Alcohol Use and Pregnancy and Fetal Alcohol Spectrum Disorder

Alcohol Use and Pregnancy and Fetal Alcohol Spectrum Disorder FASEout Project 2006 www.faseout.ca Alcohol is a Teratogen  A teratogen is a substance that interferes with the normal development of the fetus Specifically, alcohol is a neurobehavioural teratogen – alcohol can damage the brain and change behaviour  Copyright 2005, Saskatchewan Prevention Institute Teratology: Four Outcomes to Exposure  Malformations (facial, heart, skeletal) Growth Deficiency (small) Functional Deficits (learning and behavioural problems) Death (stillbirth, miscarriage) Copyright 2005, Saskatchewan Prevention Institute    Effects of Alcohol in Pregnancy      Alcohol freely crosses the placenta Adverse effects to the fetus occur at levels at or below those that are toxic to women Fetal elimination of alcohol is poor Increased risk for low birth weight Harm can be caused before a woman knows she is pregnant FASEout Project 2006 www.faseout.ca First Trimester  First Month: heart, lungs, limbs, face, ears, eyes, spinal cord, and brain begin to form Second Month: toes and eyelids form and brain grows quickly and directs body’s movements Third Month: Most major organs and the face are developed. Bones continue to grow and kidneys start to work Copyright 2005, Saskatchewan Prevention Institute   Second Trimester  Fourth Month: The placenta is fully formed and fetal movement may be felt by mother Fifth Month: Eyelashes, eyebrows and scalp and hair appear. Fetal heartbeat can be heard Sixth Month: Eyes open and close. Lungs, brain and other organs continue to develop Copyright 2005, Saskatchewan Prevention Institute   Third Trimester  In the third trimester, the fetus grows quickly in weight and length Lungs and other major organs mature to support life The brain continues to grow and develop and remains vulnerable to the damage that alcohol can cause Copyright 2005, Saskatchewan Prevention Institute   FASEout Project 2006 www.faseout.ca Drinking in Perspective In general:  Women want healthy, happy children  Some may drink before they knew they were pregnant  Some may not know it is harmful  Some drink because of life problems  Some drink because it is the social norm FASEout Project 2006 www.faseout.ca No one can predict which infants born to mothers who drink will be affected, nor can anyone predict how severe these effects will be. FASEout Project 2006 www.faseout.ca Factors Involved in FASD     The stage in the pregnancy at which alcohol is consumed The amount of alcohol consumed during the pregnancy Fetal susceptibility to alcohol Other factors such as maternal age, stress, nutrition, smoking, and the use of other drugs (prescribed or street drugs) Copyright 2005, Saskatchewan Prevention Institute Standard drinks = 0.5 oz alcohol 12 oz (341 mL) can of beer (5% alcohol) 12 oz (341 mL) bottle of cooler (5% alcohol) 5 oz (142 mL) glass of wine (12% alcohol) 1.5 oz (43 mL) distilled spirits (40% alcohol) 3 oz (85 mL) fortified wine e.g. sherry or port (18% alcoholFASEout Project 2006 ) www.faseout.ca Paternal Role  Effects on the Fetus: the effects of father’s drinking on the fetus are not fully known Effects on Pregnancy: Alcohol can result in lower sperm count and abnormal sperm, which may effect fertility. If alcohol-affected sperm does fertilize an egg, the likelihood of miscarriage is higher than if the sperm were not alcohol-affected FASEout Project 2006 www.faseout.ca  Paternal Role: Social Effects  Women most often drink with their partners Men who drink heavily are unlikely to provide the necessary emotional support and care for their pregnant partners A man’s drinking after the baby is born could adversely affect the nurturing home environment needed to raise a child FASEout Project 2006 www.faseout.ca   What is Fetal Alcohol Spectrum Disorder? FASEout Project 2006 www.faseout.ca Fetal Alcohol Spectrum Disorder (FASD)  FASD is a combination of mental and physical disabilities FASD is a lifelong condition FASD is caused by maternal alcohol consumption during pregnancy Copyright 2005, Saskatchewan Prevention Institute   Diagnostic Terms  Fetal Alcohol Syndrome (FAS) Partial Fetal Alcohol Effects (pFAS) Alcohol Related Neurodevelopmental Disorder (ARND)    Alcohol Related Birth Defects (ARBD) Fetal Alcohol Effects (FAE) has been replaced with ARND and pFAS FASEout Project 2006 www.faseout.ca  Fetal Alcohol Syndrome Recognized and documented in Nantes, France and Seattle, Washington 1968 – 1973 FASEout Project 2006 www.faseout.ca Characteristics of FAS    Facial anomalies Evidence of growth restriction (may be apparent prenatally and/or postnatally), (below the 10th percentile) and microcephaly Central nervous system abnormalities FASEout Project 2006 www.faseout.ca FAS Features FASEout Project 2006 www.faseout.ca The invisible disability Physical characteristics FASD unremarkable  Disappear: become less prominent over time  Adolescent & Adult Diagnosis often more difficult  Dr. Lori Vitale Cox, 2006 Diagnostic Process    Information is collected regarding the individual – physical, social, academic, and adaptive skill history Individual is seen by a medical doctor who may diagnose or refer for further assessment If possible, the physician, along with a psychologist and other specialists, will assess the individual in order to make an appropriate diagnosis FASEout Project 2006 www.faseout.ca Possibility of Misdiagnosis  Since FASD is not a mental health diagnosis, it might not be considered or recognized The symptom presentation of individuals with FASD is similar to that of many other mental health diagnoses FASEout Project 2006 www.faseout.ca  Possibility of Misdiagnosis  Individuals may be diagnosed with a mental health disorder without closely examining the total picture Even when FASD is recognized, another diagnosis is often used in order to get reimbursement for treatment Dan Dubovsky, 2002  Benefits to a diagnosis  Parents and professionals often find their ability to cope improves when they understand problems are most likely caused by brain damage not the child/person’s choice to be inattentive or uncooperative FASEout Project 2006 www.faseout.ca Fetal Alcohol Spectrum Disorder is a lifelong condition that affects the individual, the family and the community. Copyright 2005, Saskatchewan Prevention Institute Resources     Canadian Centre on Substance Abuse www.ccsa.ca/fas Public Health Agency of Canada www.publichealth.gc.ca/fasd Motherisk, The Hospital for Sick Children www.motherisk.org Saskatchewan Prevention Institute www.preventioninstitute.sk.ca FASEout Project 2006 www.faseout.ca