Fetal Alcohol Syndrome (FAS) Among Pregnant Women

Introduction

Fetal Alcohol Syndrome (FAS) is a severe disease that has dangerous affects on the fetus and on a born child. Moreover, the abnormal features of this harmful syndrome accompany a man throughout the life span. The biological grounds of the disease are imposed in the alcoholic impacts going on in the organism of mother. It is no surprise that such an alcoholic reaction with harmful effects does not omit the fetus. The reported findings show that alcohol is the teratogen commonly appeared among humans¹ {47/2m}. However, scientists think that it can be solely prevented, for there is no cure to be used against the disaese² {235/2m}. In this respect this study is evaluated as a description and analysis of FAS’s harmful effect on both mother and a child. Furthermore, the paper encloses the harms on different levels: biological, biochemical, physiological, social, and even economical. It means that the whole concept of the problem runs the gamut of the organism’s reaction on alcohol during the period of pregnancy.

Thus, teratogenic impacts of alcohol should be stated as key factors for the emergence of FAS. It corresponds to the idea that several supporting affects can reason FAS. The question is about the cross-related epidemiological diseases despite FAS, such as: alcohol-related birth defects (ARBD) and alcohol-related neurodevelopmental disorder (ARND)³ {1/2t}. Hence, based on the previous and current studies, the research is implemented in terms of a deep estimation of FAS going on with supposed genetically-related and physiologically impulse diseases and consequences on a child.

Methodology

The methodology used in this study is correlated in order to distill the main approaches and principles for working out the main problem. In this respect a brief descriptive analysis of the disease itself is supported by peer-reviewed researches on FAS made in the US and overseas. Thus, generally accepted and unique features on the main issue are designated in terms of several questions that give a reason of FAS, namely:

• Why alcohol is so dangerous for infants and which trimester of pregnancy is the most hazardous?
• What are the factors maximizing the risk of FAS among pregnant women?
• Is there any amount of alcohol being of no harm to fetus?
• What are the cure and stages of pregnancy on which it is better to use it?
• Are there any preventive therapies?

The variety of defects to a fetus is singled out so that to characterize the best method to be implemented in the study⁴ {514/3b}. So, the most applicable approaches to evaluate the extent of occurrences of FAS, ARBD, and ARND are as follows: passive systems, clinic-based studies, and active case ascertainment approaches⁵ {159/4m}. All in all, the research is done in accordance with the current medical practice. The methodology is concerned with reviewing studies that focus on the peculiarities of FAS as well as on its general survey.

Results

FAS, as has been aforementioned, is the result of alcohol consumption of a would-be mother. Logically, everything that mother consumes goes to the fetus as well. This direct connection of an organism of a pregnant woman and a fetus inside is apparent. It goes without saying that there is a scope of outcomes concerned with alcohol consumption. These are: spontaneous abortion, growth retardation, facial abnormalities⁶ {171/1m}. A pregnant woman does not harm herself as worse, as she makes tragedy for a new-born child. One of the reported studies claims that alcohol injures the placenta and penetrates negatively into the fetal development⁷ {129/7m}. FAS is considered with women who are alcoholics or those who drank too much previously. It is also a problem that can be inflicted during the first trimester of pregnancy, when it is not well-known either a woman pregnant or not. What is more, the last studies show that the safe to a fetus amount of alcohol is not already identified⁸ {412/1t}.

Claire D. Coles provides points on FAS exposure delineated by attention deficit hyperactivity disorder (ADHD). The researcher outlines that this alcohol-related symptom of FAS can rely on neuroconitive tests and clinical observation of children⁹ {199/2t}. This assumption shows that the roots of the disease are concerned with the prenatal alcohol consumption. This is why the brain formation retards and perceives some physiological and genetic deformations, especially in the first trimester¹⁰ {545/3m}. Scholars (pediatrician, gynaecologists, maieutologist, and therapists on the whole) should pay more attention to special behavior of women to prevent FAS and its precursors as well.

Since FAS was first defined as a medical condition in 1973, the sociologists relate it to the increase of sexual activity among adolescents and their illiteracy in the issue of normal sexual relations¹¹ {7/5b}. Thus, the social-related implications are fully considered with the lack of educational and/or economic support. Further still, pregnant women exposing their children to FAS, place the society at risk of adolescent delnquency¹² {679/1t}. This application can be explained through the mental retardation which appears as a consequence of FAS. In turn adolescents being invalid to think and act as fast as their peers seek for appreciation by means of commission of crime.

After a child potentially with FAS has been born, there are no biological markers to identify the disorder¹³ {75/3m}. Thereupon, therapists and pediatricians need time to work out if a child is healthy mentally and in terms of looks. Such observation of FAS was supposed in earlier studies to have similar effects as the syndrome of Down¹⁴ {239/2m}. However, children with attributes of FAS are not totally damaged in terms of the mental activity. The main trouble occurs in their disability in thinking and speaking aspects. Their identification of the reality around gets retarded, unfortunately. This detrimental factor begets a scope of supporting drawbacks that are inherent to a child throughout the life span.

One of the studies on FAS showed that the discrepancies that are distinctly obvious among infants in the age of 12 months than after 6 months by birth¹⁵ {617/4b}. These data help to estimate the preliminary treatment that can be done to a FAS-exposed child. It means that, in fact, the nature of the disease under analysis is neurodevelopmental. Hence, it considers brain disorders and nervous system deviations on the whole.

The development of the fetus that is exposed to FAS can be aggravated by means of additional use of light and heavy drugs (cigarettes, marijuana, cocaine, etc.). Needless to say, that the abnormality of a child’s looks can get more ominous lines by birth. In this respect since 2004 the major medical association and centers in the US agreed to include a new term concerned with FAS, namely: fetal alcohol spectrum disorder (FASD)¹⁶ {446/3m}. It concerns the use of alcohol itself and parallel substance abuse and other and other biologically-grounded factors within pregnancy.

One of the researches states an idea that even only 60-70 grams of alcohol a day during each of three trimesters of pregnancy gives grounds to constitute the emergence of FAS in an infant¹⁷ {160/1t}. This idea is supported in some instances. However, there are various cases when pregnant women consume large amounts of alcohol and it does not affect a fetus, whereas women consuming little or moderate amount of alcohol harm a fetus seriously¹⁸ {62/2t}. In this respect “playing with FAS” can play a box to a child. At least, it should not be something like drawing casting lots. The problem goes beyond one’s beliefs or expectations. It touches upon the medical implementation and the use of abstinence from alcohol during the period of pregnancy.

Qualitative interviews with a number of adolescents with alcohol-related mental disorders in the US high schools showed that ability to commit a crime by an adolescent with FAS can be explained medically¹⁹ {36/1t}. In terms of anticipated trajectories implied, it became significant to state potential at-risk behaviors among children with FAS. In fact, socially, this disease provides impulse for spontaneous or unpredicted negative deed of a child that would be treated by him/her as normal. This evokes several assumptions on why there are so various and frequent cases of suicides among children and adults with FAS. It is known that adolescents with fetal alcohol spectrum disorders (FASD) in age from 5 to 29 are inclined to hurt themselves which was proved clinically²⁰ {34/1t}. This is why therapists are suggested to provide communication with FASD individuals in terms of accurate choice of words and tone during the whole process.

There are different studies on preventive initiatives that are included into the program of many training centers for women exposed to FAS. In this respect to prevent harmful outcomes of FASDs experts recommend pregnant women making an intentional appointment with a set of doctors: pediatrician, psychologist, social worker, nurse, speech therapist, and physical or occupational therapist²¹ {365/3m}. Pre-natal therapies are concerned being the most effective anti-FAS methods²² {160/4b}. Thus, FASDs can occur easily unless a woman decreases or stops drinking at all. This is outlined in terms of different studies. The reported ones state that the characteristics of children exposed prenatally to alcohol are quite consistent with how the full syndrome of FAS is defined today²³ {103/2t}. Thus, a woman planning to have a child should think primordially of a health way of life during an ostensibly long period of time. Moreover, one can infer that a woman drinking too much prenatally cannot prevent a child from at least FASD when pregnant. This idea goes without saying. Hence, women are lack of appropriate education in this case.

Students with FAS differ from ones with FASD, because, first of all, the first one is a clinical disorder and the latter is not²⁴ {1/3t}. It does not mean that any of two has more or less harmful effects on facial looks and mental abilities. However, the probabilities of static encephalopathy and facial deformities along with severe neurobehavioral impairments cannot but omitted in both FAS and FASD students²⁵ {6/5m}. All in all, the scope of such diseases can be expanded by retardation of recognition, slowness in realizing reality and reacting on different events. Moreover, children exposed to FASD have been found to be deficient in verbal learning²⁶ {502/5b}. It gives a reason of why everything related to brain activity of an individual should not be impacted negatively from inside, meaning alcohol consumption during the pregnancy. Moreover, the quality of sperm during ejaculation of a constantly drinking father can influence harmfully on a child. The study reported by Viljoen et al. and concerned with FAS problem in the South Africa showed off that children with FAS had father who consumed 84.6 drinks per month, compared with 47.5 consumed by mother both prenatally and during pregnancy²⁷ {595/2t}.

Disinhibition theory alcohol is likely to increase the aggression among people who consume it and expose to it their generation²⁸ {54/5b}. It means that the behavioral impairments can be easily inflicted chemically through alcohol in blood of a mother to a child. Moreover, neuroanatomical studies claim that alcohol forces on the molecular structures within brain and specific tissues during gestational development of a fetus²⁹ {174/1t}. It means that from the biochemical point of view alcohol is an aggressive component poisoning nervous system and brain, particularly, first of all. In this case one should take a look at the peculiarities of families in terms of different factors (stratificational, economical, social, etc.). Here comes a question of whether alcoholism can be delivered genetically from parents to a child. This assumption gets approvals, for paternal heavy consumption of alcohol can lead to cognitive and biochemical disturbances in a child³⁰ {37/3t}.

Continuing the problem of teratogenic influences of alcohol on brain and behavior, it is vital to admit that despite total affection of brain, hippocampal area responsible for storing new memories becomes damaged seriously³¹ {187/2t}. Thus, the neurological and neurosocial characteristics of children and adults exposed to FAS or FASD need more attention on the part of therapists. It distills an idea following the prescription that neurons start decreasing or mutating if being affected by alcohol consumption intentionally (in case with parents) and unintentionally (in case with children).

One of the biomarkers to detect alcohol in pregnant women is by testing qualitatively in terms of metabolites of alcohol and probes of blood, urine, skin, cord blood, or breath³² {211/1t}. When all data are gathered, it is about time to diagnose potential threats to a fetus and a child on the whole. Moreover, the studies reported by Earnest et al. indicate that alcohol impacts internal circadian clock function by means of loss of communication between neurons inflicted by loss of cells³³ {137/1t}. Such an idea erects an assumption that cellular structure suffers due to alcohol intrusion and is being destructed on molecular level step by step. In this respect the most harmful is a binge drinking that adds detrimental impulses inside the brain structure³⁴ {171/1t}. This becomes clear when talking about loss of coordination among drunken people. It is obvious that the brain functions badly, thus its structure has got through partial destruction of cells.

Alcohol intake serves as a signal to the internal destruction of the whole nervous system. This is why to prevent women at risk of alcohol consumption from FAS and FASD, practitioners recommend counseling into gynecologic and obstetric care³⁵ {219/1t}. It means that most of the controls can abstain from drinking if they are constantly motivated not to do it for the sake of the future child. However, testing cocaine-exposed infants in growth does not differ from alcohol-exposed children³⁶ {44/4m}. This fact observed in the study outrages, as it becomes clear that there is no significant difference between consuming alcohol or heavy drugs. It influences fetus similarly.

The exposure to FAS can affect the well-being of the society. Thus, it is better to search for the reason among adolescent individuals, for risky sexual relationships often become a start for FAS. The studies reported by Miller et al. outline that 15% of FAS births among 4 million tested cases are to mothers under age 21³⁷ {521/1t}. Furthermore, $75 million and $9.7 billion per year are estimated to be the US government’s societal costs for solely 1% of live-born FAS infants³⁸ {38/2t}. Low economic status of parents and a mother, particularly, has been suggested to be a reason for FAS emergence during pregnancy³⁹ {773/5b}.

The implications on behavior peculiarities of children with FAS and FAE (fetal alcohol effects) are stated in terms of Fetal Alcohol Behavior Scale (FABS)⁴⁰ {55/3m}. To say more, the factors affecting children’s behavior are considered usually with misunderstanding of their problems from outside (on the part of peers, adults, teachers, parents) as well as with inner pressure to react aggressively. According to Dunn’s conceptual model there is a hypothesis that a continuum of interaction exists between neurological processing of sensory input and behavioral responses⁴¹ {265/2t}. This assumption was primordially proved in terms of trickledown effect (abnormalities of the bones, heart, and genitourinary tract) caused by FAS⁴² {96/1t}. Such an evaluation of disorders happened to FAS and FASD-exposed children. Genomic, transcriptomic, and proteomic analyses in biology can help in identifying the essence and extent of alcoholic intoxication on a fetus⁴³ {76/3m}. Hence, an observer should pay special attention to the neurobiological direction of alcohol intoxication as complemented the risk of FAS emergence.

Non-specific disruption of neuronal lipid bilayers caused by ethanol is apparent to the chemical explanation of the harmful effect of alcohol abuse per se⁴⁴ {263/4m}. In its pure state ethanol is really dangerous for an organism. One of the problems that appear among FAS children, despite the aforementioned, is ocular disorders and affections of cataract⁴⁵ {397/3m}. It provides a construct to hypothesize that the whole organism is exposed to disorders by means of alcohol consumption. Its severest form of negative influence can be achieved to a fragile forming of fetus in which genetic and physiological information comes from the organism of a woman bearing it.

Importantly, another significant affection through alcohol abuse outlines those alcohol-related children and those with FAS to have a problem with integrating visual information with coordinated movements⁴⁶ {35/3m}. Comparing it the above stated information, it is no surprise that having ocular affection FAS-exposed children are hard to recognize visual information. In addition, children with FAS and ARND need more efficient interventions to reduce the extent or implementation of cognitive and behavioral impairments⁴⁷ {155/3m}. All in all, the research on FAS and other alcohol-related disorders and diseases runs the gamut of reasons wherein consumption of alcohol is the main factor.

Due to respiratory activity assessed through cellular viability, it is known today that if a woman drank constantly prenatally it can fall into alcohol dependency during pregnancy⁴⁸ {226/5m}. Thus, it is one more challenge to be faced by the medical communities and officials responsible for funding sources to reduce the problem of FAS. To say more, the dependence on alcohol is among the strongest like the dependence on smoking. Hence, would-be mothers or parents at large should keep a strict eye on their future today not to lag behind perspectives on health tomorrow. In the course of chemical analysis of the reaction happened in the organism jus after the alcohol consumption ethanol provides a range of metabolic reactions wherein acetaldehyde is a product of alcohol oxidation that is concerned with a bad smell in the mouth⁴⁹ {246/1t}. Thus, the research somewhat comprehensively evaluates the dark sides of FAS imposed through alcohol consumption. Moreover, the empirical studies show that maternal attachment to a fetus is concerned with two main contributions: psychoanalytic (mother) and ecological (environement)⁵⁰ {49/2t}.

To sum up, FAS is supposed to be inflicted to a fetus through alcohol consumption of a mother during her pregnancy. In this respect it does not matter whether it was during pregnancy or prenatally. All periods are considered to be at risk of FAS and FASD (along with ARND and ARDD) affection on a fetus and a child with long implications in the span of life. In this respect, pediatricians, gynecologists and, say, therapists should work out the methodology to treat and, perhaps, prevent the FAS and its symptoms prenatally and on the first through the third trimester of pregnancy. The fact that FAS is not cured at all does not mean hereby that no interventions should be applied to a mother and a child, particularly.

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