Intergovernmental committee on Drugs working party on Fetal Alcohol Spectrum Disorders
Fetal Alcohol Spectrum Disorders in Australia: An Update
Glossary and Definitions
Alcohol Related Birth Defects (ARBD)
Birth defects, including malformations and dysplasias associated with prenatal alcohol exposure in animal models and human populations. These may include cardiac, skeletal, renal, ocular, auditory and other malformations.
Alcohol Related Neurodevelopmental Disorder (ARND)
A diagnosis of ARND requires confirmed prenatal exposure to alcohol and at least one of the following:
- clinically significant structural abnormality (e.g. head circumference ≤ 3rd percentile, abnormal brain structure), or neurological abnormality (seizure disorder or hard neurological signs); and/or
- severe dysfunction (impairment in three or more domains of function at two or more standard deviations below the mean). Functional domains include cognition, academic performance, language, memory, executive function, attention/activity and adaptive behaviour/social skills.
Binge drinking is often defined as five or more standard drinks in one occasion of use for women and as seven or more standard drinks for men. The definition of binge drinking varies in the literature, rendering comparisons between studies problematic (Henderson et al. 2007).
The study of human congenital malformations (birth defects).
Fetal Alcohol Effects and Alcohol-related Effects
These terms have been used previously in the literature to describe a range of problems associated with prenatal alcohol exposure, but where full criteria for Fetal Alcohol Syndrome, typically the distinctive facial characteristics, are not met (Aase et al. 1995; Stratton et al. 1996). The terms are not currently in use.
Fetal Alcohol Syndrome
A syndrome characterised by: specific facial abnormalities, reduced size of the newborn and/or poor growth after birth; and problems of behaviour and cognition due to structural and/or functional abnormalities of the central nervous system. FAS is most commonly seen in children born to mothers who consumed significant quantities of alcohol during early pregnancy.
Fetal Alcohol Spectrum Disorders (FASD)
Broad term for a range of outcomes that may be observed among individuals with prenatal alcohol exposure, that includes FAS, ARBD and ARND. FASD does not represent a clinical diagnosis but a group of diagnoses.
Intrauterine growth restriction (IUGR)
Failure of a fetus to achieve its growth potential, resulting in the birth of a baby whose birth weight is abnormally low in relation to its gestational age. Causes include maternal disease (e.g. infection, malnutrition, high blood pressure, smoking, and alcoholism), poor socioeconomic conditions, multiple pregnancy (e.g. twins) and fetal disease or chromosomal abnormalities. It may be, but is not necessarily, associated with preterm birth*(Oxford Reference Online).
Abnormally small head, usually defines as measuring below the third percentile on population based charts appropriate for age and sex. May result from alcohol exposure causing abnormal development of the brain.
A term used to indicate the number of pregnancies a woman has had that have each resulted in the birth of an infant capable of survival (Oxford Reference Online).
Partial Fetal Alcohol Syndrome
This term is used for patients who present with significant structural, neurological and/or functional abnormalities of the CNS and most (but not all) of the growth and/or facial features of FAS and have a confirmed history of prenatal alcohol exposure.
Standard drinkIn Australia, a standard drink contains 10 g of alcohol1. The quantity of alcohol considered to be a standard drink varies between countries. For example, it is 8 g in the United Kingdom and Ireland, 13.5 g in Canada and 14 g in the USA (International Centre for Alcohol Policies 1998).
Substance (including alcohol) abuse
DSM-IV diagnostic criteria for substance abuse is:
A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:
- recurrent substance use resulting in failure to fulfil major role obligations at work, school, or home;
- recurrent substance use in situations in which it is physically hazardous (e.g. driving while intoxicated);
- recurrent substance-related legal problems; and/or
- continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance.
Substance (including alcohol) dependence
DSM-IV diagnostic criteria for substance dependence describe a maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three or more of the following occurring at any time in the same 12-month period:
1. Tolerance, as defined by either:
- a need for markedly increased amounts of the substance to achieve intoxication or the desired effect;
- Markedly diminished effect with continued use of the same amount of the substance;
- A characteristic withdrawal syndrome;
- The same or a closely related substance is used to relieve or avoid withdrawal symptoms;
4. There is a persistent desire or unsuccessful efforts to cut down or control substance use;
5. A great deal of time is spent in activities necessary to obtain the substance, use the substance or recover from its effects;
6. Important social, occupational or recreational activities are reduced or given up because of substance use; and/or
7. Substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.
Relative Risk (RR)
The likelihood of developing a disease in an exposed group (e.g. those exposed to alcohol) relative to those who are not exposed (Hennekens and Buring 1987). A relative risk of >1 indicates increased risk.
A teratogen is an agent, such as a virus, a drug, or radiation that causes malformation of an embryo or a fetus. Alcohol is a known human teratogen. Teratology is the study of developmental abnormalities and their causes (Oxford Reference Online 2008).
Editors note: may also be independent of preterm birth.
1 For a Standard Drink Guide, see Alcohol website.