Fetal Alcohol Syndrome (FAS)

Fetal Alcohol Syndrome (FAS) is a group of congenital problems caused by the mother drinking alcohol while pregnant, including mental, physical, learning, and behavioral issues. FAS is one of several less severe alcohol-related disorders, the prevalence of which is estimated to be one in every hundred births (Ganthous, Rossi, & Giacheti, 2015). Some parents mistakenly believe that drinking alcohol during pregnancy is safe and appropriate. However, it is important to note that such misunderstanding frequently has disastrous consequences. There is no known amount of alcohol that is safe to consume during pregnancy. Alcohol frequently affects both an individual's complete body and their thinking.However, its effect on the fetuses tends to vary significantly from one individual to another. If an expectant mother is drunk so is the fetus and such often present detrimental effects to the developing baby. The paper thus intends to investigate the different aspects of the FAS.

FAS is amongst the few disorders whose complete prevention is possible. The mothers can ensure its comprehensive prevention through avoiding the consumption of alcohol at any stage of their pregnancy. However, majorities of the women is often misinformed concerning some of the dangers of alcohol consumption while one is pregnant and thus unintentionally harm their babies in the process. Majority of the women often fail to recognize pregnancy until they are between four and six week hence many women tend to indulge in drinking before the realization of the fact that they are expectant. On detection of the pregnancy, most of the women often ensure reduction of their alcohol consumption significantly. A recent study on the rates of alcohol consumption amongst the women of the childbearing age that are expectant showed that the consumption of alcohol is relatively stable at around 125 and binge drinking is often between two and three percent during pregnancy (Pei, et al., 2016). The report on the alcohol consumption amongst the pregnant women thus highlights the fact that the use of alcohol amongst the expectant women is a significant public health issue that requires attention.

Literature review on FAS

Popova, et al., (2014) defines FAS as a condition attributable to the pregnant mothers consuming alcohol and thus exposing their fetus to the drug. FAS is thus a congenital disability that tends to affect the mental development. The individuals born with the disorder are not often capable of outgrowing its effects.

Diagnosis FAS

Alcohol often presents direct lethal effects on the cells of the fetus and embryo that undergo rapid development. Prenatal exposure to alcohol often contributes to damaging of the developing fetus in multiple ways that causes a broad range of effects.

Relative to the trimester of the pregnancy that the expectant mother consumes alcohol, the effects tend to vary and the level of risk to the fetus as well differs significantly. Alcohol consumption during the first quarter of the gestation is often the most. The fetuses exposed to the alcohol during the first quarter are usually at risk of having small brains, developing physical problems, and encountering severe mental retardation.

Identification of the people exposed to alcohol prenatally often presents significant challenges. The challenges are attributable to the fact that there is usually the lack of accurate maternal drinking history and even if the child depicts some of the symptoms of FAS, the diagnosis of the child by a trained dymorphologist is often necessary. Diagnosis of the individuals is usually more difficult for identification of the individuals exposed to alcohol prenatally that fail to meet the diagnostic criteria for FAS (Price & Miskelly, 2015). Such individuals include those not exhibiting the different defining facial features of the condition. There is thus the necessity for adoption of better tools to ensure enhancement of the diagnosis, particularly since there is the necessity for a proper diagnosis for ensuring that the individuals receive the appropriate services.

Diagnosis of the congenital disabilities associated with FAS is often achieved when the children depict some of the signs that include:

A Certain pattern of facial characteristics that include thin upper lips, smooth or long philtrum, short unturned nose, flat midface and eye slits. The growth deficiency both prenatally and postnatal for height and weight is a clear indication of the condition in children. Another symptom of the disease in the children as well includes neurological damage, which entails the small size of the brain, cognitive impairments, learning disabilities, and attention deficits. Diagnosis of FAS as well necessitates some presumed history of prenatal alcohol exposure.

Using the fetal biological markers often play s significant role in aiding in the early detection of children suffering from FAS. Such early diagnosis usually plays a substantial role in allowing for the assumption of appropriate measure to provide the necessary support for both the child and family concerning social development and education. Besides timely diagnosis, the fetal biological markers are essential for ensuring a thorough understanding of the pathogenesis of FAS.

Prevention/Education

Education is a significant approach to ensure effectiveness in preventing FAS. Even the small changes in the behavior and education can play a vital role in reducing the risk of women giving birth to the babies suffering from fetal alcohol syndrome. Majority of the women have been drinking long enough without the knowledge of the effect that the alcohol consumption has on their babies. Some of the women that drink as well in some instances fail to know that they are pregnant and as such continue to expose their children to the effects of alcohol consumption unknowingly. There are as well women addicted to alcohol consumption. The drive in such instances is often stronger for alcohol than for their health or that of their unborn children. Detoxification, education, and modification of behavior thus remain as the areas that necessitate the change to help with the prevention of FAS.

On consumption of alcohol, it is often absorbed into the bloodstream of the mother and passed into the fetal central nervous system (CNS) through the placenta. Alcohol regularly contributes to depression of the CNS of the fetus. There is the necessity for noting that alcohol is usually a potent teratogen. Teratogen refers to any drug associated with the causation of congenital disabilities. However, the occurrence of the damage is not often understood entirely although alcohol frequently contributes to the creation of glucose and oxygen deficiency for the fetus.

The women that often engage in alcohol consumption during the first trimester are usually at increased risk of miscarriage, congenital disabilities, and stillbirth. Moreover, there is the necessity for noting that the quantity of alcohol consumed often increases the probability of these impacts. The development of the organs of the fetus often commences between three and ten weeks. Alcohol thus often affects the development of these organs significantly. Some of the organs that are often most affected include heart, central nervous system, and brain of the fetuses. The alcohol consumption frequently contributes considerably to causing retardation of their brains. Damaging of the brain often happen at any time during the gestation since the development of the brain usually occurs in the nine months and beyond the birth of the child.

Additionally, there is the necessity for noting that the consequences of alcohol often vary in the parts of the anatomy and range of severity on the child. Some of the babies are usually born with the growth deficiencies associated with the consumption of alcohol by their mothers during pregnancy. Such often include being underweight, small head, and short in length. The notable facial abnormalities usually include cleft palate, cleft lip, thin upper lips, underdeveloped philtrum, missing bridge of the nose and small eye openings. FAS often manifest in the occurrence of major organ defects of the heart. Such children are usually at risk of developing respiratory issues that include SIDS, pulmonary hypertension, and apnea. Some of the notable renal abnormalities often include hydronephrosis, ureteral duplications, horseshoe kidneys, and hypoplastic kidneys. The children may as well suffer from joint and limb abnormalities.

Malnutrition is usually a risk factor for the women that engage in alcohol consumption. Malnutrition often contributes significantly to the development of some of the issues that include low birth weights, growth retardation, fetal damage and as well contribute to the increased risk for the spontaneous stillbirth and abortion. There are numerous reasons attributable to malnutrition. The first reason entails the fact that most of the alcoholics often exhibit the preference for alcohol consumption over food hence their intake of the necessary nutrients is often significantly low. Moreover, there is usually the reduced absorption and metabolism of the nutrients needed for the development of the fetus.

The women that often engage in alcohol consumption often lack many vitamins and minerals that include zinc, magnesium, iron, Vitamin K, thiamine, riboflavin, folic acid and vitamin B. Deficiency of vitamin B6 often contributes significantly to some of the defects that include cleft lip and palate, and clubfoot. Folate acid deficiencies are strongly associated with the flaws that include the orofacial and those of the neural tubes. Riboflavin deficiency on the other hand often contributes to the failure to develop, grow, and thrive. The absence of thiamine usually adds to the occurrences of heart defects. Vitamin K deficiency often contributes to deformities that include the underdeveloped mouth, nose, and midface, flat nasal bridges. Cupped ears and shortened fingers. The iron deficient babies are usually shorter and smaller. Zinc deficiency regularly contributes to giving birth of infants having low immunity in infants and abnormality of the nervous system that usually contribute to the mental retardation and learning difficulties.

The study conducted by Watson, et al., (2013) strongly associate the children suffering from FAS with both the cognitive and attention deficits, expressive language, and motor problems, perseverative behaviors, hyperactivity and problems with inhibition and state regulation. Such issues often last into and throughout adulthood. The problems usually present challenges that include bonding in infants and depression in children between four and six years of age. The studies focused on investigating the existing relationship between the prenatal alcohol exposure and relation to IQ tends to depict varied severities. The research shows that some of the children tend to be more vulnerable than others for the effects of alcohol (Eaton, et al., 2014).

FAS is a preventable issue. There is the need for focusing on educating the public on some of the effects that alcohol consumption often has on the unborn children and that no quantity of alcohol is regarded safe during gestation. The consequences of consuming alcohol during gestation may last a lifetime and always range in severity. The healthcare workers thus need to ensure effectiveness in educating and advising all the females within the childbearing age concerning the potential harm that alcohol consumption poses to the unborn fetuses (Gross, et al., 2015). Moreover, there is the necessity for creating awareness that during gestation, it is never too late to terminate and ensure reduction of the risks associated with alcohol consumption to the fetus. However, it is always up to the mother to ensure that they take into consideration the warnings and advice provided by the healthcare workers.

The healthcare workers need to ensure that they create awareness of the fact that the small amounts of social drinking often exposes the fetuses to significant harm. The more the alcohol that the mother consumes, the greater the consequences and damages to the fetus. When the pregnant mothers drink alcohol, the alcohol levels in the fetus and mother is usually almost equal shortly after the consumption. Education thus a fundamental approach to protecting the future unborn babies from FAS. Training ensures that the mothers are conscious of the potential damages that they could cause their fetus hence the necessity for taking a moment to stop and think about the impact of alcohol consumption during gestation to their unborn babies.

The fact that FAS is a preventable birth disorder shows the necessity for ensuring that both the men and women are adequately educated concerning the facts of alcohol and its damaging effects on them and the babies. The different things that the pregnant women often consume usually make their way to the uterus and eventually to the bloodstream of the babies. The vulnerability of the fetus is often significant during the first trimester when the development of the fetus is rapid. The women thus have to ensure that they stop the consumption of all alcohol completely on their discovery of the fact that they are pregnant.

FAS and other alcohol-related conditions that are less severe often take place in nearly one in every a hundred births. The statistics indicate that the occurrence of the disease is usually higher than that of any other known congenital disability. Education concerning prenatal care needs to commence at young age and carry on throughout one’s lifetime. Moreover, setting a good example to the women through avoiding alcohol is also essential. The women feeling that they are at higher risk of consuming alcohol or any other drugs need to ensure that they seek professional help in time. Finding the services of the counseling group is of significance for the women that feel they are unable to stop the use of alcohol even while pregnant.

The treatments for the individuals suffering from FAS often vary significantly depending on the symptoms that one depicts. Some of the treatment options usually include behavior and education therapy, provision of parent training and some of the medications that are crucial for the provision of assistance in the management of the symptoms.

Studies show that the condition is in numerous instances underestimated significantly. Determining the prevalence of the disease has proven challenging since in most cases the children suffering from FAS tend to be misdiagnosed with other disorders. The misdiagnosis of the condition often presents significant challenges and is detrimental to the child since there is often the likelihood of giving wrong medication or commencement of the right treatment late (Xiaojie & Kroenke, 2015).

Identification of the biomarkers considered reliable in reflecting the fetal alcohol exposure in the fetuses is often essential since on numerous instances obtaining the reliable background information is often impossible. Some of the considered possible reasons for this often entail the fact that the maternal memory is usually poor, the biological parents are not often available or their inability to admit to alcohol consumption. Having such markers is thus essential for facilitating timely case identification and early intervention.

Alcohol is always a teratogen (a chemical or agent associated with congenital disabilities). Studies show that alcohol is often the most consumed teratogen across the globe. The fact that little is known concerning the exact components of alcohol-attributable to the defects necessitates its complete avoidance during pregnancy for ensuring that the child stays healthy (Singal, et al., 2017). Moreover, there lacks the considerably correct information concerning the actual time when alcohol consumption during pregnancy presents minimal harm to the fetal development. As such, its complete avoidance during the pregnancy is essential for ensuring that the fetus develops appropriately without developing any congenital disabilities.

One of the crucial aspects of the FAS prevention mainly involves identification of the risky alcohol consumption amongst the women in the childbearing age by both the prenatal clinics and the primary care physicians. Moreover, studies suggest that screening and the brief interventions in these environments is efficient in the reduction and elimination of the seemingly risky drinking habits. However, there is the necessity for noting that such educational programs and clinics are often readily available.

Living with FAS

The children having FAS often have numerous handicaps and necessitate specialized medical, community, family, and educational support. The families of these children usually require peer support, financial assistance, medical information, and educational advocacy. The people suffering from FAS are often at higher risk of neglect, physical and sexual abuse when raised in their original families. These children thus often require loving home environments that are supportive and capable of providing clear lines of communication and clear guidelines necessary for ensuring that they develop to their maximum potential.

The people having FAS often have varied talents and capabilities like everyone else. They tend to show a broad range of functional disabilities and intellectual levels that often reflect the varied extent of prenatal mental damages due to the diverse patterns, timing, and level of their exposure to alcohol during gestation (Koren, 2015). Majority of individuals suffering from FAS despite the presence of some differences tend to exhibit similar general characteristics. Ensuring the appropriate placement of the children in the special education classes starting in the elementary school is usually necessary for the children suffering from FAS.

In conclusion, FAS is often preventable provided the women ensure that the pregnancy is alcohol-free. Awareness and education serve as essential tools for ensuring the dramatic decrease of the instances of FAS. The healthcare workers are often in a better position of ensuring that the pregnant women are equipped with the necessary knowledge concerning the health of their unborn children.













References

Eaton, L. A., Pitpitan, E. V., Kalichman, S. C., Sikkema, K. J., Skinner, D., Watt, M. H., & ... Cain, D. N. (2014). Beliefs about fetal alcohol spectrum disorder among men and women at alcohol serving establishments in South Africa. American Journal Of Drug & Alcohol Abuse, 40(2), 87-94. doi:10.3109/00952990.2013.830621

Ganthous, G., Rossi, N. F., & Giacheti, C. M. (2015). LANGUAGE IN FETAL ALCOHOL SPECTRUM DISORDER: A REVIEW. Revista CEFAC, 17(1), 253-263.

Gross, A. C., Deling, L. A., Wozniak, J. R., & Boys, C. J. (2015). Objective measures of executive functioning are highly discrepant with parent-report in fetal alcohol spectrum disorders. Child Neuropsychology, 21(4), 531-538. doi:10.1080/09297049.2014.911271

Koren, G. (2015). Pharmacological Treatment of Disruptive Behavior in Children with Fetal Alcohol Spectrum Disorder. Pediatric Drugs, 17(3), 179-184. doi:10.1007/s40272-015-0118-4

Pei, J., Wing SzeWence, L., Jampolsky, F., & Alsbury, B. (2016). Experiences in the Canadian Criminal Justice System for Individuals with Fetal Alcohol Spectrum Disorders: Double Jeopardy?. Canadian Journal Of Criminology & Criminal Justice, 58(1), 56-86. doi:10.3138/cjccj.2014.E25

Popova, S., Lange, S., Burd, L., & Rehm, J. (2014). Canadian Children and Youth in Care: The Cost of Fetal Alcohol Spectrum Disorder. Child & Youth Care Forum, 43(1), 83-96. doi:10.1007/s10566-013-9226-x

Price, K. J., & Miskelly, K. J. (2015). Why Ask Why? Logical Fallacies in the Diagnosis of Fetal Alcohol Spectrum Disorder. Ethics & Behavior, 25(5), 418-426. doi:10.1080/10508422.2014.946031

Singal, D., Brownell, M., Chateau, D., Hanlon-Dearman, A., Longstaffe, S., & Roos, L. L. (2017). The Psychiatric Morbidity of Women Who Give Birth to Children with Fetal Alcohol Spectrum Disorder (FASD): Results of the Manitoba Mothers and FASD Study. Canadian Journal Of Psychiatry, 62(8), 531-542. doi:10.1177/0706743717703646

Watson, S. L., Coons, K. D., & Hayes, S. A. (2013). Autism spectrum disorder and fetal alcohol spectrum disorder. Part I: A comparison of parenting stress. Journal Of Intellectual & Developmental Disability, 38(2), 95-104.

Xiaojie, W., & Kroenke, C. D. (2015). Utilization of Magnetic Resonance Imaging in Research Involving Animal Models of Fetal Alcohol Spectrum Disorders. Alcohol Research: Current Reviews, 37(1), 39-51.