Intergovernmental committee on Drugs working party on Fetal Alcohol Spectrum Disorders
Fetal Alcohol Spectrum Disorders in Australia: An Update
4. The effects of alcohol exposure in utero
Colleen O’Leary, Elizabeth Peadon, Courtney Breen and Elizabeth Elliott
The first descriptions of prenatal alcohol effects in children of mothers with an alcohol-use disorder appeared in the late 1960s (Lemoine et al. 1968) and early 1970s (Jones and Smith 1973). Since this time researchers have been studying the relationship between prenatal alcohol exposure and fetal effects and a large body of research has been conducted. It is now well accepted that heavy maternal alcohol consumption during pregnancy places the baby at risk of a wide range of fetal effects (Stratton et al. 1996; ARND Consensus Statement 2011). These include birth defects, growth impairment, developmental disabilities and neurodevelopmental dysfunction. A complex pattern of neurodevelopmental dysfunction that is unrelated to developmental maturity or to family or home environment has been identified in children exposed to alcohol in utero. The central nervous system abnormalities include cognitive abnormalities, poor impulse control and problems in behaviour, mental health, social interactions, learning and school achievement. These indicators of brain dysfunction extend across a continuum that ranges from mild to severe impairment (Stratton et al. 1996).
This chapter describes the diagnostic classifications and the guidelines for diagnosis of the range of alcohol-related fetal effects and discusses the epidemiological evidence on the nature of the association between prenatal alcohol exposure and fetal effects.