Alcohol & Pregnancy

Alcohol and Pregnancy – Fetal Alcohol Spectrum Disorders

Fetal Alcohol Spectrum Disorders (FASD) is an umbrella term for a range of disabilities resulting from prenatal alcohol exposure.

Australian Guidelines to Reduce Risks from Drinking Alcohol (National Health and Medical Research Council 2009)

Fetal Alcohol Spectrum Disorders (FASD) is an umbrella term for a range of disabilities resulting from prenatal alcohol exposure.

Guideline 4: Pregnancy and Breastfeeding

Maternal alcohol consumption can harm the developing foetus or breastfeeding baby.

  1. For women who are pregnant or planning a pregnancy, not drinking is the safest option.
  2. For women who are breastfeeding, not drinking is the safest option.
Gaps in FASD research and practice – we need to:
  • Raise awareness that not drinking alcohol during pregnancy or when planning pregnancy is the safest option. This should start with a concerted campaign to make sure that all GPs are advising women who are pregnant or of childbearing age about the risks of drinking alcohol during pregnancy.
  • Ensure women receive health education from an early age concerning alcohol use in general and are additionally made aware of the risk alcohol poses to unborn children when alcohol is consumed during pregnancy.
  • Further professional development in risk screening, diagnosis and reporting on FASD.
  • Improve supports for girls and women who misuse alcohol.
  • Improve information and resources available to parents and carers (including foster carers).
  • Improve referral pathways for women deemed "at-risk" of giving birth to a child with a FASD, including women suffering with alcohol addiction and victims of abuse.
  • Develop a model of care for service delivery. The model of care published in 2010 by the Western Australian Department of Health provides a good example of a prevention strategy that targets at-risk groups and women of childbearing age through risk screening during pregnancy and at birth; diagnosis; referral pathways; improved health surveillance; and health care for children within the child protection system.
Background:
  • FASD are preventable, but incurable, and require lifetime care and support.
  • FASD are a leading cause of preventable, non-genetic, birth defects and intellectual disability in Australia.
  • Whilst FASD is the leading cause of non-genetic intellectually disability, another major issue of concern is that the majority (75% - 80%) of people living with a FASD actually have a normal IQ but struggle with everyday living skills, making accessing developmental disability services very difficult.
  • Fetal Alcohol Syndrome (FAS) is often considered to be the most serious of the disorders within the spectrum. A person living with FAS will have a brain injury, impaired growth, neurological deficits and facial dysmorphology.
  • The difficulties experienced by people with a FASD can include:
    • Difficulty with mathematical concepts, time and handling money;
    • Thinking things through and learning from experience;
    • Understanding consequences of their actions or "cause and effect";
    • Difficulty with social skills;
    • Difficulty storing and retrieving information, including following instructions; and
    • Impulsivity and distractibility.
    • Without diagnosis and appropriate intervention, people affected by a FASD may develop secondary disabilities which can manifest over time, such as:
      - Mental health problems;
      - Contact with the criminal justice system;
      - Incomplete education (suspension, expulsion or truancy);
      - Inappropriate sexual behaviour;
      - Problems with parenting;
      - Unemployment and homelessness and Alcohol and other drug misuse.
References

1 Streissguth, A.P., Barr, H.M., Kogan, J. & Bookstein, F. L., (1996). "Understanding the Occurrence of Secondary Disabilities in Clients with Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE)," Final Report to the Centers for Disease Control and Prevention (CDC), Seattle: University of Washington, Fetal Alcohol & Drug Unit, Tech. Rep. No. 96-06.

2 National Organisation for Fetal Alcohol Syndrome and Related Disorders website: http://www.nofasard.org/

3 Streissguth A. (1997). Fetal Alcohol Syndrome – A Guide for Families and Communities, University of Washington Fetal Alcohol and Drug Unit Seattle, Maryland: Paul H Brookes Publishing Co.

4 Elizabeth Peadon, Emily Fremantle, Carol Bower, Elizabeth Elliott, 'International Survey of Diagnostic Services for Children with Fetal Alcohol Spectrum Disorders', BMC Pediatrics 2008, 8:12.