fetal alcohol spectrum disorders


Summary: An umbrella term used to describe a pattern of disabilities and abnormalities that result from fetal exposure to ETHANOL during pregnancy. It encompasses a phenotypic range that can vary greatly between individuals, but reliably includes one or more of the following: characteristic facial dysmorphism, FETAL GROWTH RETARDATION, central nervous system abnormalities, cognitive and/or behavioral dysfunction, BIRTH DEFECTS. The level of maternal alcohol consumption does not necessarily correlate directly with disease severity.

Top Publications

  1. Little B, Snell L, Rosenfeld C, Gilstrap L, Gant N. Failure to recognize fetal alcohol syndrome in newborn infants. Am J Dis Child. 1990;144:1142-6 pubmed
  2. Mattson S, Riley E, Gramling L, Delis D, Jones K. Heavy prenatal alcohol exposure with or without physical features of fetal alcohol syndrome leads to IQ deficits. J Pediatr. 1997;131:718-21 pubmed
    ..They also emphasize the need for conducting a thorough history of prenatal alcohol exposure in children with intellectual deficits. ..
  3. Johnson V, Swayze VW I, Sato Y, Andreasen N. Fetal alcohol syndrome: craniofacial and central nervous system manifestations. Am J Med Genet. 1996;61:329-39 pubmed
    ..The association of these anomalies becomes self-evident with recognition of the concept of the midline as a special developmental field, vulnerable to adverse factors during embryogenesis and fetal growth and development. ..
  4. Sulik K, Johnston M, Webb M. Fetal alcohol syndrome: embryogenesis in a mouse model. Science. 1981;214:936-8 pubmed
    ..Decreased development of the neural plate and its derivatives apparently accounts for the craniofacial malformations. The critical exposure period is equivalent to the third week in human pregnancy. ..
  5. Guerri C, Montoliu C, Renau Piqueras J. Involvement of free radical mechanism in the toxic effects of alcohol: implications for fetal alcohol syndrome. Adv Exp Med Biol. 1994;366:291-305 pubmed
  6. Ishak K, Zimmerman H, Ray M. Alcoholic liver disease: pathologic, pathogenetic and clinical aspects. Alcohol Clin Exp Res. 1991;15:45-66 pubmed
    ..Perhaps the most important facet of the hepatotoxicity of alcohol is its enhancement of the effects of a number of other hepatotoxic agents, among which acetaminophen is the prime example. ..
  7. Nogales F, Ojeda M, Jotty K, Murillo M, Carreras O. Maternal ethanol consumption reduces Se antioxidant function in placenta and liver of embryos and breastfeeding pups. Life Sci. 2017;190:1-6 pubmed publisher
    ..Therefore, Se supplementation therapy in dams could contribute as an interesting antioxidant that prevents fetal alcohol syndrome. ..
  8. Green C, Roane J, Hewitt A, Muhajarine N, Mushquash C, Sourander A, et al. Frequent behavioural challenges in children with fetal alcohol spectrum disorder: a needs-based assessment reported by caregivers and clinicians. J Popul Ther Clin Pharmacol. 2014;21:e405-20 pubmed
    ..These data will be used to inform the development of an intervention program that will provide a family-centered approach to training, education, and support for children with FASD and their families. ..
  9. Fox D, Pettygrove S, Cunniff C, O Leary L, Gilboa S, Bertrand J, et al. Fetal alcohol syndrome among children aged 7-9 years - Arizona, Colorado, and New York, 2010. MMWR Morb Mortal Wkly Rep. 2015;64:54-7 pubmed
    ..Addressing these factors through training of medical and allied health providers can lead to practice changes, ultimately increasing recognition and documentation of the characteristics of FAS. ..

More Information


  1. Baker R, Jerrells T. Recent developments in alcoholism:immunological aspects. Recent Dev Alcohol. 1993;11:249-71 pubmed
    ..In this review the effect of acute ethanol intoxication or chronic ethanol use on leukocyte and lymphocyte numbers, alteration of cellular function, and ability of the cells to arrive at the site of infection are addressed. ..
  2. Henderson G, Devi B, Perez A, Schenker S. In utero ethanol exposure elicits oxidative stress in the rat fetus. Alcohol Clin Exp Res. 1995;19:714-20 pubmed
    ..05). E decreased GSH levels in fetal brain by 19%, from 19.88 +/- 0.72 to 16.13 +/- 1.06 (nMol/mg protein) (p < 0.05). A 10% decrease in GSH was seen in fetal liver (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) ..
  3. Ewald S. T lymphocyte populations in fetal alcohol syndrome. Alcohol Clin Exp Res. 1989;13:485-9 pubmed
    ..Spleen T cell function, assessed by response to Concanavalin A (Con A), or Con A plus T cell growth factors, was somewhat depressed in ethanol-exposed 6-day pups. ..
  4. Johnson S, Knight R, Marmer D, Steele R. Immune deficiency in fetal alcohol syndrome. Pediatr Res. 1981;15:908-11 pubmed
    ..Impairment of immunity may explain an increased susceptibility to infection in FAS. ..
  5. Wolcott R, Jennings S, Chervenak R. In utero exposure to ethanol affects postnatal development of T- and B-lymphocytes, but not natural killer cells. Alcohol Clin Exp Res. 1995;19:170-6 pubmed
    ..These data show that prenatal exposure to ethanol causes a transient immunodeficiency in some, but not all compartments of the immune system. ..
  6. Camargo Moreno M, Mooney S, Middleton F. Heterogeneity of p53 dependent genomic responses following ethanol exposure in a developmental mouse model of fetal alcohol spectrum disorder. PLoS ONE. 2017;12:e0180873 pubmed publisher
    ..Thus, p53 may function in a way that underlies the intellectual and behavioral deficits observed in FASD. ..
  7. Lecuyer M, Laquerrière A, Bekri S, Lesueur C, Ramdani Y, Jégou S, et al. PLGF, a placental marker of fetal brain defects after in utero alcohol exposure. Acta Neuropathol Commun. 2017;5:44 pubmed publisher
    ..of fetal alcohol syndrome (FAS), and a challenge for clinicians is to make an early diagnosis of fetal alcohol spectrum disorders (FASD) to avoid lost opportunities for care...
  8. Burd L. Fetal alcohol spectrum disorder: complexity from comorbidity. Lancet. 2016;387:926-927 pubmed publisher
  9. Bonthius D, Bonthius N, Napper R, Astley S, Clarren S, West J. Purkinje cell deficits in nonhuman primates following weekly exposure to ethanol during gestation. Teratology. 1996;53:230-6 pubmed
    ..8%, relative to controls. Alcohol had no effect on the length of the Purkinje cell line. The findings suggest that alcohol-induced reduction in neuronal number may be an important factor underlying the CNS dysfunction in FAS. ..
  10. Fitzpatrick J, Latimer J, Ferreira M, Martiniuk A, Peadon E, Carter M, et al. Development of a reliable questionnaire to assist in the diagnosis of Fetal Alcohol Spectrum Disorders (FASD). BMC Pediatr. 2013;13:33 pubmed publisher
    A battery of clinical assessments was used in the Lililwan Project, Australia's first population-based Fetal Alcohol Spectrum Disorders (FASD) prevalence study, conducted in the remote Fitzroy Valley, Western Australia...
  11. Klecka M, Janas Kozik M, Jelonek I, Siwiec A, Rybakowski J. Validation of the Polish Version of the Washington 4-Digit Diagnostic Code for the Assessment of Fetal Alcohol Spectrum Disorders. Psychiatr Pol. 2017;51:335-347 pubmed publisher
    ..Due to the problems associated with the measurement of the palpebral fissure, it is necessary to verify the normal growth charts for the Polish population. ..
  12. Morton Ninomiya M. More than words: Using visual graphics for community-based health research. Can J Public Health. 2017;108:e91-e94 pubmed publisher
  13. Stoler J, Holmes L. Under-recognition of prenatal alcohol effects in infants of known alcohol abusing women. J Pediatr. 1999;135:430-6 pubmed
    ..Continued efforts at education regarding the importance of asking about prenatal alcohol exposure and the spectrum of fetal alcohol effects are needed for early diagnosis. ..
  14. Rivier C. Alcohol stimulates ACTH secretion in the rat: mechanisms of action and interactions with other stimuli. Alcohol Clin Exp Res. 1996;20:240-54 pubmed
    ..A better understanding of the mechanisms through which the drug alters their release thus may permit the development of therapies designed to alleviate some of the consequences of alcoholism. ..
  15. Hammer R, Scheibel A. Morphologic evidence for a delay of neuronal maturation in fetal alcohol exposure. Exp Neurol. 1981;74:587-96 pubmed
  16. Corrigan P, Lara J, Shah B, Mitchell K, Simmes D, Jones K. The Public Stigma of Birth Mothers of Children with Fetal Alcohol Spectrum Disorders. Alcohol Clin Exp Res. 2017;41:1166-1173 pubmed publisher
    Stigma affects not only the person with a stigmatizing condition such as fetal alcohol spectrum disorders (FASD), but also their family members...
  17. Cook J, Green C, Lilley C, Anderson S, Baldwin M, Chudley A, et al. Fetal alcohol spectrum disorder: a guideline for diagnosis across the lifespan. CMAJ. 2016;188:191-7 pubmed publisher
  18. Alati R. In Western Australia, 70% of mothers of babies with fetal alcohol syndrome did not have an alcohol-related diagnosis recorded during pregnancy. Evid Based Nurs. 2014;17:78 pubmed publisher
  19. O Connor M, Rotheram Borus M, Tomlinson M, Bill C, Leroux I, Stewart J. Screening for fetal alcohol spectrum disorders by nonmedical community workers. J Popul Ther Clin Pharmacol. 2014;21:e442-52 pubmed
    South Africa has the highest prevalence of Fetal Alcohol Spectrum Disorders (FASD) in the world yet many women have no access to clinic care or to physicians in their communities...
  20. Daily D, Ardinger H, Holmes G. Identification and evaluation of mental retardation. Am Fam Physician. 2000;61:1059-67, 1070 pubmed
    ..The family physician is encouraged to continue regular follow-up visits with the child to facilitate a smooth transition to adolescence and young adulthood. ..
  21. . Alcohol use and binge drinking among women of childbearing age--United States, 2006-2010. MMWR Morb Mortal Wkly Rep. 2012;61:534-8 pubmed
    ..Alcohol-exposed pregnancies (AEPs) can lead to fetal alcohol syndrome and other fetal alcohol spectrum disorders (FASDs), which result in neurodevelopmental deficits and lifelong disability...
  22. Ewald S, Walden S. Flow cytometric and histological analysis of mouse thymus in fetal alcohol syndrome. J Leukoc Biol. 1988;44:434-40 pubmed
    ..These results indicate that thymus immaturity is one of the accompanying features of fetal alcohol syndrome. ..
  23. Svanidze I, Museridze D, Didimova E, Sanikidze T, Gegenava L, Gvinadze N. [Disorders of neurogenesis of cortical and subcortical structures in rat brain limbic system during fetal alcohol syndrome formation]. Morfologiia. 2012;141:18-22 pubmed
    ..This resulted in the changes in the number of neurons in cortical and subcortical structures of rat brain limbic system and in fetal alcohol syndrome formation. ..
  24. Hansen M, Armstrong P, Bower C, Baynam G. Prevalence of microcephaly in an Australian population-based birth defects register, 1980-2015. Med J Aust. 2017;206:351-356 pubmed
    ..FASD is an important cause of microcephaly in the Aboriginal population. ..
  25. Burd L, Christensen T. Treatment of fetal alcohol spectrum disorders: are we ready yet?. J Clin Psychopharmacol. 2009;29:1-4 pubmed publisher
  26. Houle K, Abdi M, Clabough E. Acute ethanol exposure during late mouse neurodevelopment results in long-term deficits in memory retrieval, but not in social responsiveness. Brain Behav. 2017;7:e00636 pubmed publisher
    ..and may result in the emergence of a broad spectrum of neurobehavioral abnormalities termed fetal alcohol spectrum disorders (FASD). The effects of ethanol exposure during development are both time and dose dependent...
  27. Moscatello K, Biber K, Jennings S, Chervenak R, Wolcott R. Effects of in utero alcohol exposure on B cell development in neonatal spleen and bone marrow. Cell Immunol. 1999;191:124-30 pubmed
    ..Together, these data suggest that in utero exposure to ethanol can result in abnormalities in B cell development that may initiate at an early stage of B cell development. ..
  28. Jarmasz J, Basalah D, Chudley A, Del Bigio M. Human Brain Abnormalities Associated With Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorder. J Neuropathol Exp Neurol. 2017;76:813-833 pubmed publisher
    ..Prevention must be the main societal goal, however, a clear understanding of the neuropathology is necessary for provision of care to individuals already affected. ..
  29. Mello N, Mendelson J, Teoh S. Neuroendocrine consequences of alcohol abuse in women. Ann N Y Acad Sci. 1989;562:211-40 pubmed
    ..The implications of alcohol's effects on reproductive hormones for impairment of fetal growth and development are discussed. ..
  30. Davies D, Smith D. A Golgi study of mouse hippocampal CA1 pyramidal neurons following perinatal ethanol exposure. Neurosci Lett. 1981;26:49-54 pubmed
    ..Qualitative and quantitative evaluation of Golgi-impregnated cells revealed a marked reduction in the extent of basilar dendrites in ethanol-exposed animals which suggested a delay in neuronal development. ..
  31. Bearer C, Gould S, Emerson R, Kinnunen P, Cook C. Fetal alcohol syndrome and fatty acid ethyl esters. Pediatr Res. 1992;31:492-5 pubmed
    ..These results provide a basis for further research into the role of FAEE in the development of fetal alcohol syndrome. ..
  32. Gale T, White J, Welty T. Differences in detection of alcohol use in a prenatal population (on a Northern Plains Indian Reservation) using various methods of ascertainment. S D J Med. 1998;51:235-40 pubmed
    ..We also found that various interpretations of the screening questions by the patients highlighted the need to tailor the wording of individual questions to the particular patient population. ..
  33. Haynes K, Nulman I, Koren G. Fetal alcohol spectrum disorder and the neurobehavioural screening tool: evaluating the effect of maternal depression. J Popul Ther Clin Pharmacol. 2014;21:e387-94 pubmed
    ..Further studies are needed to examine the potential effects of other maternal psychopathologies on endorsement rates. ..
  34. Girault V, Gilard V, Marguet F, Lesueur C, Hauchecorne M, Ramdani Y, et al. Prenatal alcohol exposure impairs autophagy in neonatal brain cortical microvessels. Cell Death Dis. 2017;8:e2610 pubmed publisher
    ..Moreover, our results suggest that rapamycin represents a potential therapeutic strategy to reduce PAE-related brain developmental disorders. ..
  35. Laufer B, Diehl E, Singh S. Neurodevelopmental epigenetic etiologies: insights from studies on mouse models of fetal alcohol spectrum disorders. Epigenomics. 2013;5:465-8 pubmed publisher
  36. Donald K, Fernandez A, Claborn K, KUO C, Koen N, Zar H, et al. The developmental effects of HIV and alcohol: a comparison of gestational outcomes among babies from South African communities with high prevalence of HIV and alcohol use. AIDS Res Ther. 2017;14:28 pubmed publisher
    ..Interventions are needed to reduce alcohol consumption among pregnant mothers and to support healthy growth and psychosocial development of infants. ..
  37. Baber M, Koren G. Investigating the fetal and postnatal effects of paternal alcohol exposure in mouse offspring: a review. J Popul Ther Clin Pharmacol. 2015;22:e57-8 pubmed
  38. Lange S, Probst C, Gmel G, Rehm J, Burd L, Popova S. Global Prevalence of Fetal Alcohol Spectrum Disorder Among Children and Youth: A Systematic Review and Meta-analysis. JAMA Pediatr. 2017;171:948-956 pubmed publisher
    ..However, most countries do not have population-level prevalence data for FASD...
  39. Riley E, Mattson S, Sowell E, Jernigan T, Sobel D, Jones K. Abnormalities of the corpus callosum in children prenatally exposed to alcohol. Alcohol Clin Exp Res. 1995;19:1198-202 pubmed
    ..They verify callosal agenesis in children with FAS, which previously had only been noted in autopsy reports.(ABSTRACT TRUNCATED AT 250 WORDS) ..
  40. Muggli E, Matthews H, Penington A, Claes P, O Leary C, Forster D, et al. Association Between Prenatal Alcohol Exposure and Craniofacial Shape of Children at 12 Months of Age. JAMA Pediatr. 2017;171:771-780 pubmed publisher
    ..Although the clinical significance of these findings is yet to be determined, they support the conclusion that for women who are or may become pregnant, avoiding alcohol is the safest option. ..
  41. Breiner P, Nulman I, Koren G. Identifying the neurobehavioral phenotype of fetal alcohol spectrum disorder in young children. J Popul Ther Clin Pharmacol. 2013;20:e334-9 pubmed
    ..In this pilot study, the NST has shown very high sensitivity and specificity and can be used to identify children who are very likely to be diagnosed with FASD. ..
  42. . Committee opinion no. 496: At-risk drinking and alcohol dependence: obstetric and gynecologic implications. Obstet Gynecol. 2011;118:383-8 pubmed publisher
    ..Health care providers should advise women that low-level consumption of alcohol in early pregnancy is not an indication for pregnancy termination. ..
  43. Ewald S, Frost W. Effect of prenatal exposure to ethanol on development of the thymus. Thymus. 1987;9:211-5 pubmed
    ..The thymuses of fetal mice exposed prenatally to ethanol were reduced both in cell number and proliferative response to Concanavalin A plus a source of interleukin 2. ..
  44. Zhang P, Wang G, Lin Z, Wu Y, Zhang J, Liu M, et al. Alcohol exposure induces chick craniofacial bone defects by negatively affecting cranial neural crest development. Toxicol Lett. 2017;281:53-64 pubmed publisher
    ..In addition, ethanol affected the delamination, epithelial-mesenchymal transition (EMT) and cell migration of cranial NCCs, which may have contributed to the etiology of the craniofacial defects. ..
  45. Joenje H. Metabolism: alcohol, DNA and disease. Nature. 2011;475:45-6 pubmed publisher
  46. LaFrance M, McLachlan K, Nash K, Andrew G, Loock C, Oberlander T, et al. Evaluation of the neurobehavioral screening tool in children with fetal alcohol spectrum disorders (FASD). J Popul Ther Clin Pharmacol. 2014;21:e197-210 pubmed
    There is a growing need for validated tools to screen children at risk of fetal alcohol spectrum disorders (FASD)...
  47. Bakoyiannis I, Gkioka E, Pergialiotis V, Mastroleon I, Prodromidou A, Vlachos G, et al. Fetal alcohol spectrum disorders and cognitive functions of young children. Rev Neurosci. 2014;25:631-9 pubmed publisher
  48. Chartier K, Vaeth P, Caetano R. Focus on: ethnicity and the social and health harms from drinking. Alcohol Res. 2013;35:229-37 pubmed
    ..Studies also are needed to delineate the mechanisms that give rise to and sustain these disparities in order to inform prevention strategies. ..
  49. Ganthous G, Rossi N, Giacheti C. Oral narrative of individuals with Fetal Alcohol Spectrum Disorder. Codas. 2017;29:e20170012 pubmed publisher
    ..Future studies may explore whether the association between narrative performance and the 4-Digit Diagnostic Code items present predictive values in the narrative performance of individuals with FASD. ..
  50. Vall O, Salat Batlle J, Garcia Algar O. Alcohol consumption during pregnancy and adverse neurodevelopmental outcomes. J Epidemiol Community Health. 2015;69:927-9 pubmed publisher
  51. Dreosti I. Nutritional factors underlying the expression of the fetal alcohol syndrome. Ann N Y Acad Sci. 1993;678:193-204 pubmed
  52. Elliot D, Hickam D. Use of the T-ACE questions to detect risk-drinking. Am J Obstet Gynecol. 1990;163:684-5 pubmed
  53. Payne J, Watkins R, Jones H, Reibel T, Mutch R, Wilkins A, et al. Midwives' knowledge, attitudes and practice about alcohol exposure and the risk of fetal alcohol spectrum disorder. BMC Pregnancy Childbirth. 2014;14:377 pubmed publisher
    ..Policy should support midwives' practice to screen for alcohol consumption in pregnancy and offer brief intervention when indicated. ..