Fetal Alcohol Syndrome
Fetal Alcohol Syndrome (FAS) is a pattern of mental, physical, and behavioral defects that may develop in the unborn child when its mother drinks during pregnancy. These defects occur primarily during the first trimester when the teratogenic effects of the alcohol have the greatest effect on the developing organs. The symptoms associated with FAS have been observed for many centuries, but it was not until 1968 that Lemoine and his associates formally described these symptoms in the scientific literature, and again in 1973 when Jones and associates designated a specific pattern of altered growth and dysmorphogenesis as the Fetal Alcohol Syndrome (Rostand, p. 302). The set of abnormalities characterized by Jones included; "intrauterine growth retardation, an unusual facies, psychomotor retardation, and a 25% incidence of congenital anomalies (especially cleft palate and cardiac malformations)" (Luke, p. 3330. The incidence of FAS world-wide, can be illustrated on the basis of the extreme to which the characteristics of mental, physical, and behavioral defects are exhibited in the newborn. Full characteristics are estimated to be present in 1.9 per 1,000 live births, and partial characteristics are evident in approximately 3-5 per 1,000 live births. The incidence of FAS increases dramatically when only alcoholic women are considered to 25 per 1,000 for full characteristics and as high as 90 per 1,000 for partial characteristics (Luke, p. 333).
Currently, FAS is the most common cause of birth defects leading to mental retardation. Down’s Syndrome and spina bifida, the other two most common causes, can be identified and managed during pregnancy. Yet, FAS remains the only cause of retardation that is completely preventable with maternal cooperation (Feld, p. 15). The annual cost associated with caring for children afflicted with FAS has been "conservatively estimated at about $321 million", an extremely high price for such a preventable disease (Luke, p. 333). Clearly the incidence of this syndrome could be greatly reduced, and possibly prevented, through education on the topic. This paper will present the metabolic basis of Fetal Alcohol Syndrome, the pathogenic basis for brain and facial anomalies associated with FAS, and the effects of maternal alcohol consumption on the immune system. Characteristics of diagnosing FAS will follow the discussion of those factors causing the symptoms of this disease.
As stated earlier, alcohol has its greatest effect on the developing embryo during the first trimester of pregnancy with its teratogenic effect causing mental retardation as well as characteristic craniofacial abnormalities that are characteristic of the disease. It has also been demonstrated with experimental animal models that there is a clear "dose-response" effect between the amount of alcohol consumed by the mother and the risk that is associated with developing FAS symptoms (Walpole, p. 875). It has been...