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Foetal alcohol spectrum disorder

In this series of articles, medical students from across the country will share their knowledge and insight of medical physiology, anatomy and biochemistry to give you a taster of medical school. This will be a fantastic opportunity to build upon your A-Level Knowledge.

These articles give you a basic overview of the principles; we have attached videos and useful websites to develop a more detailed insight.

Foetal alcohol spectrum disorder (FASD) is a condition affecting children whose mothers consumed alcohol during pregnancy. It is an umbrella term for a range of birth defects, some more severe than others. Alcohol can readily cross the placenta, and because the foetus cannot make the enzymes to break it down yet, it can severely affect their development. Developmental issues include permanent damage to the brain, problems with various organs and vision and hearing problems. Some babies may not show these development issues, but instead, have characteristic facial abnormalities such as thin upper lips, a flat philtrum and smaller eyes.

It is thought that alcohol consumption is the most damaging in the first trimester of pregnancy, however the amount of alcohol you must drink to cause harm is unknown. Therefore, NICE specifically recommends that women do not consume any alcohol during the first 3 months of pregnancy, and if they do choose to drink during pregnancy, they should drink no more than one to 2 UK units once or twice a week.

In some states in America, including Alaska, California and Illinois, it is illegal to drink alcohol while pregnant due to the devastating effects of it. In England however, no woman has been prosecuted for this. Stella, who suffers from FASD, found out when she was 19, when her father finally told her the reasons for her erratic behaviour and poor timekeeping. She is also unable to read and write. Since finding out, she has been determined to raise awareness about the syndrome, however she does not believe that women should be prosecuted for drinking while they are pregnant. Instead, Stella says, ‘What difference will it make? She hasn’t committed a crime – she has an issue with alcohol’.

Britain has one of the highest rates of FASD in the world – there are 61.3 cases per 10,000 births. It is more common than births with Down’s syndrome. However, it is the most preventable cause of brain damage in children.

There has been confusion in the past about being able to drink alcohol during pregnancy – for example, some headlines in newspapers include ‘pregnant women who drink one or two units of alcohol a week may actually find their child is better behaved than if they abstained’ and ‘binge drink is safe for foetus’. Therefore, prevention methods include healthcare professionals delivering a clear message on alcohol during pregnancy, and ensuring that women who have already drank alcohol during their pregnancy don’t feel stigmatised.