FASD Elephant (TM) #001: Definitions and Terminology

Today's episode covers the definiton of FASD and attempts to clear up the confusing terminology that has been used in the past.

Fetal Alcohol Spectrum Disorder (FASD) describes a continuum of permanent birth defects caused by maternal consumption of alcohol during pregnancy. Maternal alcohol crosses the placental barrier and can stunt fetal growth or weight, create distinctive facial stigmata, damage neurons and brain structures, and/or cause other physical anomalies. While prenatal alcohol exposure does not automatically result in FASD, the U.S. Surgeon General advises pregnant women to abstain from alcohol use due to the risk of FASD.

The main effect of FASD is permanent central nervous system damage, in which developing brain cells and structures have been capriciously garbled, malformed, or underdeveloped by prenatal alcohol exposure. The risk of brain damage exists during each trimester, since the fetal brain develops throughout the entire pregnancy. Fetal alcohol exposure is regarded by researchers as the leading known cause of mental retardation in the Western world. In the United States alone, it is estimated that every year up to 40,000 infants are born with some form of FASD. The lifetime medical and social costs of each child are estimated to be as high as US$800,000 across the lifespan.

The term Fetal Alcohol Spectrum Disorder is not in itself a clinical diagnosis but describes the full range of disabilities that may result from prenatal alcohol exposure. Currently, Fetal Alcohol Syndrome (FAS) is the only expression of prenatal alcohol exposure that is defined by the International Statistical Classification of Diseases and Related Health Problems and assigned ICD-9 and ICD-10 diagnoses.

There are a number of other subtypes based on partial expressions of FAS, including Partial Fetal Alcohol Syndrome (PFAS), Alcohol-Related Neurodevelopmental Disorder (ARND), Alcohol-Related Birth Defects (ARBD), and Fetal Alcohol Effect (FAE). The latter two terms (ARBD and FAE) are not in general use today due to definitional vagueness.

There are four components to an FASD evaluation and diagnosis:

1. Growth deficiency (low height and/or weight, at birth or any point in lifetime)
2. FAS facial features (small eyes, smooth philtrum [groove between the nose and upper lip], flattened upper lip)
3. Central nervous system damage (there will be at least a couple podcasts just on this topic)
4. Prenatal alcohol exposure (drinking while pregnant)

Diagnostics will be covered in the next podcast.

Feedback or comments may be sent to: Michael__at__FASDElephant__dot__com.