Fetal Alcohol Spectrum Disorders (FASDs)
FASDs are a collection of diagnoses that can result from exposure to alcohol in utero. The effects of this prenatal alcohol exposure are lifelong and can include physical, behavioral, and cognitive symptoms. These symptoms can range from mild to severe; no two individuals with an FASD are affected the same way.
According to the Centers for Disease Control and Prevention, a person with an FASD might experience any of the following conditions:
Low body weight
Poor coordination
Learning disabilities
Attention difficulties
Poor reason and judgement skills (executive functioning)
Problems with the development of their heart, kidneys, or skeletal system
Growth deficits
Characteristic facial features (e.g., smooth philtrum, thin upper lip)
The most well-known type of FASD is fetal alcohol syndrome, or FAS. However, FAS is often considered to be the "tip of the iceberg" - most individuals who have an FASD do not have FAS, which requires the presence of specific physical and central nervous system characteristics or deficits. Other conditions along the spectrum can include alcohol-related neurodevelopmental disorder (ARND), alcohol-related birth defects (ARBD), and neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE).
Research estimates the prevalence of FASDs in the United States to be 50 per 1,000 (approximately 1 in 20), higher than autism spectrum disorders (approximately 14 per 1,000) or Down syndrome (1 per 1,000), (May et al., 2018).
To learn more about FASD assessment, diagnosis, and treatment, please visit the www.cdc.gov/ncbddd/fasd/facts.html or the American Academy of Pediatrics.
Preventing FASDs: Health care providers can make a difference
FASD: How providers can make an impact
Dr. Tony Dunn on the ob-gyn's role in preventing FASD
Dr. Elizabeth Barlet shares her family story and works to prevent FASD
FASDs are preventable if a person does not drink alcohol during pregnancy. Routine and universal alcohol screening and brief intervention, when provided by health care professionals, can help identify people whose pattern of alcohol use may put them or others at risk of harm. It can provide people with advice to reduce their risk through reducing or stopping drinking and/or through the use of effective contraceptive methods.
Universal alcohol screening and brief intervention is an evidence-based preventive practice that is recommended by the US Preventive Services Task Force, the Centers for Disease Control and Prevention, and the Substance Abuse and Mental Health Services Administration.
More information and training on alcohol screening and brief intervention can be found on our professional development page.
Assessment, diagnosis, treatment, and support for individuals with an FASD and their families is best done through an interdisciplinary team. To learn more, visit the American Academy of Pediatrics or Centers for Disease Control and Prevention.
References and Further Reading
Bertrand, J. (2016). Fetal alcohol spectrum disorders are clearly brain-based. Developmental Medicine & Child Neurology, 58(8), 794-795. doi:10.1111/dmcn.13086
Denny, C. H., Acero, C. S., Naimi, T. S., & Kim, S. Y. (2019). Consumption of alcohol beverages and binge drinking among pregnant women aged 18-44 years - United States, 2015-2017. Morbidity and Mortality Weekly Report (MMWR), 68(16), 365-368. doi: http://dx.doi.org/10.15585/mmwr.mm6816a1
May, P. A., Chambers, C. D., Kalberg, W. O., Zellner, J., Feldman, H., Buckley, D., & Taras, H. (2018). Prevalence of fetal alcohol spectrum disorders in 4 US communities. JAMA, 319(5), 474-482. doi:10.1001/jama.2017.21896
Popova, S., Lange, S., Probst, C., Gmel, G., & Rehm, J. (2018). Global prevalence of alcohol use and binge drinking during pregnancy, and fetal alcohol spectrum disorder. Biochemistry and Cell Biology, 96(2), 237-240. doi:10.1139/bcb-2017-0077
Shogren, M. D., Harsell, C., & Heitkamp, T. (2017). Screening women for at-risk alcohol use: an introduction to screening, brief intervention, and referral to treatment (SBIRT) in women's health. Journal of Midwifery & Women's Health, 62(6), 746-754. doi:10.1111/jmwh.12659
Wright, T. E., Terplan, M., Ondersma, S. J., Boyce, C., Yonkers, K., Chang, G., & Creanga, A. A. (2016). The role of screening, brief intervention, and referral to treatment in the perinatal period. American Journal of Obstetrics and Gynecology, 215(5), 539-547. doi:10.1016/j.ajog.2016.06.038