Substance Exposure - pg. 4


Alcohol is the only substance of abuse that is well associated with physical malformations as well as the neurodevelopmental defects. The classic triad of fetal alcohol syndrome (FAS) consists of growth retardation, physical anomalies (with a characteristic face) and central nervous system dysfunction. Many mothers will reduce their drinking after learning of their pregnancy. This has led to what has been described as the fetal alcohol effect, which represents a milder dose-dependent version of the entire syndrome. At this time, there is no known safe level of alcohol use during pregnancy that will prevent either condition. The most severe aspects of Fetal Alcohol Syndrome are associated with first-trimester use of alcohol, especially in those women with a poor diet.

Women who drink heavily during their pregnancy are also at risk of spontaneous abortions and premature placental separation. Alcohol-exposed infants may develop mental retardation, one of the hallmarks of FAS. There is an apparent dose-dependent relationship, and FAS now accounts for approximately 33% of all mental retardation. Milder cognitive effects include prolonged language delays and sleep dysfunction.

Newborn children exposed to alcohol can go through withdrawal once they have been delivered. Signs of alcohol withdrawal may include hyperactivity, crying, irritability, poor suck, tremors, seizures, and poor sleeping pattern. Signs usually appear at birth and may continue up to 18 months.

The victims of Fetal Alcohol Syndrome suffer all of the following impairments:

  • Growth retardation
  • Characteristic facial features, such as:
    • Small eyes with drooping upper lids
    • Short, upturned nose
    • Flattened cheeks
    • Small jaw
    • Thin upper lip
    • Flattened philtrum (the groove in the middle of the upper lip)
  • Central nervous system problems, including:
    • Mental retardation
    • Hyperactivity
    • Delayed development of gross motor skills such as rolling over, sitting up, crawling, and walking
    • Delayed development of fine motor skills such as grasping objects with the thumb and index finger, and transferring objects from one hand to the other
    • Impaired language development
    • Memory problems, poor judgment, distractibility, impulsiveness
    • Problems with learning
    • Seizures

They may also have a visibly smaller skull size and develop hearing disorders.

Fetal Alcohol Syndrome or the milder Fetal Alcohol Effects are permanent. Children will not outgrow the symptoms and will have to try to cope with the results their entire lives. Their future will include some or all of the following conditions.

  • Mental health problems such as attention deficit disorder, conduct disorder, depression, and psychotic episodes.
  • Problems in school, including higher rates of suspension and expulsion due to difficulty getting along with others, disobedience, and truancy.
  • Trouble with the law. Those born with FAS may have problems controlling anger and frustration, and problems understanding the motives of others. This may lead to violent behavior. As a result, teenagers and adults with FAS are more likely to be involved with the criminal justice system than their peers. Also, those with FAS can be especially susceptible to persuasion and manipulation, which may lead to unwitting involvement in illegal activities.
  • Drug and alcohol abuse. More than one-third of those with FAS have problems which require inpatient treatment for drugs and/or alcohol abuse at some time in their lives.
  • Difficulty holding a job and living independently.

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