Alcohol consumed by a pregnant woman can cause problems in her unborn baby. Fetal (also spelt foetal) alcohol spectrum disorder (FASD) describes a range of conditions caused by in utero (inside the womb) alcohol exposure, including fetal alcohol syndrome (FAS), partial fetal alcohol syndrome (pFAS), alcohol-related neuro-developmental disorders (ARND) and alcohol-related birth defects (ARBD).
Alcohol and the developing fetus
Alcohol crosses the placenta from the mother’s blood into the baby’s bloodstream and the baby is exposed to similar concentrations of alcohol as the mother.
The effects of alcohol on a fetus include:
- Harm to the development of the fetal nervous system, including the brain. Research shows that alcohol can damage developing brain cells
- Under-nourishment of the growing baby
- Triggering of changes in the development of the baby’s face, resulting in the typical FASD facial features.
Features of fetal alcohol spectrum disorder
A spectrum (range) of disorders has been described because the features in children exposed to alcohol during pregnancy vary. An accurate diagnosis is important. It can help provide appropriate care for the child and prevent FASD happening again in any later pregnancy.
The features of these disorders include:
- Fetal alcohol syndrome (FAS) – where a child has problems with growth and learning, and has distinctive facial features and structural abnormalities due to alcohol exposure during pregnancy
- Partial FAS – where a child has some, but not all, features reported in FAS
- Alcohol-related neuro-developmental disorders (ARND) – refers to children with problems with learning and behaviour related to alcohol exposure
- Alcohol-related birth defects (ARBD) – refers to abnormalities in organs such as the heart or kidneys related to alcohol exposure.
Alcohol and the risk to unborn babies
Babies severely affected by FASD are at risk of dying before they are born. The risk of harm to the fetus is highest when the mother drinks a large amount of alcohol very often.
Pregnant women should avoid alcohol
The National Health and Medical Research Council (NHMRC), Australia’s main health research organisation, recommends that for women who are pregnant or planning a pregnancy, not drinking is the safest option. The World Health Organization recommends that pregnant women should be advised not to drink alcohol.
Diagnosis of FASD
When a child has been exposed to alcohol during pregnancy, they should be assessed for features of the different conditions within FASD, including FAS, partial FAS, ARND and ARBD. For each condition, there are diagnostic criteria to help a doctor make a diagnosis. In severe cases, FASD may be diagnosed at birth, but in many cases, the diagnosis occurs later, when the child is having problems with learning or behaviour. Sometimes, the condition may never be diagnosed.
Occurrence of FASD is unknown
Researchers estimate that FASD occurs in one in 100 children, but the incidence of FASD varies from study to study for a number of reasons, including:
- While FASD is considered internationally to be the leading preventable cause of intellectual and developmental problems, there is evidence that FASD is under-diagnosed. Parents and doctors may not realise that FASD is the cause of a child’s developmental problems.
- Maternal intake of alcohol varies during a pregnancy and can be difficult to accurately record.
- Alcohol may not be the only drug consumed during pregnancy.
- There are many environmental and individual factors that can contribute to learning and behavioural problems. Many children diagnosed with alcohol-related problems are exposed to social difficulties that may also impact on their development.
Risk factors for FASD
FASD occurs in babies exposed to alcohol during pregnancy, but not all babies exposed to alcohol develop FASD.
The biggest factor associated with an increased risk of FASD is the amount of alcohol drunk and how often it is drunk throughout the pregnancy. Frequent binge drinking is associated with especially high risks.
Diagnosis of FASD
There is no specific medical test for the FASD conditions. Diagnosis relies on a doctor establishing a child’s exposure to alcohol during pregnancy, and assessing the child for the features of FASD using the diagnostic criteria for FASD conditions.
Treatment of FASD
FASD causes a lifelong disability and cannot be cured, but a person with FASD can be assisted by programs to help them with their learning and behaviour. Such assistance can enable a person with FASD to maximise their independence and achievements.
Where to get help
- Your doctor
- Monash Medical Centre, Monash Drug Information Service Tel. (03) 9594 2361
- National Organisation for Fetal Alcohol Syndrome and Related Disorders (NOFASD Australia) Tel. 1300 306 238
- DrugInfo Tel. 1300 85 85 84 – for information
- DirectLine Tel. 1800 888 236 – for counselling and referral
Things to remember
- Fetal alcohol spectrum disorder (FASD) refers to a range of problems caused by exposure to alcohol during pregnancy.
- There is no cure for FASD and its effects last a lifetime.
- A person with FASD can get help with their learning and behaviour to maximise their independence and achievements.
- The World Health Organization recommends that pregnant women should avoid alcohol.
- NHMRC recommends that for women who are pregnant or planning a pregnancy, not drinking is the safest option.
This page has been produced in consultation with and approved by:
Victorian Clinical Genetics Services (VCGS)
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