Fetal Alcohol Syndrome

  • What is FAS?
  • How common is FAS?
  • What are the characteristics of children with FAS?
  • How can we prevent FAS?

What is FAS?

Prenatal exposure to alcohol can cause a spectrum of disorders. One of the most severe effects of drinking during pregnancy is fetal alcohol syndrome (FAS). FAS is one of the leading known preventable causes of mental retardation and birth defects. If a woman drinks alcohol during her pregnancy, her baby can be born with FAS, a lifelong, physically and mentally disabling condition. FAS is characterized by (1) abnormal facial features, (2) growth deficiencies, and (3) central nervous system (CNS) problems. People with FAS may have problems with learning, memory, attention span, communication, vision, and/or hearing. These problems often lead to difficulties in school and problems getting along with others. FAS is a permanent condition. It affects every aspect of an individual's life and the lives of his or her family. However, FAS is 100% preventable - if a woman does not drink alcohol while she is pregnant.

Many terms have been used to describe children who have some, but not all, of the clinical signs of FAS. Three terms are fetal alcohol effects (FAE), alcohol-related neurodevelopmental disorder (ARND), and alcohol-related birth defects (ARBD). FAE has been used to describe children who have all of the diagnostic features of FAS, but at mild or less severe levels. In 1996, the Institute of Medicine (IOM) replaced FAE with the terms ARND and ARBD. Those with ARND may have functional or mental problems linked to prenatal alcohol exposure. These include behavioral and/or cognitive abnormalities. Examples are learning difficulties, poor school performance, and poor impulse control. They may have difficulties with mathematical skills, memory, attention, and/or judgment. Those with ARBD may have problems with the heart, kidneys, bones, and/or hearing.

How common is FAS?

The reported rates of FAS vary widely. These different rates depend on the population studied and the surveillance methods used. CDC studies show FAS rates ranging from 0.2 to 1.5 per 1,000 live births in different areas of the United States. Other prenatal alcohol-related conditions, such as alcohol-related neurodevelopmental disorder (ARND) and alcohol-related birth defects (ARBD) are believed to occur approximately three times as often as FAS.

What are the characteristics of children with FAS?

FAS is the severe end of a spectrum of effects that can occur when a woman drinks during pregnancy. Fetal death is the most extreme outcome. FAS is a disorder characterized by abnormal facial features, and growth and central nervous system (CNS) problems. If a pregnant woman drinks alcohol but her child does not have all of the symptoms of FAS, it is possible that her child has an alcohol-related neurodevelopmental disorder (ARND). Children with ARND do not have full FAS, but may demonstrate learning and behavioral problems caused by prenatal exposure to alcohol. If you think a child may have FAS or other alcohol-related effects, contact a doctor. Children with FAS or ARND may have the following characteristics or exhibit the following behaviors:

  • small for gestational age or small in stature in relation to peers;
  • facial abnormalities such as small eye openings;
  • poor coordination;
  • hyperactive behavior;
  • learning disabilities;
  • developmental disabilities (e.g., speech and language delays);
  • mental retardation or low IQ;
  • problems with daily living;
  • poor reasoning and judgment skills;
  • sleep and sucking disturbances in infancy.

Children with FAS are at risk for psychiatric problems, criminal behavior, unemployment, and incomplete education. These secondary conditions are problems that an individual is not born with, but might acquire as a result of FAS. These conditions can be very serious, yet there are protective factors that have been found to help individuals with these problems. For example, a child who is diagnosed early in life can be placed in appropriate educational classes and given access to social services that can help the child and his or her family. Children with FAS who receive special education are more likely to achieve their developmental and educational potential. In addition, children with FAS need a loving, nurturing, and stable home life in order to avoid disruptions, transient lifestyles, or harmful relationships. Children with FAS who live in abusive or unstable households or become involved in youth violence are much more likely to develop secondary conditions than children with FAS who have not had such negative experiences.

CDC is working to identify ways to help individuals with FAS and their families lessen or prevent secondary conditions. CDC is currently sponsoring (1) a five-site collaborative effort investigating effective strategies for intervening with children with FAS and/or alcohol-related neurodevelopmental disorder (ARND) and their families and (2) the development of educational curricula about FAS and ARND targeting parents, school staff, health and social service providers, law enforcement officials and medical and allied health students and professionals.

How can we prevent FAS?

FAS and other prenatal alcohol-related conditions are completely preventable - if a woman does not drink alcohol while she is pregnant or could become pregnant. If a woman is drinking during pregnancy, it is never too late for her to stop. The sooner a woman stops drinking, the better it will be for both her baby and herself. If a woman is not able to stop drinking, she should contact her physician, local Alcoholics Anonymous or local alcohol treatment center, if needed. The Substance Abuse and Mental Health Services Administration (SAMHSA) has a Substance Abuse Treatment Facility locator. This locator helps people find drug and alcohol treatment programs in their area. If a woman is sexually active and not using an effective form of birth control, she should not drink alcohol. She could be pregnant and not know it for several weeks or more.

Mothers are not the only ones who can prevent FAS. The father's role is also important in helping the woman abstain from drinking alcohol during pregnancy. He can encourage her abstinence from alcohol by avoiding social situations that involve drinking and by abstaining from alcohol himself. Significant others, family members, schools, health and social service organizations, and communities alike can help prevent FAS through education and intervention.

To reduce prenatal alcohol exposure, prevention efforts should target not only pregnant women who are currently drinking, but also women who could become pregnant, are drinking at high-risk levels, and are engaging in unprotected sex.

National Center on Birth Defects and Developmental Disabilities
Last Updated Wednesday, April 13, 2005