Fetal alcohol syndrome (FAS) is a permanent birth defect caused by maternal alcohol consumption during pregnancy. In the United States, prenatal alcohol exposure is one of the leading known preventable causes of intellectual disabilities. Not all individuals with prenatal alcohol exposure have the birth defect known as FAS. Most present with lifelong neurocognitive and behavioral problems, without the facial features of FAS. This occurs because the window of vulnerability for alcohol to cause the unique facial features is very narrow, perhaps as narrow as the second and third weeks of pregnancy. The window of vulnerability for neurocognitive problems, in contrast, extends throughout pregnancy. The damage caused by prenatal alcohol exposure presents along a continuum. This continuum is called Fetal Alcohol Spectrum Disorders (FASD).
There are 4 diagnoses that fall under the umbrella of FASD. They include FAS, partial FAS (PFAS), Static Encephalopathy/Alcohol-Exposed (SE/AE) and Neurobehavioral Disorder/Alcohol-Exposed (ND/AE). See Figure 1 on page 2. Individuals with FAS have growth deficiency, unique facial features (See Figure 2 on page 2), and severe structural and/or functional CNS abnormalities. Individuals with PFAS have FAS without the growth deficiency. Individuals with SE/AE have severe structural/functional CNS abnormalities without the facial features of FAS. Individuals with ND/AE have moderate CNS dysfunction without the facial features. FASD is diagnosed by an interdisciplinary team using a rigorous FASD diagnostic system like the FASD 4-Digit Diagnostic Code.
In the United States, the estimated prevalence of FAS in the general population is 1-to 3- per 1,000 live births. The prevalence of FAS in high risk populations like foster care is ten-fold higher (1/100). The prevalence of all other diagnoses under the umbrella of FASD is 5 to 10 times higher than the prevalence of FAS.
This volume of the NUTRITION FOCUS newsletter updates an article published in 2006. The current article describes new terminology and knowledge related to the full spectrum of outcomes called FASD. Nutrition issues related to alcohol use by pregnant and lactating women are presented. In addition, nutrition concerns for children, exposed to alcohol inutero, are reviewed.
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Fetal Alcohol Spectrum Disorders
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