Alcohol and Pregnancy and the Fetal Alcohol Syndrome

Ann P Streissguth, University of Washington School of Medicine, Seattle, Washington, USA
Daniel J Bonthius, University of Iowa College of Medicine, Iowa City, Iowa, USA

Published online: January 2006

DOI: 10.1038/npg.els.0002251

Fetal alcohol syndrome (FAS) is a specific pattern of birth defects caused by prenatal alcohol exposure; the term fetal alcohol spectrum disorders (FASD) includes the broad range of offspring effects caused by in utero alcohol exposure. Alcohol is a teratogenic drug to which the developing brain is particularly vulnerable; thus, many alcohol-exposed people, even without FAS, can have alcohol-induced neurodevelopmental sequelae, ranging from mild to severe, depending on the dose, timing and conditions of exposure.

Keywords: fetal alcohol syndrome; fetal alcohol effects; birth defects; developmental disabilities; pregnancy outcome; alcohol

Figure 1. Brain regions most vulnerable to damage from prenatal alcohol exposure. (a) a human brain viewed from its medial surface; (b) a horizontal section of human brain at the plane corresponding to the line in (a). Prenatal alcohol exposure disrupts neuronal migration of the cerebral cortex (green), and changes the shape of the corpus callosum (blue), while it kills neurons in the hippocampus (red) and cerebellum (yellow).
Figure 2. The characteristic face of FAS is most conspicuous in the prepubescent child. Image is from: Streissguth and Little (1994) Alcohol, pregnancy and the fetal alcohol syndrome, Alcohol and its Medical Consequence: A Comprehensive Slide Teaching Program for Biomedical Education, 2nd edn, Unit 5, developed by Project Cork at Dartmouth Medical School, distributed by Milner-Fenwick, Timonium, MD.
Figure 3. Patient with FAS diagnosed at birth, shown here as a neonate, and at 8 and 18 years of age. In childhood he manifests the classic torso of a child with FAS: weight is low for age, and his weight-for-height ratio is disproportionately low. In late adolescence, he remains lean and somewhat short, but is not as growth deficient as he was during childhood. (Images (a) and (b) from Streissguth; Barr, and Martin (1984) Alcohol exposure in utero and functional deficits in children during the first 4 years of life. Mechanisms of Alcohol Damage in Utero. CIBA Foundation Monograph 105, London: Pitman; Image (c) from Streissguth and Little (1994) Alcohol, pregnancy and the fetal alcohol syndrome, Alcohol and its Medical Consequence: A Comprehensive Slide Teaching Program for Biomedical Education, 2nd edn, Unit 5, developed by Project Cork at Dartmouth Medical School, distributed by Milner-Fenwick, Timonium, MD.
Figure 4. FAS is only the ‘tip of the iceberg’ in terms of the proportion of people adversely affected by prenatal alcohol exposure. Many individuals prenatally exposed to alcohol lack the facial characteristics and somatic growth deficiencies of FAS, but can have brain dysfunction ranging from mild to severe, which can last for a lifetime.
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 References
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 Further Reading
    Church MW and Kaltenbach JA (1997) Hearing, speech, language, and vestibular disorders in the fetal alcohol syndrome: a literature review. Alcoholism: Clinical and Experimental Research 21: 495–512.
    Guerri C (1998) Neuroanatomical and neurophysiological mechanisms involved in central nervous system dysfunctions induced by prenatal alcohol exposure. Alcoholism: Clinical and Experimental Research 22: 304–312.
    book Institute of Medicine (1996) In: Stratton K, Howe C and Battaglia F (eds) Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment. Washington, DC: National Academy Press.
    Mattson SN and Riley EP (1998) A review of the neurobehavioral deficits in children with fetal alcohol syndrome or prenatal exposure to alcohol. Alcoholism: Clinical and Experimental Research 22: 279–294.
    book Riley EP and Vorhees CV (1986) Handbook of Behavioral Teratology. New York: Plenum Press.
    book Spohr HL and Steinhausen HC (eds) (1996) Alcohol, Pregnancy, and the Developing Child. Cambridge: Cambridge University Press.
    book Streissguth AP (1997) Fetal Alcohol Syndrome: A Guide for Families and Communities. Baltimore: Paul H. Brookes Publishing Company.
    book Streissguth AP and Kanter J (eds) (1997) The Challenge of Fetal Alcohol Syndrome: Overcoming Secondary Disabilities. Seattle: University of Washington Press.
    book West J (ed.) (1986) Alcohol and Brain Development. New York: Oxford University Press.

Related Sub-Topics:

Genes, Molecules and Cellular Processes | Developmental Disorders | Growth and Development | Biomolecular Interactions | Other Biomolecules: Structure, Function, Metabolism
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Article Title: Alcohol and Pregnancy and the Fetal Alcohol Syndrome
 
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Streissguth, Ann P, and Bonthius, Daniel J(Jan 2006) Alcohol and Pregnancy and the Fetal Alcohol Syndrome. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1038/npg.els.0002251]