The Prevalence of Fetal Alcohol Spectrum Disorders (FASDs)

Fetal alcohol spectrum disorder (FASD) is a blanket term for a group of conditions that can affect someone who was exposed to alcohol in the womb. FASD is not a life-threatening condition, but it can cause several birth defects—many of which can affect behavior and learning.

Here’s more about the prevalence of FASDs, how to reduce your risk, and how to contact Lompoc Valley Medical Center for all your prenatal care needs.

What Are FASDs?

FASDs are conditions that affect people whose mothers drank alcohol during pregnancy.

Women are typically advised to avoid any alcohol during pregnancy due to the risk of birth defects. Alcohol can pass from your bloodstream into your baby’s bloodstream and interfere with the development of your baby’s brain and other organs.

According to the National Institutes of Health (NIH), prenatal alcohol exposure is a leading cause of birth defects in the U.S. Birth defects caused by FASD are also entirely preventable.

The effects of prenatal alcohol exposure can appear at any time during your child’s life. Children with FASDs usually need treatment for life to improve their social skills, behavioral skills, and mental health. Medications, behavioral therapy, and educational interventions are common treatments for people with FASDs.

What Are the Different Types Of FASDs?

There are many types of FASDs. Each type of FASD is based on a set of specific symptoms.

Fetal Alcohol Syndrome (FAS)

FAS is the most severe type of FASD. It is usually caused by heavy alcohol use during the first trimester, which can disrupt the development of the brain and face. Signs and symptoms of FAS are usually distinct. Your doctor may diagnose FAS in your child if the following criteria are met:

• There is evidence of prenatal alcohol exposure.
• Your child has a lower-than-average height and/or weight.
• Your child has three facial abnormalities: a smooth area between the lip and nose, a thin upper lip, and narrow eye openings.
• Your child has central nervous system abnormalities.

Partial Fetal Alcohol Syndrome (pFAS)

Your child may be diagnosed with pFAS if they do not meet the full diagnostic criteria for FAS. Kids with pFAS usually have at least one symptom of FAS, such as poor growth.

Alcohol-Related Neurodevelopmental Disorder (ARND)

Children who are diagnosed with ARND have neurological problems that cause learning disabilities, intellectual disabilities, and behavior problems. They may also suffer from abnormalities that affect the brain and nerves. They do not have problems with growth and do not have abnormal facial features. Kids with ARND usually struggle in school due to poor behavior and impulse control.

Alcohol-Related Birth Defects (ARBD)

Kids with ARBD have problems with their organs, which may not be formed or functioning correctly. The bones, kidneys, and heart are some of the many organs that can be affected in people with ARBD. Hearing and vision may also be affected. Many times, people with ARBD are also diagnosed with another type of FASD, such as FAS.

Neurobehavioral Disorder Associated With Prenatal Alcohol Exposure (ND-PAE)

Children can develop ND-PAE if their mothers drank more than 13 alcoholic drinks per month of pregnancy or two or more alcoholic drinks in one sitting at any point during pregnancy. Kids with ND-PAE will experience behavioral problems and problems with thinking and memory. They will also have difficulty doing normal everyday activities like getting dressed and brushing their teeth.

How Common Are FASDs?

According to the American Academy of Pediatrics (AAP), it is unknown exactly how many children in the U.S. have FASDs. The AAP suspects that every year, an estimated 40,000 babies in the U.S. are born with a FASD. Also, between 800 and 8,000 babies are born with FAS.

In a 2022 report published by the American Psychological Association (APA), researchers stated that an estimated 2% to 5% of schoolchildren in the U.S. (as many as one in 20 kids) had some type of FASD. The APA also referenced a study in which 547 foster and adopted children were evaluated for FASD. Researchers learned that 86.5% of this group had FASD that had either been misdiagnosed or not been diagnosed.

What Causes FASDs?

Any level of alcohol use during pregnancy can contribute to FASDs. Alcohol passes into the placenta, where it can interfere with the growth and development of your baby.

The NIH reports that several risk factors play a role in how an unborn baby is affected by its mother’s alcohol use. The top three risk factors are:

• Quantity, or the amount of alcohol a pregnant woman drinks on one occasion.
• Frequency, or how often a pregnant woman drinks alcohol.
• Timing, or the stage of pregnancy during which a pregnant woman drinks.

Other risk factors for FASDs include:

• Poor nutrition.
• Multiple births and pregnancies.
• Weight, height, and body mass index (BMI) that are lower than average.
• Smoking.
• Older age.
• Family history of heavy alcohol use.
• High stress level.
• Social isolation.
• Exposure to alcohol misuse.
• Limited access to prenatal care.
• Genetics.

Which Birth Defects Are Caused By FASDs?

FASDs can cause a wide range of different birth defects. Some people may have many symptoms or conditions caused by FASDs, while others may only have one or two. Additionally, these symptoms and conditions can range from mild to severe.

Birth defects and health problems that can be caused by FASDs include:

• Poor balance and coordination.
• Poor memory and concentration.
• Poor decision-making ability.
• Problems with following directions.
• Poor judgment and reasoning skills.
• Difficulty paying attention.
• Poor impulse control.
• Difficulty with controlling emotions.
• Difficulty with communicating with others.
• Inability to socialize.
• Learning disabilities.
• Low intelligence, or IQ.
• Speech and language delays.
• Difficulty in school, especially in math.
• Hyperactive behavior.
• Low body weight.
• Shorter-than-average height.
• Small head size.
• Problems with certain organs, particularly the heart, bones, and/or kidneys.
• Problems with vision and hearing.
• Problems with sleep as a baby.
• Problems with sucking or latching as a baby.
• Abnormal facial features.

The NIH says that brain damage in people with FASDs makes it difficult for them to perform normal everyday activities. Bathing, telling the time, and counting money are examples of such activities. It adds that individuals with FASDs also tend to make the same mistakes repeatedly, trust the wrong people, and struggle with trying to understand the consequences of their actions.

Mental health disorders are also more common in people with FASDs than in those without FASDs. People with FASDs are often at higher risk for also having:

• Attention deficit hyperactivity disorder (ADHD).
• Mood disorders, such as anxiety and depression.
• Drug and alcohol use disorders.
• Behavioral problems, such as those involving hyperactivity, conduct, and impulse control.

How To Reduce Your Risk For FASDs

The most effective way to reduce your baby’s risk for FASD is to not drink any alcohol at all before and during pregnancy. FASDs are 100% preventable as long as you do not drink, and if your baby is not exposed to any alcohol while in the womb.

The CDC recommends not drinking at all if it is possible you could become pregnant. Many women do not know they are pregnant for between four and six weeks, which is around the time they miss their first period.

Between 20% and 30% of women have said they drank alcohol at some point during their pregnancies, usually during the first trimester, reports the NIH. Additionally, more than 8% of women said they engaged in binge drinking at least once during pregnancy—again, typically during the first trimester.

If you are pregnant and drink alcohol, it is not too late to stop. Your baby’s brain and other organs continue to grow and develop during pregnancy. This means that stopping alcohol use as soon as possible can improve your baby’s overall health and well-being. This is true even if your baby has already been exposed to alcohol.

Talk to your doctor or OB-GYN if you think you may have an alcohol use disorder, which is a physical and psychological dependence (or addiction) to alcohol. Your doctor can work with you to help you stop drinking or refer you to another provider that specializes in helping pregnant women with substance use disorders. These specialists are devoted to helping both you and your baby achieve a positive outcome, regardless of how much alcohol you have consumed during pregnancy.

How Parents Can Help Children With FASDs

If your child has FASDs, early intervention and treatment may help improve their quality of life. The CDC says this is especially true if your child is diagnosed with FASD before the age of six.

Ask your doctor for a referral to a provider that specializes in FASDs. These specialists can accurately diagnose the type of FASD that is affecting your child. They can also develop a customized treatment plan that focuses on addressing your child’s symptoms or conditions.

FASDs treatments include, but are not limited, to:

• Educational interventions, which may include collaboration with your child’s school.
• Developmental services.
• Behavioral therapy or modification.
• Parent training - to teach you how to help your child manage FASD.
• Social skills training.
• Medications, including those for comorbid conditions like depression or ADHD.

A quality healthcare provider will modify your child’s treatment plan as needed and follow up with you regularly to discuss your child’s treatment progress.

Pediatric Care at Lompoc Health

Our pediatric team is committed to partnering with you to guide your child through every stage of development. Call us today at (805) 736-1253 to schedule an appointment or for more information on how our pediatric team can help your child. 

Dr. Tabek Bakir, a Lompoc Health pediatrician, contributed this article. Learn more.