abuse during pregnancy, and alcohol is frequently one of the substances employ by these populations. A rather large issue funded by NIDA was the Perinatal 20 demonstration project assessing prevention of substance a buse during pregnancy.Although the major adjudicate was to look at the abuse of illegal substances, some data were befooled on alcohol use, as well. Another key USPHS agency involved in FAS work is the Centers for Disease Control and streak (CDC). The FAS Prevention voice is ho utilize in CDCs National Center for Environmental Health, Division of Birth Defects and Developmental Disabilities. CDCs role is to collect data to define the scope of the problem support the phylogenesis and evaluation of FAS prevention projects and build call forth capacity for coordinated, state-based FAS surveillance and prevention programs (CDC submission to IOM committee).The CDC maintains and analyzes surveillance programs that include FAS, such as the Birth Defects monitor Program. In addition, CDC sponsors and supports efforts to prevent FAS. The CDC currently has FAS prevention and surveillance projects supported through states and universities. As with NIAAA, CDC has ancillary programs relate d to maternal and child health, alcohol abuse, and epidemiologic surveillance that can support and inform FAS programs. Other agencies in the USPHS maintain important programs related to FAS, but these programs have much less emphasis on research.The Indian Health Service, the Health Resources and Services garbage disposal (HRSA), and the Substance Abuse and Mental Health Services Administration (SAMHSA) fund services or demonstration projects directly or indirectly related to FAS. At this time, no agency has been able to support research on the clinical aspects of FAS, on the medical treatment of children with FAS, or on the education and remediation of these children. A notable USPHS program is the Pregnant and Postpartum Women and Their Infants (PPWI) initiative. This program was let by the Anti-Drug Abuse wreak, passed by relation in 1988.The demonstration grant program commissiones on the development of innovative, community-based models of drug prevention, education, and t reatment, targeting pregnant and postpartum women and their babes (National Center for Education in Maternal and Child Health, 1993). The program is funded conjointly by the Center for Substance Abuse Prevention (CSAP) of SAMHSA and the Maternal and Child Health Bureau of HRSA. It has funded 147 demonstration projects. The most common drug addressed was cocaine, followed by alcohol and polydrug use.Be showcase demonstration projects are rigorously evaluated lone(prenominal) infrequently, the nature, utility, and transferability of their findings are difficult to assess. The Center for Substance Abuse manipulation (CSAT), a part of SAMHSA, was charged by Congress to support grants for residential and outpatient substance abuse treatment for pregnant and postpartum women and their childs (information provided to the committee). CSAT funded 31 residential projects in 20 states in the PPWI program and 34 projects in 24 states in its Residential Treatment for Women and Their Children program.The quintette treatment programs that serve Native American women include comprehensive services specific to FAS. In addition, CSAT has other activities, such as its Treatment Improvement Protocols, relevant to FAS, but the abuse substance of focus is usually cocaine or opiates, not alcohol. CONGRESSIONAL INTEREST In recognition of the seriousness of this problem, which affects some(prenominal) the health and the societal functioning of many Americans, several times in the past few years, members of Congress have introduced legislation related to FAS (see Table 1-2).The bills have focused largely on creating an interagency task strength on FAS and increasing resources for prevention programs and prevention research. These bills, with one exception, have never been passed. The U. S. Congress mandated in Section 705 of Public Law 102-321, the ADAMHA Reorganization Act, that the Institute of Medicine (IOM) of the National Academy of Sciences conduct a study of FAS and relat ed birth defects. TABLE 1-2 Congressional wits Related to Fetal Alcohol Syndrome (FAS) or Women and Alcohol Bill No. and Date Introduced Bill Name Major Sponsor Overview H. R. 1322 3/7/91. world-wide Indian Fetal Alcohol Syndrome Prevention and Treatment Act Campbell (D-CO) Authorize services for the prevention, intervention, treatment and aftercare of American Indian and Alaskan Native children and their families at risk for FAS and fetal alcohol effect (fuel-air explosive). Authorization of grants to Native American tribes for preparedness, prevention, and intervention programs. Convening of FAS/FAE task force including federal representation and representation from Native American tribes. Would have authorized $10 million annually for FY 1993-1995 and $15 million annually for FY 1996-2000.S. 923 5/7/93 Comprehensive Fetal Alcohol Syndrome Prevention Act Daschle (D-SD) Expand resources for basic and applied epidemiological research related to FAS/FAE. hit programs to coordinat e and support national, state, and community-based public awareness, prevention, and educational programs on FAS/FAE. Establish and despatch a national surveillance program to monitor the incidence of FAS/FAE and the effectiveness of prevention programs. Establish a task force to foster coordination among federal agencies that conduct FAS/FAE research, prevention, and treatment.H. R. 3569 11/19/93 Women and Alcohol Research Equity Act of 1993 Morella (R-MD) Provide for an increase in the amount of federal funds expended to conduct research on alcohol abuse and alcoholism among women. Would have authorized up to $23,250,000 to enable NIAAA to increase such research. H. R. 3783 2/2/94 Comprehensive Fetal Alcohol Syndrome Prevention Act Richardson (D-NM) Establish a comprehensive program to help prevent FAS and FAE and to coordinate federal efforts to prevent FAS and FAE. CDC to coordinate and support applied epidemiologic research on FAS and FAE.NIAAA to conduct and support basic res earch targeted to developing data to improve prevention and treatment of FAS and FAE. Develop a plan to disseminate symptomatic criteria to health care and social services providers. Establish an interagency task force on FAS and FAE. SAMHSA to support, conduct, and evaluate training programs for professionals and prevention and education programs for the public. S 170 1/5/95 Comprehensive Fetal Alcohol Syndrome Prevention Act Daschle (D-SD) Establish interagency task force on FAS and FAE.Organize a program of basic research on services and effective prevention, treatment and intervention for pregnant alcohol-dependent women and those with FAS or FAE Originally introduced as S. 1821 in previous session but died in committee. H. R. 1649 5/16/95 Comprehensive Fetal Alcohol Syndrome Prevention Act Richardson (D-SD) Establish a program for the conduct and support of research and training and the dissemination of health information about the cause, diagnosis, prevention and treatment of FAS and related conditions. Establish an.Interagency set up Committee on Fetal Alcohol Syndrome. Develop uniform criteria for the collection and reporting of data on FAS and related conditions. NOTE CDC = Centers for Disease Control and Prevention NIAAA = National Institute on Alcohol Abuse and Alcoholism and SAMHSA = Substance Abuse and Mental Health Services Administration. The National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health funded the project. This report is in response to that mandate. The Committee to Study Fetal Alcohol Syndrome was convened in mid-1994.Committee expertise included pediatrics, developmental psychology and neurology, obstetrics, nosology, teratology, epidemiology, sociology, substance abuse prevention and treatment, and psychiatry. The charge to the committee was to improve the empathizeing of available research knowledge and experience on tools and approaches for diagnosis FAS and related disorders, the prevalence of FAS and related disorders in the general population of the United States, the effectiveness of surveillance systems, and the approachability and effectiveness of prevention and treatment programs for these conditions.As part of its work, the committee assessed and reviewed U. S. Department of Health and Human Services agency research on the topic and provided guidance for the future. SOME IMPORTANT DEFINITIONS Before going further, some clarification of term is warranted. Several terms are used in this report to refer to drinking patterns and problems. The terms used here are intended to be consistent in spirit with an front IOM report Broadening the Base of Treatment for Alcohol Problems (IOM, 1990), particularly in their emphasis on the heterogeneity of alcohol problems, the course of alcohol use disorders, patterns of consumption, and etiology.In this schema, alcohol consumption is seen as ranging from none to light to moderate to heavy. Alcohol-related problems (e. g. , medical, legal, social, psychological) also range from none to mild to moderate to severe. Research has pointed to a positive coefficient of correlation between level of alcohol consumption and level of alcohol problems, with the most severe problems generally seen at the highest levels of drinking. This relationship is, however, variable across individuals that is, in some cases, severe problems can be seen at relatively moderate levels of drinking.The fourth edition of the American psychiatrical Associations Diagnostic and Statistical Manual (DSM-IV 1994) defines alcohol use disorders as alcohol dependence and alcohol abuse. In general, these terms refer to maladaptive patterns of drinking and consequences which pretend a syndrome, usually associated with moderate to heavy alcohol consumption and moderate to severe alcohol-related problems (Edwards et al. , 1981 IOM, 1990).In DSM-IV, alcohol dependence is diagnosed when the individual meets three or more of the following seven criteria in a 12-month geological consequence (1) tolerance (2) withdrawal (3) drinking in larger amounts or over a longer period than intended (4) persistent desire or unsuccessful efforts to cut down on drinking (5) a great deal of time spent drinking or recovering from alcohol effects (6) declining enfolding in social, occupational, or recreational activities because of alcohol use and (7) use of alcohol despite knowledge of a persistent or perennial physical or psychological problem caused or exacerbated by that use.Alcohol abuse is a less severe syndrome characterized by significant adverse consequences associated with alcohol use and is diagnosed when at least one of the following four criteria is met recurrently during a 12-month period (1) failure to fulfill major role obligations because of alcohol use (2) recurrent alcohol use in situations when it is physically barbaric (3) recurrent alcohol-related legal problems or (4) continued use despite social or interpersonal problems. In addition, the symptoms have never met the criteria for alcohol dependence (American Psychiatric Association, 1994).Alcohol abuse and alcohol dependence have fairly specific meaning in DSM-IV. However, these terms are frequently used as umbrella terms for maladaptive patterns of alcohol use. In this report on FAS, the committee has chosen to use alcohol abuse as an umbrella term to indicate heavy drinking, including binge drinking, that is risky for the given individual circumstances. If it is take a leak that a strict DSM-IV diagnosis is intended, it will be so noted. Similar conventions will be used for substance abuse, which is treated very similarly in DSM-IV (American Psychiatric Association, 1994).DSM-IV does not define the term alcoholic, but the National Council on Alcoholism and Drug Dependence does (Morse et al. , 1992). Alcoholism, too, is used but only occasionally in this report. It should be noted that there are no specific levels of consumption associate d with alcohol abuse, either as used in DSM-IV or as an umbrella term in this report. Survey data from 1992 show that approximately 4 percent of all women and approximately 4 percent of women between the ages of 30 and 44 years of age could be considered to satisfy the DSM-IV criteria for alcohol abuse and alcohol dependence (Grant et al., 1994).As described in the report, the relation between levels and patterns of drinking during pregnancy and the risk of delivering an infant with FAS is complex. In this report, terms such as heavy drinking and heavier drinking are used to refer to levels of drinking associated with the highest risk for delivering an infant with FAS. Binge drinking is used to refer to a pattern of episodic heavy drinking, which is also associated with higher(prenominal) risk for FAS.Terms such as risk drinking, or moderate drinking are used to indicate lower levels of drinking, usually not associated with FAS, but which may be associated with alcohol-related effec ts in infants. It is important to note that definitions of these terms have varied across studies, settings, and samples. In particular, operational definitions of terms used to describe the level and pattern of drinking in studies of pregnant women frequently have not corresponded to definitions for women in general, which in turn often do not correspond to definitions for men.For example, a prospective study of the effects of prenatal alcohol exposure defines heavy drinking as an average of one or more drinks per day (Day et al. , 1989) a seminal FAS prevention intervention project defined heavy drinking as five or six drinks on some occasions and at least 45 drinks per month (Rosett et al. , 1981) large-scale surveys of drinking in women usually define heavy drinking as two or more standard drinks per day, where a standard drink contains approximately 0.5 ounce of absolute alcohol) some clinical research projects define heavy drinking in women as four or more drinks per day (Wils nack et al. , 1994), which differs from parallel definitions of heavy drinking in men (six or more standard drinks per day). The lack of dead body in terms regarding level of alcohol consumption across studies has led to confusion regarding the relationship between specific levels of drinking and risk for fetal alcohol syndrome and alcohol-related effects (see Abel and Kruger, 1995 for a review of this problem).The committee defines the relevant history for diagnosis of FAS (see Chapter 4) as one of a pattern of excessive intake characterized by substantial, unwavering intake or heavy episodic drinking. Evidence of this pattern may include frequent episodes of intoxication, development of tolerance or withdrawal, social problems related to drinking, legal problems related to drinking, engaging in physically hazardous behavior while drinking, or alcohol-related medical problems such as hepatic disease. REFERENCES Abel EL, Kruger ML. Hon v.Stroh Brewery Co. What do we mean by modera te and heavy drinking? Alcoholism Clinical and Experimental Research 1995 191024-31. Abel EL, Sokol RJ. Incidence of fetal alcohol syndrome and economic impact of FAS-related anomalies. Drug and Alcohol Dependence 1987 1951-70. Abel EL, Sokol RJ. A revised unprogressive estimate of the incidence of FAS and its economic impact. Alcoholism Clinical and Experimental Research 1991 15514-524. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders 4th Edition.Washington, DC American Psychiatric Association, 1994. Bloss G. The economic cost of FAS. Alcohol Health Research World 1994 1853-54. Blume SB. Women and Alcohol Issues in Social Policy in Alcohol and Gender. R. W. Wilsnack and S. C. Wilsnack (eds. ). New Brunswick, New Jersey Rutgers University Center of Alcohol Studies, in press. Chavkin W. Drug Addition and Pregnancy Policy crossroads. American Journal of Public Health 1990 80483-487. Clarren SK, Smith DW. The fetal alcohol syndrome. New England Journal of Medicine 1978 298 1063-1067.Day NL, Jasperse D, Richardson G, Robles N, Sambamoorthis U, Taylor P et al. Prenatal exposure to alcohol Effect on infant growth and morphologic characteristics. Pediatrics 1989 84536-541. Day NL, Robles N, Richardson G, Geva D, Taylor P, Scher M et al. The effects of prenatal alcohol use in the growth of children at three years of age. Alcoholism Clinical and Experimental Research 1991 1567-71. Edwards G, Arif A, Hodgson R. Nomenclature and classification of drug- and alcohol-related problems A WHO memorandum. Bulletin of the World Health Organization 1981 59225-242.Grant BF, Harford RC, Dawson DA, bread P, Dufour M, Pickering R. Epidemiologic Bulletin No. 35 Prevalence of DSM-IV alcohol abuse and dependence United States, 1992. Alcohol Health Research World 1994 18243-248. Alcohol (wine, beer, or liquor) is the leading known preventable cause of developmental and physical birth defects in the United States. When a woman drinks alcohol duri ng pregnancy, she risks giving birth to a child who will pay the price in mental and physical deficiencies for his or her entire life. Yet many pregnant women do drink alcohol.Its estimated that each year in the United States, 1 in every 750 infants is born with a pattern of physical, developmental, and functional problems referred to as fetal alcohol syndrome (FAS), while another 40,000 are born with fetal alcohol effects (FAE). Fetal alcohol syndrome (FAS) is a condition that results from alcohol exposure during pregnancy. Problems that may be caused by fetal alcohol syndrome include physical deformities, mental retardation, learning disorders, vision difficulties and behavioral problems.The problems caused by fetal alcohol syndrome vary from child to child, but defects caused by fetal alcohol syndrome are irreversible. There is no amount of alcohol thats known to be galosh to consume during pregnancy. Early diagnosis may reduce the risk of problems, including learning difficul ties and substance abuse. Signs and Symptoms Fetal alcohol syndrome isnt a single birth defect. Its a cluster of related problems and the most severe of a group of consequences of prenatal alcohol exposure. Collectively, the range of disorders is known as fetal alcohol spectrum disorders (FASDs).Fetal alcohol syndrome is a common yet preventable cause of mental retardation. The severity of mental problems varies, with some children experiencing them to a far greater degree than others. Signs of fetal alcohol syndrome may include Distinctive facial features, including small eyes, an exceptionally thin upper lip, a short, upturned nose, and a smooth skin surface between the nose and upper lip Deformities of joints, limbs and fingers Slow physical growth before and after birth Vision difficulties or hearing problems Small head circumference and brain size (microcephaly) Poor coordinationMental retardation and delay development Learning disorders Abnormal behavior, such as a short att ention span, hyperactivity, poor heart rate control, extreme nervousness and anxiety Heart defects low birth weight failure to thrive developmental delay organ dysfunction facial abnormalities, including smaller eye openings, flattened cheekbones, and indistinct philtrum (an underdeveloped crease between the nose and the upper lip) .Epilepsy poor coordination/fine motor skills poor socialization skills, such as difficulty building and maintaining friendships and relating to groups lack of imagination or curiosity learning difficulties, including poor memory, inability to understand concepts such as time and money, poor language comprehension, poor problem-solving skills behavioral problems, including hyperactivity, inability to concentrate, social withdrawal, stubbornness, impulsiveness, and anxiety.The facial features seen with fetal alcohol syndrome may also occur in normal, healthy children. Distinguishing normal facial features from those of fetal alcohol syndrome requires exp ertise. Doctors may use other terms to describe some of the signs of fetal alcohol syndrome. An alcohol-related neurodevel.