Overview
- Incidence: 1/300 to 1/2000
- Worst effect during first 2 months
- 30-50% of infants born to mothers who drink >3oz pure EtOH/day will show features of FAS
Diagnosis
- Growth failure (pre or postnatal weight, height, head circumference)
- Characteristic facies
- Midface hypoplasia (depressed nasal bridge)
- Smooth and long philtrum
- Thin upper lip
- Short palpebral fissures, epicanthal folds
- Narrow forehead (hirsutism over forehead)
- Small eyes, ptosis, wide-spaced eyes
- Microcephaly
- Cleft lip/palate
- Characteristic behaviour/intellectual profile
- IQ 70-90
- Hyperactivity
- Failure to learn
- Naiveté when dealing with others
- Over friendliness
- Poor imagination at play
- Aggressive, lack of impulse control
- Poor self esteem due to perceived abnormality by parent
Washington criteria (rated from 1-4)
- Facial features
- Growth deficiency
- CNS impairment
- Prenatal alcohol exposure or maternal history of alcohol consumption
Management
- Eyes – corrective lenses
- Cleft palate – repair
- Heart/kidney – repair
- Skeletal abnormality
- Behaviour – start rehab/PT early to decrease deficit
- Speech language
- Psychiatry – self esteem, substance abuse