Alcohol is one of the medications that is commonly consumed all over the world, resulting in a variety of devastating effects on the addict, the most serious of which are infectious diseases. Any of the lifelong illnesses that may occur from alcohol consumption include liver cirrhosis, cancer, and even fetal syndrome.
The term “fetal alcohol syndrome” refers to a group of conditions known collectively as “alcohol spectrum disorders,” in which a fetus is born with a variety of disabilities (Harding, 2016). The fetal alcohol syndrome is caused by a pregnant woman’s heavy alcohol intake. Usually, a child who is suffering from the fetal alcohol syndrome (FAS) has some differences on their head and face (for instance, having a small head or face) and may also have some learning disabilities. Fetal alcohol spectrum disorders (FASD) has been noted to be one of the leading causes of the preventable congenital disabilities and disabilities globally.
Occurrence of the FAS
FAS is not hereditary and is caused by alcohol consumption. While in its mother’s womb, the baby (fetus) is nourished through the bloodstream of its mother, which implies that any alcohol within the mother’s bloodstream will no doubt be passed to the baby’s bloodstream. Since alcohol is a toxic substance, it comprises of some poisonous elements – commonly referred to as teratogens – that end up hurting the baby and, hence, affecting its normal growth (Catterick et al., 2014). Therefore, every time a gestating mother drinks alcohol some amount end up being passed over to the fetus. With time the blood alcohol (BAC) level within the fetus raises to an equal amount or even at a higher amount than the blood alcohol level of the mother’s bloodstream. The high level of the BAC remains within the infant’s bloodstream since it (the infant) is incapable of breaking down the alcohol as its mother does. Once taken, the liver metabolizes the alcohol (which results in its total breakdown), but since the infant’s liver is not yet developed, alcohol is continuously accumulated in its bloodstream, which eventually leads to the infant’s blood being saturated with alcohol. On the other hand, the mother’s liver is fully developed and, thus, the alcohol dehydrogenase (ADH) enzyme converts the alcohol into acetaldehyde with ease (West Virginia University). After that, the acetaldehyde is converted to acetic acid, which is later metabolized to fatty acids, water (to be consumed by the body), and carbon dioxide. The high level of the BAC eventually triggers the death of the fetus’ cells, hence, leading to an abnormal development of the embryo. For instance, the alcohol can disrupt the development of the nerve cells, which inhibits the normal development of the brain.
Additionally, the high BAC content might lead to the constriction of the blood vessels, which also hinders the efficient flow of the nutrients, blood, and even oxygen to the placenta, thus resulting in the improper growth of the infant. The toxic substances (teratogens) may also accumulate within the infant’s brain, hence, leading to FAS. However, brain damage can also be caused as a result of prenatal exposure to alcohol or even at any age of the embryo development since the brain development and the embryo development takes place simultaneously.
Wattendorf and Muenke are of the opinion that there is no evidence that suggests any prenatal period is safe and, thus, alcohol consumption would not affect an infant (Wattendorf & Muenke, 2005). Evidence garnered from Magnetic Resonance Imaging (MRI) suggest that some people have brain deficiencies – such as having a smaller brain – as a result of prenatal exposure to alcohol (U.S. Department of Health and Human Services, 2007). In addition, brain disorder might occur due to the failure of successive development of the cerebellum, basal ganglia, and even the corpus callosum.
The Risk Factors
Alcohol consumption during the gestation period is believed to be the main cause of FAS. However, there is no evidence that suggests that all women who consume alcohol while they are pregnant give birth to children suffering from FAS. Therefore, some other factors like the woman’s drinking pattern, her age, and her health status can be termed as elements that affect the potential of the infant to suffer from FAS (. Nonetheless, clinical bodies such as the British Medical Association (BMA) and the National Institute for Health and Care Excellence (NICE) advise women to cut alcohol consumption once they intend to conceive and all through their pregnancy life.
Symptoms of FAS
Among the FASD, FAS is the easiest one to be clinically recognized. The symptoms of the fetal alcohol syndrome can be broadly classified into either facial appearances or behavioral and mental activities of the newborn.
Usually, a child suffering from FAS has a smaller head, than the normal head size of a new-born. The child might also be suffering from ptosis; a condition resulted by the drooping of the upper eyelid. Ptosis might result in the partial or complete blockage of the pupil, which hinders the child’s normal vision. However, this condition is treated through surgery. The newborn might also be having epicanthic folds – the infant’s upper eyelids might be having some skin folds (Wattendorf et al, 2005). At the seventh week of the fetus development, the choroid fissure may fail to close, which leads to the occurrence of a cleft in the iris (Abdelrahman & Conn, 2009). This condition referred to as coloboma iridis, evidence suggests that this ailment is quite prevalent among children suffering from FAS. The child might also be having a relatively flat nasal bridge and minute palpebral fissures as illustrated in the figure below.
A diagram showing the facial characteristics of a child suffering from fetal alcohol syndrome
Behavioral and Mental Activities
As a result of brain damage (or failure by the brain to develop fully), a child suffering from FAS experiences a myriad of behavior and mental challenges. Usually, such children are unable to pay attention and are excessively active (hyperactivity). In addition, such children have low memory retention levels and, hence, perform dismally in their academics. Children suffering from FAS also has poor problem-solving skills (poor sense of judgment), which makes it totally difficult for them to comprehend some basic concepts such as time. As a result of hyperactivity, victims of the FASD disorders tend to be very aggressive and usually behave in an immature manner, thus making it quite impossible for them to relate well with the other members of the society. Evidence also suggests that children suffering from FAS have difficulties while sucking and usually experience speech delays.
The Intervention Measures
The fetal alcohol syndrome is preventable as the only thing that is required is to encourage women to curb alcohol intake. Statistics show that the probability of more children suffering from FAS is still high since most women within the child-bearing age are still engaged in binge-drinking (Willacy, 2016). For instance, in the U.K. a study conducted by the Leeds of pregnant women between the ages of 18-45 years revealed that 79% of them had taken alcohol during the first semester of pregnancy, 63%had done it in the second semester while 49% admitted that they took alcohol during the last semester of pregnancy.
The devastating effects of the FAS have led to the implementation of various measures, whose major objective is to ensure that the number of infants suffering from FAS is minimized. Three major strategies are used as the intervention measures; the universal prevention measures, the selective preventive measures, and the indicated preventive measures (Stratton, Howe, & Battaglia, 1996). The universal prevention measures are aimed at ensuring that all societal members are aware of the alcohol consumption effects during the gestation period. The societal members are also advised to refrain from alcohol intake before the conception period. Also, women are also advised to visit medical practitioners so as they can be advised on the importance of responsible alcohol intake and the risks that alcohol use might pose to the fetus.
On the other hand, the selective preventive measures are targeted towards women who are noted to be at a higher risk of giving birth to children suffering from FAS. The target group usually comprises of the women who take alcohol and are still within the reproductive group (Stratton et al., 1996). Besides, their partners are also advised to ensure that they support women by encouraging them to minimize their alcohol intake and eventually stop its intake before they conceive. The indicated preventive measures are aimed at women who are considered to be at a high risk of giving birth to children who suffer from FAS. The target women are noted to be binge drinkers during the gestation period or before conception.
In a nutshell, fetal alcohol syndrome (FAS) is a form of disease whereby a newborn is born with various disabilities such as a small face and droopy eyelids. FAS is non-hereditary, and its major cause is excessive consumption of alcohol by a pregnant woman. Just like the nutrients and oxygen, alcohol is transmitted to the fetus through the bloodstream. However, since the infant’s liver is not fully developed, it cannot effectively convert acetaldehyde into acetic acid for it to be metabolized to water, carbon dioxide, and fatty acids. Children suffering from FAS have low rates memory retention, tend to be very aggressive, and have very low problem-solving skills. Nonetheless, to ensure that the number of children born with FAS is minimized, various intervention measures have been enacted, which include; the universal prevention measures, the selective preventive measures, and the indicated preventive measures. The universal prevention measures are focused on making sure that all women are made aware of the devastating effects of alcohol intake during the pregnancy period. The selective preventive measures are focused on the women at the childbearing age, who are deemed to be at a high risk of giving birth to children with FAS. On the other hand, the indicated preventive measures are aimed at educating the women who are at a high risk of giving birth to children with FAS. Such women include the ones who engage in binge-drinking while they are pregnant or before they conceive.
Abdelrahman, A., & Conn, R. (2009). Eye abnormalities in fetal alcohol syndrome. Ulster Med J, 78(3), 164-165.
Catterick, M., & Curran, L. (2014). ). Understanding fetal alcohol spectrum disorder: A guide to FASD for parents, careers and professionals. Jessica Kingsley Publishers.
Harding, M. (2016). Fetal alcohol syndrome. Retrieved April 13, 2017, from Patient Platform Limited: https://patient.info/pdf/28643.pdf#
Stratton, K., Howe, C., & Battaglia, F. (1996). Fetal alcohol syndrome: Diagnosis, epidemiology, prevention, and treatment. National Academies Press.
U.S. Department of Health and Human Services. (2007). Effects of Alcohol on a fetus. Retrieved April 13, 2017, from SAMHSA Fetal Alcohol Spectrum Disorders Centre for Excellence: https://store.samhsa.gov/shin/content/SMA07-4275/SMA07-4275.pdf
Wattendorf, D., & Muenke, M. (2005). Fetal alcohol spectrum disorders. Retrieved April 13, 2017, from American Academy of Family Physicians: http://www.aafp.org/afp/2005/0715/p279.html
West Virginia University. (n.d.). Alcohol Awareness. Retrieved April 13, 2017, from School of Public Health: http://publichealth.hsc.wvu.edu/alcohol/effects-on-the-body/alcohol-metabolism/
Willacy, H. (2016). Fetal alcohol syndrome. Retrieved from Patient Platform Limited: https://patient.info/doctor/fetal-alcohol-syndrome-pro