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An Overview of Fetal Alcohol Spectrum Disorders for Physicians
Authors: Sara J. Paton, PhD , Epidemiologist, Boonshoft School of Medicine, Wright State University, Dayton, OH; Public Health -- Dayton & Montgomery County, OH; and Christopher S. Croom, MD , Boonshoft School of Medicine, Wright State University, Dayton, OH.
Peer Reviewer: Judith Eckerle Kang, MD , Assistant Professor of Pediatrics, University of Minnesota, Minneapolis.
The U. S. Surgeon General has advised women not to drink if they become pregnant, plan to become pregnant, or are at risk of becoming pregnant. Innocent children suffer the consequences of physical, mental, and behavioral manifestations that can extend into adulthood. Since fetal alcohol syndrome is 100% preventable, the primary care physician needs to be vigilant and diligent in the education of female adolescents and women of childbearing age. This issue highlights the spectrum of fetal alcohol syndrome, its recognition, and treatment.
--The Editor
Introduction
The idea that a fetus could be harmed by exposure to alcohol during pregnancy has been around for a long time. Perhaps the first written record is in the Bible, Judges 13:4, in which the birth of Samson is being discussed. The angel of the Lord appears to Samson's mother and says "Now see to it that you drink no wine or other fermented drink and that you do not eat anything unclean, because you will conceive and give birth to a son." Experimental data regarding the effects of alcohol on a fetus have been conducted since near the beginning of the 20th century with the use of animal models. 1 The first journal article was published in 1968, when Lemoine et al. 2 reported the common problems of 127 children born to mothers who drank large amounts of alcohol during pregnancy. This report was largely ignored until 5 years later, when Jones and Smith in 1973 3 described children of similar symptoms and coined the term "fetal alcohol syndrome." This term was used to describe a group of children, born to alcoholic mothers, who had growth retardation, characteristic facial features, and central nervous system involvement. It is now well known that prenatal alcohol exposure may lead to fetal alcohol spectrum disorders (FASD), an umbrella term describing the range of effects that can occur in...