Problem: Fetal Alcohol Syndrome (FAS) is a pattern of mental and physical 
    defects which develops in some unborn babies when the mother drinks too much 
    alcohol during pregnancy. A baby born with FAS may be seriously handicapped 
    and require a lifetime of special care. Some babies with alcohol-related 
    birth defects, including smaller body size, lower birth weight, and other 
    impairments, do not have all of the classic FAS symptoms. These symptoms are 
    sometimes referred to as Fetal Alcohol Effects (FAE). Researchers do not all 
    agree on the precise distinctions between FAS and FAE cases. 
    Cause of the Problem: Alcohol in a pregnant woman's bloodstream circulates 
    to the fetus by crossing the placenta. There, the alcohol interferes with 
    the ability of the fetus to receive sufficient oxygen and nourishment for 
    normal cell development in the brain and other body organs. 
    Possible FAS Symptoms:
    
    Growth deficiencies: small body size and weight, slower than normal 
        development and failure to catch up. 
        Skeletal deformities: deformed ribs and sternum; curved spine; hip 
        dislocations; bent, fused, webbed, or missing fingers or toes; limited 
        movement of joints; small head. 
        Facial abnormalities: small eye openings; skin webbing between eyes and 
        base of nose; drooping eyelids; nearsightedness; failure of eyes to move 
        in same direction; short upturned nose; sunken nasal bridge; flat or 
        absent groove between nose and upper lip; thin upper lip; opening in 
        roof of mouth; small jaw; low-set or poorly formed ears. 
        Organ deformities: heart defects; heart murmurs; genital malformations; 
        kidney and urinary defects. 
        Central nervous system handicaps: small brain; faulty arrangement of 
        brain cells and connective tissue; mental retardation -- usually mild to 
        moderate but occasionally severe; learning disabilities; short attention 
        span; irritability in infancy; hyperactivity in childhood; poor body, 
        hand, and finger coordination. 
        Size of the Problem: The incidence (number of new cases each year) of FAS 
    and FAE are significantly under-reported. Therefore, projections are usually 
    based on estimates of their occurrence per 1,000 live births. Recent studies 
    by researchers Ernest Abel and Robert Sokol suggest that the incidence of 
    FAS can conservatively be estimated at 0.33 cases per 1,000 live births. 
    Missouri recorded 78,468 live births in 1991 and 76,005 in 1992, which would 
    yield at least 25 new cases of FAS per year. The incidence of FAE is 
    generally regarded to be several times the magnitude of FAS cases, perhaps 
    in the hundreds in Missouri. 
    Recommendations: Studies suggest that drinking a large amount of alcohol at 
    any one time may be more dangerous to the fetus than drinking small amounts 
    more frequently. The fetus is most vulnerable to various types of injuries 
    depending on the stage of development in which alcohol is encountered. A 
    safe amount of drinking during pregnancy has not been determined, and all 
    major authorities agree that women should not drink at all during pregnancy. 
    Unfortunately, women sometimes wait until a pregnancy is confirmed before 
    they stop drinking. By then, the embryo/fetus has gone through several weeks 
    of critical development, a period during which exposure to alcohol can be 
    very damaging. Therefore, the Division of Alcohol and Drug Abuse urges women 
    who are pregnant or anticipating a pregnancy to abstain from drinking 
    alcoholic beverages. 
    Sources: National Institute on Alcohol Abuse and Alcoholism
    Missouri Department of Health, State Center for Health Statistics
    Abel, Ernest; and Sokol, Robert. A revised conservative estimate of the 
    incidence of FAS and its economic impact. Alcoholism: Clinical and 
    Experimental Research 15(3), 1992.
    Food and Drug Administration
    National Council on Alcoholism
    United States Surgeon General
    United States Department of Health and Human Services
    
 

MISSOURI DEPARTMENT OF MENTAL HEALTH
Division of Alcohol and Drug Abuse
1706 East Elm; P.O. Box 687
Jefferson City, Missouri 65102

RSmith:02-15-94 
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