Introduction
Fetal alcohol spectrum disorders (FASDs) are multiple physical and behavioral conditions in a person exposed to alcohol before birth. When a pregnant woman consumes any amount of alcohol, it passes from the mother’s blood to the unborn through the placenta and stays for long in the baby’s body because the baby has a reduced capacity to break it down faster as the mother, ultimately causing defects in a baby’s physical appearance, learning ability, and behaviors (Popova et al. 1). This disease is also referred to as fetal alcohol syndrome (FAS).
Alcohol has toxic effects on human organs and tissues. Alcohol can lead to the development of chronic diseases and other adverse conditions, including mouth, throat, liver, rectum, and colon cancer. It can also cause high blood pressure, heart disease, stroke, and digestive problems (Rusyn and Bataller 3). Furthermore, alcohol weakens the immune system undermining the body’s ability to fight diseases. Besides social problems such as job and family problems, mental health issues such as anxiety, depression, and poor school performance due to memory problems also result from alcohol use.
Ethanol and Acetaldehyde have effects on human embryos and fetuses. These substances can cause long-term morbidity and fetal growth restriction. They can also cause placental growth leading to placental insufficiency and reduced functionality. Research shows that these substances can negatively affect trophoblast migration and impede the function of amino acid transporter responsible for normal neurological development (Lui et al. 5). Trophoblast migration is a critical process in implantation and placentation that enhances successful pregnancy. Acetaldehyde enhances the toxicity of ethanol and also impedes the uptake of isobutyric acid.
Alcohol deaths statistics are appalling. Data from the National Institute of Alcohol Abuse and Alcoholism shows that alcohol is the third leading preventable cause of death. It also shows that 68,000 men die while 27,000 women succumb to alcohol-related issues annually (National Institute on Alcohol Abuse and Alcoholism 1). The high prevalence of binge drinking and heavy alcohol use underscore the high number of deaths. 85.6 Americans 18 years of age or older drink alcohol at some point. The doubling of the death rate from alcohol-related causes between 1999 and 2017 indicates that alcohol has become a major public health challenge.
The mechanisms of alcohol-induced toxicity and organ damage
The toxicity damages organs by increasing oxidative stress and causing methylation impairments. Oxidative stress is a condition of the human body that occurs when antioxidant levels are low. Another mechanism involves causing aberrant posttranslational modifications of proteins and causing dysregulation in lipid metabolism and signal transduction pathways (Osna and Kharbanda 4). These processes limit cell survival ad adversely affects their functions.
Alcohol consumption during different fetal development trimesters influences the pattern and severity of structural and functional abnormalities. However, it is essential to note that alcohol intake affects the unborn from the first trimester to the last. The quantity of alcohol a pregnant woman consumes is directly proportional to abnormalities.
Response to the problem
FASD is a heterogeneous condition characterized by neurological abnormalities such as epilepsy, brain tumors, and cerebral palsy, and cognitive behavioral impairment such as memory loss, poor reasoning and judgment, and memory loss (Popova et al. 4). From a medical perspective, neurological abnormalities are infections and diseases that alter nerve functioning throughout the human brain and body, while cognitive behavioral impairment present psychological disruptions of in an individual.
Growth retardation-reduced rate of fetal development and craniofacial anomalies, including cleft lip and palate, craniosynostosis, and hemifacial microsomia. Alcohol consumption during pregnancy is detrimental to an individual’s head and facial appearance because the craniofacial anomalies distort the appearances and may affect other body parts.
Risk Factors of Alcohol
Alcohol consumption increased among the female population even though their number is less than half of men’s number. Report shows that 1 in 5 women in colleges experiences alcohol-related sexual assault. In 2019, 9.5 percent of pregnant women aged between 15 and 44 consumed liquors in the past month (National Institute on Alcohol Abuse and Alcoholism 4). Notably, smoking increases the risk of alcohol consumption, as 86 percent of smokers consume alcohol. Besides, smokers are 1.32 times more likely to drink than nonsmokers. Besides, many students and unmarried people have a high risk of drinking.
Report also shows that 59.1 percent of men drank in 2021, while 29.7 percent of men 18 years and older engaged in binge drinking. Many unmarried men and male students are more susceptible to drinking than women (National Institute on Alcohol Abuse and Alcoholism 5). Similarly, those with salaries of more than $50,000 have a high chance of engaging in heavy drinking. Other factors that determine an individual’s risk of drinking alcohol include genetics, personality, psychological conditions, and history.
The need to regulate alcohol attracted the federal government’s attention, which in response, made the 21st amendment. The amendment prohibits the importation or transportation into any state, territory, or possession of the United States for delivery or use of intoxicating liquors. This legal approach has lowered alcohol abuse.
Physical appearance, hearing, and eye disorders in Children with FAS
Physically, these children have flat midface, short, upturned noses, and thin upper lips. They also have epicanthal folds, underdeveloped jaw, and small, widely spaced eyes. Similarly, these children have smooth wide philtrum. It should be noted that physicians can consider diagnosing FAS only when a child presents several of these physical appearances and central nervous system symptoms because one or two of the signs can be genetic and occur in a healthy child.
Research shows that FAS is associated with four kinds of hearing disorders. These include the developmentally delayed auditory function characterized by the slow development of hearing ability and sensorineural hearing loss caused by the damage to the inner ear or the nerve that connects the ear to the brain (McLaughlin et al. 3). Other problems are intermittent conductive hearing loss caused by recurrent otitis media. These hearing problems, including central hearing loss, expose the children to more speech and language development problems.
Ninety percent of children with Fetal alcohol syndrome encounter eye abnormalities. Research shows that between 25 and 50 percent of these children face strabismus while others encounter nystagmus-involuntary rapid eye movements as others experience clouding of the eye lens, also termed cataracts (McLaughlin et al. 3). While some child re may also experience changes in eyelids, it should be noted that this does not thwart visual development. Similarly, optic nerve hypoplasia and tortuosity of the retinal blood vessels. Therefore, children with FAS must go for an eye examination to diagnose and detect the disorders early before they worsen.
Other disorders children with FAS may experience include low body weight, difficulties in school due to learning disabilities, and hyperactive behaviors. Others include poor coordination and low attentiveness, which can result in autism (McLaughlin et al. 5). Research shows that 72 percent of children with FAS have autism.
Primary Disabilities
Children with FAS suffer from primary disabilities, including loss of intellectual function (IQ) and behavioral disorders. Because of the mental and brain problems that children with FAS endure, the disease leads to their IQs falling below average. This adversely impacts their ability to process information and to be attentive to matters that require attention (Osna and Kharbanda 2). Behavioral disorders caused by FAS include aggression and breaking the rules or lack of cognizance of rules. These children can also not consider the repercussions of their actions because the disorders make them insensitive. Besides, people with FAS tend to engage in drug abuse because they overlook the consequences of the abuse.
Children with FAS also encounter learning disabilities characterized by a lack of the ability to grasp concepts due to poor attention skills and memory problems. Additionally, the low IQ impedes their abilities to reason and think critically, making them unable to comprehend questions and concepts that require a high IQ (Popova et al. 5). The social impairments that come with FAS include social misconduct due to impaired practice reasoning ability and skills which also lead to inability to form social relationships due to social incompetence. Other abnormalities in children with FAS include joint, limb, and finger deformities, poor judgment, low activity levels, delay in academic skills, and problem-solving problems.
Documentation of facial abnormalities, growth deficits, and CNS abnormality
Physicians consider diagnosing children with three or more facial abnormalities among children suspected to have FAS. Some facia abnormalities are an upturned nose, thin upper lip, flat midface, and a short nose. Other features include epicanthal folds, small eyes that are widely spaced, and underdeveloped jaws. The presence of a smooth and wide philtrum and nasal bridge are other facial features for FAS patients that should be considered for diagnosis. These children also have a small head circumference and other facial defects.
Fetal growth restrictions are a common growth defect of FAS. After birth, these children also encounter slow physical growth compared to their peers without FAS. This is because the alcohol intake lowers the functionality of growth cells inside and outside the womb. Joint deformities also impede normal growth; these children encounter joint problems that prevent them from growing normally. Besides, growth deficits in people with FAS emanate from the central nervous system because these children tend to have central nervous system problems.
The status of the central nervous system (CNS) is of dire concern in children with FAS, and it can be used to determine the diagnosis of FAS. Evidence-based study shows that the CNS is damaged by the fetal alcohol spectrum disorder, especially the brain (Rusyn and Bataller 3). It is important to note that taking alcohol during pregnancy exposes the fetus to alcohol which circulates in their bodies and through the brain. Alcohol disrupts certain parts of the brain and interferes with their development.
The problems in the central nervous system lead to more signs and symptoms of FAS, such as irritability, lack of proper eating, lack of good sleep, and strong startle reflex. They also experience extra sensitivity to sensory stimulation. Other CNS symptoms include the children extending their heads or limbs and exhibiting hypertonia or hypotonia.
Prevention and treatment of FAS
The earliest intervention identifies alcohol use among women of childbearing age and pregnant women and implements preventive strategies (Petrenko and Alto 4). Besides, Parent-Child Assistance Program can provide women with substance and alcohol abuse issues t transform their lives by abandoning the behaviors and connecting them with community resources that can offer them further support.
FAS lacks a cure or specific treatment, and the mental deficiencies and physical defects last throughout an individual’s life. However, treatment processes can improve a child’s growth and development (Petrenko and Alto 5). It can help them to interact with others, walk, talk, and form interpersonal relationships. Protective interventions that might help in FAS include early diagnosis at a young age, creating a stable and nurturing environment, absence of violence, and participation in special education.
Parent education and training are evidence-based interventions to solve or prevent the FAS problem. The education and training scope should incorporate the impacts of alcohol consumption during pregnancy and how to prevent it. It should also involve stopping alcohol consumption among pregnant women and those of childbearing age (Petrenko and Alto 4). Education is also important in covering self-regulation, nutrition, adaptive functioning, and medication. Parents should also be educated on understanding and responding to their children’s neurodevelopmental problems.
Conclusion and Recommendations
FAS remains a public health problem in the U.S. because it alters the affected children’s physical, social, and mental health. Since it is primarily caused by alcohol intake during any trimester of pregnancy, expectant mothers should be assisted in stopping or avoiding drinking. It is also recommended that treatments for primary disabilities are necessary to protect the children from experiencing the adverse problems of FAS. Women who plan to start their pregnancy journey are also recommended to be enrolled in community programs to educate and train them on how to avoid drinking alcohol to protect their babies from FAS.
Works Cited
Lui, Sylvia, et al. “Detrimental effects of ethanol and its metabolite acetaldehyde, on first-trimester human placental cell turnover and function.” PloS one 9.2 (2014): e87328.
McLaughlin, Susan A., et al. “Listening difficulties in children with fetal alcohol spectrum disorders: More than a problem of audibility.” Journal of Speech, Language, and Hearing Research 62.5 (2019): 1532-1548.
National Institute on Alcohol Abuse and Alcoholism. “Alcohol Facts and Statistics.” National Institute on Alcohol Abuse and Alcoholism, Mar. 2022, www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics.
Osna, Natalia A., and Kusum K. Kharbanda. “Multi-organ alcohol-related damage: mechanisms and treatment.” Biomolecules 6.2 (2016): 20.
Petrenko, Christie LM, and Michelle E. Alto. “Interventions in fetal alcohol spectrum disorders: An international perspective.” European journal of medical genetics 60.1 (2017): 79-91.
Popova, Svetlana, Danijela Dozet, and Larry Burd. “Fetal alcohol spectrum disorder: can we change the future?.” Alcoholism, Clinical, and Experimental Research 44.4 (2020): 815.
Rusyn, Ivan, and Ramon Bataller. “Alcohol and toxicity.” Journal of Hepatology 59.2 (2013): 387-388.
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