Fetal Alcohol Syndrome
Consuming alcohol of any amount during pregnancy cannot be regarded as harmless to the fetus. Even though a causal relationship between alcohol consumption during pregnancy and the toxic effects on the unborn child has not yet been established, it is evident that the idea of responsible drinking and low risk is not applicable to pregnant women. The fetus is safer if the mother desists from alcohol consumption. Women relax and forget to take care of their own health and those of their babies during pregnancy. A woman`s body system is significantly affected by external chemical influences, and alcohol is one of them. The society as a whole should be significantly concerned with the effects of alcohol use on young children. In particular, the occurrence of Fetal Alcohol Syndrome (FAS) is one of the most imminent problems in the modern prenatal medicine. The syndrome is a major problem that requires immediate fixing.
Fetal Alcohol Syndrome (FAS) refers to numerous mental, physical, behavioral and learning difficulties suffered by a child because her mother engaged in alcohol consumption during pregnancy. FAS was first discovered in the 1973 at the the University of Washington in Seattle by two men David Smith and Kenneth Jones (Golden, 2005). Not all fetuses are affected by FAS. The main reasons why the disease affects some children and not others is not fully known. According to CDC (2014), each year, between 0.2 and 1.5 per 1000 children are born with defects that are directly linked to alcohol use by their mothers during pregnancy.
When a person takes alcohol, numerous metabolic reactions happen in her body. Firstly, the alcohol gets into the blood through the digestive tract. Alcohol dehydrogenase (ADH) is then oxidized to produce acetaldehyde. An enzyme known as the acetaldehyde dehydrogenase (ALDH) changes the acetaldehyde into acetic acid. The acid is then synthesized through a series of complex processes and broken down into water (H2O) and carbon dioxide (CO2) that are then discharged outside the body. How the alcohol is metabolized in a pregnant woman`s body is more depressed compared to a woman who is not pregnant. This is because estrogen in pregnant women is impedes the activities of both ADH and ALDH (Balatbat, 2005). During the first trimester, the volume of estrogen in the serum increases by between 10 and 100 times. In late pregnancy, it increases by between 100 and 1000 times. This has a direct effect on how alcohol is metabolized in a pregnant woman`s body. As a result, a pregnant woman is at a disadvantage because alcohol cannot be efficiently metabolized. Worse still, a fetus lacks the capability to break down alcohol molecules (Balatbat, 2005). Furthermore, because alcohol is highly soluble, it can pass across the placenta membrane into the fetus` blood stream. It is estimated that nearly half of alcohol that crosses the placenta enters the fetus` blood stream while the other half enters the fetus` circulatory system through the liver. Given that the alcohol consumed stays in the blood stream, the fetus is literally fed with alcohol from the mother`s blood stream (Soby, 2006).). The fetus is a highly vulnerable being, particularly during the first three trimesters of pregnancy. The high vulnerability is explained by the fact that during these stages, the fetus is developing its basic formations. The fetus is affected by everything the mother is exposed to, including alcohol. Consequently women who take alcohol when they are pregnant cause a chain of incorrect development to the fetus (Soby, 2006). Nearly 18% of pregnant take alcoholic drinks in the first trimester of pregnancy, 4.2% during their second trimester, and 3.7% in their third trimester of pregnancy (SAMHSA, 2013).
According to Soby (2006), a pregnant female who drinks 3 ounces of pure alcohol each day exposes the fetus to high risk of FAS. Once alcohol enters the fetus` organism through the placenta, it may cause contraction of the umbilical cord and placenta vessels. This in turn prevents the fetus from receiving enough oxygen supply. Similarly, because of alcohol, the volume of zinc in the cells quickly declines, which has a negative effect on the fetus` growth and development. These deviations in turn force the fetus` DNA cells to mutate. The mutation in the fetus DNA cells leads to abnormalities in the development of different body tissues and organs. Alcohol is also known to be a cause of lack of vitamin in the fetus organism. Furthermore, some women are often not aware that they are pregnant during the initial three to four weeks of their pregnancy. Because they do not know, they continue with their habit of alcohol consumption, which adversely affects the cartilage formation during the entire embryonic stage. The fetal stage starts after approximately 46 to 48 days and continues until the baby is born. This period determines the future of the child, because it is during this stage that the baby is formed. Even lesser use of alcohol during this period may result in irreparable harm to the fetus. The destruction happens inside the fetus causing irreversible damage on the genetic makeup.
The mechanism though which alcohol originates and leads to the development of FAS is not yet clear. However, a number of mechanisms have been put forward. The first mechanism is the direct toxic impacts of alcohol on the fetus at important stages of the fetus` development. In particular, alcohol exposure during the first trimester affects embryo development, which results in visceral and skeletal abnormalities. Similarly exposure to alcohol at later development stages leads to behavioral anomalies. The second mechanism is through the placental function, whereby alcohol use among pregnant women changes the placenta`s transport functions. Alcohol equally causes the collapse of umbilical vessels, these results in reduced fetal blood flow leading to hypoxia that has been found to be a cause of alcohol-related growth retardation. Another mechanism is prostaglandin synthesis. Alcohol intake may increase the volume of prostaglandins that consequently hinder fetal blood flow.
There are many risk factors linked to FAS. It is worth emphasizing that FAS arises because of alcohol use in the course of pregnancy. The quantity and frequency of alcohol intake is one of the leading risk factors. Women who are binge drinkers (those who take no less than 5 drinks in each occasion) are exposed to the risk of FAS compared to those women who consume the same amount over an extended time period. The more chronic the binge drinking, the severe the damage and the exposure is likely to happen during critical stages of fetus development. Evidence indicates that even small doses of alcohol are dangerous because all FAS cases have been diagnosed among women who take alcohol. The second risk factor is the mother`s age. The risk of FAS is positively correlated with age. This can be due to the fact as age increases, concentration of alcohol in the blood rises. As age increases, the ratio water to body fat increases, which results in higher levels of alcohol in the blood. Social-economic status is yet another risk factor. Although FAS affects all races, its prevalence is much higher among people with low social-economic status. Poverty may be positively correlated with drug abuse. The last risk factor is genetics. Genetic factors not only determines how alcohol is synthesized, but also determines an individual`s sensitivity to alcohol toxicity (Astley, Bailey, Talbot & Clarren, 2000).
As already noted, fetal alcohol syndrome represents numerous problems as a result; there are many symptoms and signs associated with FAS. Infants with FAS tend to exhibit a number of characteristics. Firstly, they have distinctive facial features that include a smooth ridge in between the nose and upper lip, a small head, tiny eyes, a very tinny upper lip and other unusual facial characteristics. These children also tend to have delayed growth. In particular, these children have less than expected height; they have a thin head circumference and have less weight. In addition, these children tend to delay in the development of language, motor skills and social skills among others. Other symptoms include hypersensitivity, learning disabilities, lower IQ, mental retardation, mood swings, heart problems, and difficulties in understanding particular concepts such as time, mathematics and money, memory lapses, lack of problem solving skills, hearing and visual impairments, and lack of focus (Burd et al., 2007).
There are many secondary conditions that develop from FAS. Firstly, individuals with FAS face many barriers in life, which denies them the opportunity to enjoy life like their normal counterparts. They are unable to complete their schooling in time, find jobs and cannot live on their own without support. The syndrome also leads to communication problems. These barriers make their lives to depend on others. In addition, they tend to feel isolated because at young age their peers tend to avoid them. Secondly, FAS patients have undeveloped social skills, which make their social adaptation very difficult. They cannot think logically and as a result they continuously make poor judgments. Similarly, these individuals have no self-control; they cannot build and maintain friendship, and are stubborn and anxious. Because of the many social defects that these patients have, they tend to be socially withdrawn. Thirdly, the academic performance of children with fetal alcohol syndrome is always lower than those of their healthy counterparts. In some instances, the IQ of these children allows them to learn almost normally, however, in most cases, the social and language barriers they face acts as a barrier to knowledge acquisition.
There are various strategies for preventing fetal alcohol syndrome. Primary strategies focus on education for women and their partners should be conducted in relation to FAS and the negative impacts of alcohol on the unborn baby. Secondly, all women patients who are within the motherhood age should be asked questions relating to their alcohol use and advice given. Similarly, FAS educative materials should be available to patients and the general public (Astley, Bailey, Talbot & Clarren, 2000).
With regard to secondary prevention, women who take alcohol when pregnant should be identified and their level of risk assessed. Secondly, expectant mothers who consume alcohol should be counseled on the dangers that they pose to their health and that of the fetus. In addition, they should be counseled on the benefits of avoiding alcohol or reducing intake throughout their pregnancy period. Moreover, women who use alcohol should be referred for appropriate treatment and contraceptive advice given (Astley, Bailey, Talbot & Clarren, 2000).
Under tertiary intervention, women whose future pregnancies are highly exposed to FAS should be identified. After they identified, they should be asked the reasons why they are drinking. High risk women who are already pregnant should be referred for necessary treatment. Furthermore, benefits relating avoiding or reducing alcohol use during pregnancy should be provided (Astley, Bailey, Talbot & Clarren, 2000).
FAS puts a permanent mark on an individual`s life and changes it into a major life “test”. However, in order to help an individual pass this test, physicians must first know that the patient is facing the problem of FAS. Timely diagnosis of FAS can help the doctors to give a well-timed assistance to a child with FAS. As a result, the syndrome should be diagnosed immediately after they are born. Late diagnosis may result in further complications and problems and reduce the accuracy of diagnosis. It is worth noting that a misdiagnosis of FAS may result in severe complications (Kim & Park, 2011). The special support that FAS patients desperately need can never be provided if the disease is misdiagnosed. A baby with FAS requires medical monitoring, education support and nutrition right from the early stages of his/her life, and this can make a huge difference in the child`s development. Similarly, early diagnosis allows the FAS affected baby to be socialized into the society. Through role-playing the various social situations beginning from early preschool and providing the right “sensory” diet and Auditory Integration Training (AIT), the FAS patient is prepared for a positive socialization in his/her future as an adult. The most important component of providing the right diagnosis is giving the right medication and ensuring the patient takes all the necessary medication (Astley, Bailey, Talbot & Clarren, 2000). Given that it is not possible to completely cure FAS, physicians may work with the different types of signs and symptoms and try to reduce them by giving the right medication. As already notes, FAS has no cure, the effects are permanent and the patients have to learn how to live with the disease for the rest of their lives. The best that can be achieved is improving on the symptom manifestations provided the diagnosis is correctly done at the right time and the right medication given to the FAS patient (Paley & OÂ¿Connor, 2011). All these interventions will allow the FAS patient to live close to normal life. However, it is worth emphasizing that nothing can be done to completely recover a child`s organism from the ethanol exposure.
It is quite evident that a FAS patient does not fit well within the contemporary society. This is because such children may need special personal attention from parents and guardians in order to tackle the numerous challenges they face on a day-to-day basis. As a result, these children require a treatment protocol that can help them succeed. Firstly, these children need a structured environment. This implies that each child suffering from FAS should be trained on how to cope with daily routine. In addition, children with FAS need adult supervision to ensure they are protected from situations that may threaten their lives. Thirdly, the instructions that supervisors give to children with FAS must not only be clear, but should also be communicated in a manner that ensures that the child comprehends what he/she is expected to do (Paley & OÂ¿Connor, 2011). The instructions must be precise and clear. Similarly, big assignments should be broken down into smaller components. The smaller units may later on be combined and implemented at a higher level. It is worth remembering that children suffering from FAS should also be informed about the disease. Having a complete understanding of the disease will help them confront their fears. In addition, personal touch between these children and their teachers is very important. The relations have to be confidential and conducted with a lot of kindness (Golden, 2005). All children suffering from FAS may have difficulties in following the curriculum. However, this can be overcome by creating a curriculum that that replicates the life at home. Everything should be conducted using a similar fashion and in the same order.
Alcohol consumption has become an integral component of modern day celebrations. Nearly all celebrations ranging from birthday parties to charismas have alcohol in the menu. On the face of it, it appears that nothing bad may follow after taking alcohol. However, the bitter fact is that alcohol has far reaching implications on the health of mothers and their unborn babies. Even the smallest doses of alcohol can cause severe harm both the mother and the future baby. FAS has been associated with many abnormalities including damages to the central nervous system and facial deformities. Children diagnosed with FAS face many developmental disorders, yet these disorders can be easily prevented by abstaining from alcohol consumption. The majority of women are ignorant of the consequences of alcohol consumption on the fetus. However, the main reason why women engage in alcohol consumption is because young mothers do not understand the destructive consequences of alcohol. The adverse effects of FAS do not change with age; however, some specific manifestations may change as the child grows. Hypersensitivity, attention disorder, facial deformities and damages to the central nervous system are some of the adverse effects of FAS that occur in nearly 75% of all FAS patients. These factors hinder these children from socializing with their peers, making their lives incomplete. The social problems faced by children with FAS patients are a major problem to both parents and the children alike. The only remedy is for pregnant women to completely desist from alcohol consumption. Any woman who engages in alcohol consumption exposes her health and that of her unborn child to numerous health complications. Given that these effects can be prevented, the society as a whole has a role in encouraging alcohol free lifestyles among pregnant women. For those women who are unable to stop drinking, the use of contraceptives to avoid pregnancies should be an alternative solution. However, abstaining from alcohol remains the best cure For FAS. It is worth reiterating some of the facts about women and alcohol. Firstly, women have less dehydrogenate, as a result, their bodies absorb approximately 30% more alcohol than men`s bodies. Secondly, alcohol is highly soluble in both fat and water, as a result it can readily penetrate the body`s cell membranes and tissues.
Astley, S., Bailey, D., Talbot, C., & Clarren, S. (2000). Fetal alcohol syndrome (FAS) primary prevention through FAS diagnosis: II. A comprehensive profile of 80 birth mothers of children with FAS. Alcohol And Alcoholism, 35(5), 509-519.
Balatbat, J. (2005). Fetal alcohol syndrome: the belly grows, the baby shrinks. Journal of Continuing Education Topics & Issues, 7(3), pp. 110-117.
Burd, L., Deal, E., Rios, R., Adickes, E., Wynne, J., & Klug, M. (2007). Congenital heart defects and fetal alcohol spectrum disorders. Congenital Heart Disease, 2(4), 250-255.
CDC. (2014). Facts About FASDs. Retrieved 19 September 2014, from http://www.cdc.gov/ncbddd/fasd/facts.html
Golden, J. (2005). Message in a bottle the making of fetal Alcohol Syndrome. Cambridge: Harvard University Press.
Kim, O., & Park, K. (2011). Prenatal alcohol consumption and knowledge about alcohol consumption and fetal alcohol syndrome in Korean women. Nursing & Health Sciences, 13(3), 303-308.
Paley, B., & OÂ¿Connor, M. J. (2011). Behavioral Interventions for Children and Adolescents With Fetal Alcohol Spectrum Disorders. Alcohol Research & Health, 34(1), 64-75.
SAMHSA. (2013). Nearly 18 percent of pregnant women drink alcohol in early stages of pregnancy. Retrieved 19 September 2014, from http://www.samhsa.gov/newsroom/advisories/1309064526.aspx
Soby, J. (2006). Prenatal exposure to drugs/alcohol. Springfield, IL: Charles C Thomas