Fetal Alcohol Syndrome as a Serious Condition - Research Paper Example

? Fetal Alcohol Syndrome Cover Page Introduction Of all the preventable birth defects and developmental disorders, Fetal Alcohol Syndrome is the most common. Having a devastating impact on the children that must bear its burden for the rest of their lives, this disease ravages individuals and society alike. Gaining a better grasp on what this disorder is, how it works, and what it causes will empower the professional to better identify risk factors in patients, to have discussions about prevention, and to ultimately assist patients in making more healthy decisions for themselves and their families. Given the frequency of this disorder, it is one that all medical professionals should be familiar with. What is Fetal Alcohol Syndrome? Fetal Alcohol Syndrome—the number one preventable cause of birth defects and developmental disorders in the United States—was first given its name in 1973 (Warren, Hewitt, & Thomas, 2011). Though there had been many instances of women drinking during pregnancy, the symptoms caused in the fetus and child hadn’t been a focus of study. It occurs in .5 to 7.0 cases per 1,000 births in this country (Warren et al., 2011). Subcategories of the syndrome have also been identified to describe disorders of lesser severity. These include partial Fetal Alcohol Syndrome, Fetal Alcohol Effects, alcohol-related birth defects, alcohol-related neurodevelopmental disorder, and fetal alcohol spectrum disorders (Warren et al., 2011). “Partial Fetal Alcohol Syndrome” describes some of the same features as Fetal Alcohol Syndrome but does not require all of the same diagnostic criteria to be met (Warren et al., 2011). The term “Fetal Alcohol Effects” is used when symptoms of maternal exposure are present but not severe enough to meet criteria for Fetal Alcohol Syndrome (Warren et al., 2011). “Alcohol-related birth defects” are the physical features related to alcohol exposure, while “alcohol-related neurodevelopmental disorder” describes central nervous system developmental impairment (Warren et al., 2011). Finally, “fetal alcohol spectrum disorders” is a term used to describe the entire variety of impairments that can occur when alcohol exposure occurs in pregnancy (Warren et al., 2011). Clearly, alcohol has the capacity to impact the fetus on many levels and with a multitude of possible manifestations. Although Fetal Alcohol Syndrome falls within the range of fetal alcohol spectrum disorders, the term encompasses many other varieties of the disorder. When taking the entire range of fetal alcohol spectrum disorders into account, these disorders are estimated to occur in 1 percent and possibly many more births (Warren et al., 2011). Though there is a spectrum of severity amongst fetal alcohol disorders, Fetal Alcohol Syndrome is the most profound (Warren et al., 2011). Obviously, all of these disorders have a profound impact on the sufferer, no matter what diagnostic label is chosen. It goes without saying that the pregnant woman’s use of alcohol will harm the fetus to some degree. There are a variety of factors contributing to the degree of damage maternal alcohol use exerts on the fetus (Davis, Desrocher, & Moore, 2011). First, the quantity of alcohol consumed by the mother will determine the level of alcohol in the blood stream of the fetus, and the regularity or pattern of maternal consumption also plays a role (Davis et al., 2011). If a mother consumes alcohol during the first trimester of pregnancy, the development of brain cells is disturbed, while third trimester exposure damages areas of the brain structure (Davis et al., 2011). Indeed, the amount, timing, and duration of alcohol use determines the severity of the disease (Larkby & Day, 1997). Another factor that affects the severity of damage done to the fetus relates to the mother’s genetics, which determine in part the body’s rate of metabolizing alcohol as well as sensitivity to it (Davis et al., 2011). The fetus that inherits sensitivity to alcohol based on genetics may be at an even greater disadvantage (Davis et al., 2011). Symptomatology The symptoms of Fetal Alcohol Syndrome are exhibited in numerous bodily systems. Diagnosis of the syndrome requires the presence of symptoms in three distinctive categories (Warren et al., 2011). First, there are physical disfigurements that are identifiable markers of Fetal Alcohol Syndrome (Warren et al., 2011). Second, there is evidence of growth deficits during prenatal and postnatal stages (Warren et al., 2011). Third, there are abnormalities of the central nervous system (Warren et al., 2011). These are all predictable and easily identifiable characteristics that lead to the diagnosis. The physical disfigurements displayed in Fetal Alcohol Syndrome involve distinct facial characteristics. These include microcephaly (a smaller than normal head circumference), and a thin upper lip (Davis et al., 2011). The philtrum, or groove between the nose and upper lip, is smooth, and the bridge of the nose is low (Davis et al., 2011). Epicanthal folds and minor ear abnormalities are also seen (Davis et al., 2011). Not all of these characteristics are present in every case, but at least some of them must be present in order to definitively diagnose Fetal Alcohol Syndrome. However, the diagnosis cannot be made based on facial deformities alone (Davis et al., 2011). Other physical abnormalities associated with the disorder include a smaller than normal size with height, weight, and head circumference all impacted (Davis et al., 2011). Research has suggested that the degree of growth impairment is related to the amount of alcohol the fetus was exposed to, with higher quantities of alcohol exposure resulting in greater impairment of growth (Davis et al., 2011). Unfortunately, the use of alcohol affects more than the fetus’s physical attributes and growth. Since alcohol’s effects on the fetus are so closely related to brain cells and brain development, the long-term implications on functioning extend to cognition and intellect. The level of intelligence and intellectual functioning in children with fetal alcohol exposure is lower than in unexposed peers, and this attribute continues into adolescence and beyond (Davis et al., 2011). Even the brain size and brain volume of exposed children is smaller (Davis et al., 2011). Children with Fetal Alcohol Syndrome also have learning impairments and memory difficulties, which can be explained in part by the smaller size of hippocampus that is the result of this disease (Davis et al., 2011). Language deficits and abnormal motor functioning have also been evident in children diagnosed with Fetal Alcohol Syndrome (Davis et al., 2011). With impairments across so many systems and areas of functioning, the child born with Fetal Alcohol Syndrome is certainly faced with a lifetime of challenges. In children with Fetal Alcohol Syndrome, there are a number of prominent comorbid health problems. According to Davis et al., (2011), attention deficit hyperactivity disorder is frequently diagnosed in this population and in the fetal alcohol spectrum in general. Other behavioral problems, such as poor concentration, social withdrawal, and conduct problems are also common in children with Fetal Alcohol Syndrome (Larkby &Day, 1997). Depression, anxiety, and an elevated risk for alcohol and drug dependency are also exhibited in this population (Larkby & Day, 1997). This suggests the need to carefully assess the child with Fetal Alcohol Syndrome so that symptoms of depression and anxiety as well as substance abuse can be identified. Prevention of Fetal Alcohol Syndrome Given all of these devastating effects, it seems obvious that the best choice would be to consume no alcohol at all during pregnancy. However, some women become pregnant and aren’t aware of the pregnancy until they are several months in. During these early and sensitive months of pregnancy, their continued drinking can do harm to the fetus. Other women may be incapable of quitting drinking on their own due to extreme alcohol dependency. No matter what reason a woman may have for drinking during her pregnancy, it is the role of the professional to assist the patient to move toward a more healthy and alcohol-free pregnancy. Studies have suggested several methods for preventing Fetal Alcohol Syndrome and fetal alcohol spectrum disorders. According to Floyd, Weber, Denny, and O’Connor (2009), the amount a woman drinks prior to pregnancy is a good predictor for alcohol use during pregnancy. This suggests that prevention should take place prior to a pregnancy even happening, and that the medical professional should assess patients for alcohol abuse and dependency as a routine part of care. This would reduce the potential negative effects occurring in the interim when the woman does not know she is pregnant, since less drinking all the time would also mean less drinking while pregnant. Social approaches have also attempted to curtail alcohol abuse by pregnant women. For example, the use of signage at bars and at liquor stores explaining the potential harm that could come to the fetus has been employed, as have warning labels on the actual bottles of alcoholic beverages (Warren et al., 2011). Research has also identified women of childbearing age with a diagnosis of alcoholism as being a target population for prevention efforts (Warren et al., 2011). In women that have already consumed alcohol during the pregnancy or who continue to do so, certain medications and substances have been shown to provide some protection for the fetus, including prostaglandin inhibitors and choline (Warren et al., 2011). It is also believed that the poor nutritional health of women who consume alcohol while pregnant may have an adverse effect on the fetus, with zinc and folic acid deficiency playing a role (Idrus & Thomas, 2011). Treatment Some treatments are available to help with the symptoms caused by Fetal Alcohol Syndrome. Studies have shown that the administration of choline during the first three weeks after birth resulted in better working memory in adulthood (Idrus & Thomas, 2011). Choline is also suspected to have behavioral and cognitive effects in this population (Idrus & Thomas, 2011). Environmental interventions can also be introduced to help the child with Fetal Alcohol Syndrome, with special sensitivity toward sensory stimulation (Idrus & Thomas, 2011). However, since Fetal Alcohol Syndrome is a developmental disorder and birth defect, there is no cure and no medication that will reverse the condition. Conclusion Fetal Alcohol Syndrome is a serious condition that occurs far too frequently for a preventable disease. Patients need to know the severe consequences their drinking will have on the development of the fetus, and how fetal alcohol exposure impairs the physical, neurological, cognitive, and behavioral functioning of the child. Patients of child-bearing age need to know that their heavy drinking and binge drinking during unknown pregnancy can be devastating to the fetus. Based on this study, I learned that although I can’t change the fact that many children have been born with Fetal Alcohol Syndrome, I can do my part to engage in preventative measures. By educating women about alcohol and substance abuse and assessing them for possible dependency, treatment can be sought and Fetal Alcohol Syndrome cases can be prevented. References Davis, K., Desrocher, M., & Moore, T. (2011). Fetal alcohol spectrum disorder: A review of neurodevelopmental findings and interventions. Journal of Developmental & Physical Disabilities, 23(2), 143-167. Floyd, R.L., Weber, M.K., Denny, C., & O’Connor, M.J. (2009). Prevention of fetal alcohol spectrum disorders. Developmental Disabilities Research Reviews, 15(3), 193-199. Idrus, N.M., & Thomas, J.D. (2011). Fetal alcohol spectrum disorders: Experimental treatments and strategies for intervention. Alcohol Research & Health, 34(1), 76-85. Larkby, C., & Day, N. (1997). The effects of prenatal alcohol exposure. Alcohol Health and Research World, 21(3), 192-198. Warren, K.R., Hewitt, B.G., & Thomas, J.D. (2011). Fetal alcohol spectrum disorders. Alcohol Research & Health, 34(1), 4-14. Read More