Chapter 207 Fetal Alcohol Syndrome
INTRODUCTION
Description: Fetal alcohol syndrome is characterized by malformations found in infants born to mothers who have consumed alcohol during pregnancy. Abnormalities include structural malformations (predominantly facial), growth restriction, and neurologic abnormalities including mental retardation.
Prevalence: Estimates vary from 6 of 10,000 births (1993) to 2 of 1000 births (2000). Studies by the Centers for Disease Control and Prevention show fetal alcohol syndrome rates ranging from 0.2 to 1.5 per 1000 live births in different areas of the United States.
ETIOLOGY AND PATHOGENESIS
Causes: Alcohol consumption during pregnancy (generally >3 oz/day). There does not appear to be a lower limit of safety, nor are the effects confined to one part of pregnancy. The severity of the effects does appear to be proportional to the amount and duration of exposure. Clinically identifiable effects are generally not seen with sporadic exposures of less than 1 oz of alcohol per day, although absolute safety cannot be assured even at this dose.
CLINICAL CHARACTERISTICS
Signs and Symptoms
• Facial deformities—microcephaly, short palpebral fissures, flat midface, underdeveloped philtrum and thinned upper lip; low nasal bridge, epicanthal folds, minor ear anomalies, small teeth with faulty enamel, foreshortened nose and micrognathia may also be seen; two or more abnormal facial features must be present to make the diagnosis
