FREE ESSAY ON FETAL ALCOHOL SYNDROME

FETAL ALCOHOL SYNDROME

Many pregnant women are not aware of the complications that are involved with pregnancy.
The greater majority of young women see pregnancy as a way of bringing a life into the
world but do not use precaution in their dietary habits to prevent the destruction or
inhibition of such a life. Most pregnant women continue on their drinking and drug abuse
binge right throughout their pregnancy. They do not think ahead to the inexplicable
damage that it could do to their fetus. What they do not know is that when a woman drinks
while pregnant it could do damage, and pose problems not only to herself, but to the
fetus that she is carrying. 
The problem? FAS, Fetal Alcohol Syndrome. According to many physicians it is the leading
cause of birth defects and developmental disabilities in the United States today. Douglas
A. Milligan states that, FAS is the single greatest cause of mental retardation in the
U.S. today. ( Seachrist, p. 314) Fetal Alcohol Syndrome was first named and treated and
found in the late 1960's. This condition results from the toxic effect of alcohol and its
chemical factors on the developing fetus and its brain. The alcohol enters the
bloodstream though the placenta and then the damage begins to occur. FAS consists of a
characteristic pattern of abnormalities resulting from the exposure that the fetus has
had with alcohol during early development. 
There have been many reports linking alcohol use and fetal deficiencies in growth that
emerged from France in the late 1950's. Not until the 1960's was the correlation made
between the number of defects and the increasing amount of babies born with the syndrome.
The term Fetal Alcohol Syndrome was coined to describe the pattern of the abnormalities
found in some children born to alcoholic women. It clearly was very noticeable and
distinctive in the recognition of itself and was distinct from all other patterns of
malformation in the fetus; there was a significant association found between the alcohol
consumption rates during pregnancy and a lower general cognitive index of these children.
Being further studied in the 1970's under the heading as a birth defect that occurs, FAS
was one of the most common causes of birth defects. Researchers said that it occurred in
almost 1 of every 500 to 1 in every thousand births.( Seachrist, p. 314) There is a major
thing that causes difficulty in the diagnosis of this disorder though, its main diagnosis
hinges on the obvious facial abnormalities, short stature, and low IQ. Children who do
not meet all of these factors are diagnosed with FAE, Fetal Alcohol Effect, a milder form
of FAS.
There are general abnormalities which affect both forms of the disease. These
abnormalities include a deficiency in growth, a pattern of malformation affecting the
face, heart, and urinary tract. There are abnormalities within the brain that lead to
various intellectual and behavioral problems in early childhood, as well as problems
within the central nervous system. As I stated before many factors do play a role in the
development of FAS in an infant. The most prominent among these are the frequency and the
quantity of maternal alcohol consumption during the pregnancy. The timing of the
gestation of alcohol is what determines the level of abnormalities that occur. The stage
of development at which alcohol consumption takes place and that in correlation to the
gestation period, nutritional status, and genetic background all play parts in the
development of the baby and its defects. The alcohol that is being consumed does have an
effect on the cellular and molecular development of the fetus and that is what generally
underlies the development of FAS. 
There are specifics in diagnosing that doctors look for in treating a patient for FAS.
First of all the eyes are the most common and consistent sign of FAS, the eyelids
especially. Children often appear to have widely spaced eyes but measurements reveal that
they are spaced apart normally. This disparity in sight is caused by short fissures (eye
openings). The distance between the inner and outer corners of each eye is palpebral
shortened making the eyes appear smaller and farther apart than normal. Following the
downward pattern, the next common facial defect in children of FAS/FAE is slow growth in
the center of the face. This produces an underdeveloped midface and the zone between the
eye and the mouth may seem to be flattened or depressed and in congruence the bridge of
the nose is often very low. As a result of slow nose growth, the nose tends to point
forward and downward in that same respect. ( Aase, p.5)
Subtle but still a characteristic feature is the philtrum, the area between the nose and
the mouth. Characterized by a vertical midline groove, bordered by two vertical ridges of
the skin, where the grooves meet the red margin of the upper lip it forms a cupid's bow.
In the development of the FAS child there is a long, smooth philtrum without the ridges
that should be there coupled with a smoothly arched upper lip margin. Where as the facial
abnormalities are very obvious when looked for the abnormalities of the limbs and joints
are less consistent. These include deformities of the small joints of the hands as well
as an incomplete rotation at the elbow. ( Aase, p.5)
Looking inwardly to the problems that may occur children with FAS are also for the most
part stricken with a increased risk for many common birth defects. Of these chronic
defects include congenial heart disease, anomalities of the urinary tract and genitals,
and spina bifida. These aforementioned abnormalities are not specific to FAS but coupled
with FAS characteristics they help to provide a more clear and concise diagnosis. 
There were many reports of behavioral and intellectual trouble in all the children that
have thus been diagnosed. Beginning with infancy, the children have problems at feeding
and are highly irritable. They also exhibit unpredictable sleeping and eating patterns
which make it hard for the baby to be cared for and for maternal bonding to occur. During
development, both physical and mental, FAS children have very fine and poor motor
coordination skills and it becomes very apparent at the preschool age. They also are very
affectionate but at the same time very hyperactive, which makes it a problem for the
teachers who have them in class to deal with. This is why they are, during the first few
years of school, given the diagnosis of having attention-deficit hyperactivity disorder
(ADHD); this diagnosis is given because of their high activity level, short attention
span, and poor short-term memory. Many of these children require special education help
regardless of the fact that their IQ falls between the normal range. Their hyperactivity
calls for them to receive special attention that normal teachers cannot and at most time
will not give them. 
As FAS children grow into FAS adults, their level of development and how they developed
begins to show in everything that they do. Since their social and mental health has been
compromised as adults they exhibit inadequate communication skills, impulsivity, poor
judgment, trouble with abstract thinking, and limited problem solving skills. With all
these problems they often have difficulty in holding down a job because of their
unreliability, lack of social skills, and functional illiteracy.
There are many different factors involved in fetal development in relation to FAS. The
two things involved that stand out the most are teratogens and acetaldehydes. These two
stand out as the things that are not in a detailed way nutritionally involved. No
laboratory tests can rule out the diagnosis of FAS but growing research is directed
toward finding the underlying mechanisms that contribute to fetal alcohol damage.
Scientists also are searching for genetic and biochemical characteristics associated with
the susceptibility to FAS. 
Human gestation is divided into two major periods: the embryonic period (up to 8 weeks)
and the fetal period (from 8 weeks to delivery). It's during the embryonic period that
various drugs are introduced directly into the maternal bloodstream or administered
through the maternal diet. Chemical/Physical agents that produce these fetal
malformations are called teratogens. Most teratogens show selectivity towards certain
organs, based on the timing of the embryo to the teratogen, the dosage taken, and the
sensitivity of the dividing cells. Organs and limbs of the developing embryo are formed
from collections of specialized cells. Exposure of an embryo to a teratogen during this
period may have devastating effect on the formation of that organ. (Michaelis and
Michaelis, p. 17) 
The primary metabolic product of alcohol is acetaldehyde which could also produce some
damaging effects. The reasons that this is looked at, but not as directly as is alcohol,
is because of the following reasons; Alcohol is distributed rapidly and nearly equally in
maternal and fetal tissues, Alcohol applied directly onto embryos in vitro conditions in
which no acetaldehyde is formed causes growth retardation. Because of this, these two
mentioned factors are in effect causes indirectly, if not adversely directly, to the
formation of the defects that are causes in the children of FAS. 
The nutritional aspect of FAS is not as simple. Normal growth and development during this
priming period requires the transfer of a continuous supply of amino acids and glucose
from mother to fetus. Several studies have shown that with the human placental tissue
alcohol directly obstructs the transport of both these substances. These are two
essential substances that, through research with rat embryos, have proven that the
depravity of such causes malformations of fetal tissue's energy sources. The materials
needed for cell proliferation, growth, and differentiation are also affected in this. The
supplemental glucose thus becomes only minimally effective because of the lack of
diminution of fetal growth retardation. (Michaelis and Michaelis, p. 21)
Included within the nutritional deficiencies that occur are the loss of vitamins B6 and
A. There is noted decrease in the transfer of B6 from an alcoholic mother to her fetus
through the placenta. This vitamin is especially important in the development of the
fetus because it functions as protein metabolism. There exists also a possible defect in
the metabolism of folic acid. The lack of which during the gestation period produces
malformations in the fetus. 
The last vitamin deficiency that I will note revolves around the receiving of vitamin A
from the alcoholic mother to the fetus via the placenta. There is no sufficient evidence
to support that there is actually a vitamin A deficiency, but it appears that the vitamin
accumulates in the liver of the alcohol-exposed fetus. This suggests that the vitamin is
not being metabolized normally. Since this vitamin is supposed to normally produce
retinoic acid, which is significant to development, it is a very vital ingredient in the
nutritionally diet of the mother. Retinoic acid functions as a chemical agent of the
activation of DNA; The lessening of this particular vitamin is said what may be
responsible for the delays and malformations seen in FAS. (Michaelis and Michaelis, p.
22)
The release and production of hormonal factors are needed to be supplied to the fetus
through the mother for normal development and this is yet another fact that is tampered
within the mother who drinks throughout her pregnancy. The production and release of
hormones from both the maternal and fetal glands and from the placenta influence the
formation and development of tissues as diverse as the brain and the palate. In
experimental animals exposed in the uterus to alcohol, there is a decrease in blood and
brain concentration of the corticosteroid hormones. the deficiency in said hormone leads
to the failure in the response of a newborn to stress. Thyroid hormonal deficiencies are
also have a harmful effect on the development of some tissues, especially the brain. In
the cerebellum, a part of the brain controlling posture and balance, there is a change in
the maturation and migration of nerve cells to their respective locations that is caused
by the deficiencies linked to the thyroid hormone. (Michaelis and Michaelis, P. 19) 
Prostaglandins are local tissue chemicals derived from fatty substances. There is a
marked increase in the activity of these chemicals during the exposure that the fetus has
to alcohol. These chemicals have very powerful affects on the blood vessels of the
uterus, placenta, and the fetus. Their overproduction may be responsible for the lack of
oxygen brought about by prostaglandin-induced constriction of the blood vessels. This
lack of oxygen functions as a trigger for the cells in different tissues. This in turn
leads to the aggravation of the preexisting hypoxia and could lead to tissue damage and
growth retardation. The increased production and release of the substances that are
produced by the prostaglandin and its developmental hypoxia can diminish blood
circulation to tissues and set the stage for the cessation or delay in cell
proliferation, growth, and migration. (Michaelis and Michaelis, p. 16)
There are many things that are factors in the growth and continual deformation in the
babies born with FAS but there can be many or one simple thing that can also avoid the
fetus to be affected by the exposure to alcohol. There continues to be ongoing research
on the nutritional, hormonal, and cellular events regulating fetal development to help
guide early interventions in children with FAS. There will always exist a continual risk
because of the lack of education in mothers-to-be.
The one thing most importantly stressed is that mother who knows or even thinks that she
is pregnant should not drink anything that is made of alcohol. The educating of these
mothers to the harm that they can cause themselves and their unborn children is what we
need to do. They should know that with the imbalance of their meals and alcohol
consumption that their children are suffering and cannot at times be given that chance to
live and survive in society as normal children should. Because of the lack of education
that they have they do not understand that what they do to themselves is also what they
do to their children.
Bibliography
Works Cited
1. Aase, Jon M. Clinical Recognition of FAS: difficulties of detection and diagnosis.
Alcohol Health and Research World, Wntr 1994. v18. n1, p.5-10
2. Michaelis, Elias and Michaelis, Mary L. Cellular and Molecular Bases of Alcohol's
Terato
genic Effects. Alcohol Health And Research World, Wntr 1994. v18.n1.p.17-22
3. Seachrist, Lisa. Birth Defects Too Often Blamed On Alcohol. Science News, Nov 1995.
v148. n20, p.314
4. Prenatal Alcohol Exposure and Psychomotor Development. American Family Physician, 
June 1996. v53.n8, p. 26-40