MEDICAL SURFARI: FETAL ALCOHOL SYNDROME IS PREVENTABLE

Perhaps one of the most undervalued miracles of our everyday world is human development. This all begins embryologically around a hollow neural tube that ultimately develops into a complex nervous system.

The central nervous system appears at the beginning of the third week of development as a slipper-shaped plate of thickened tissue called the neural plate. The edges of this tissue elevate and form folds that ultimately develop into the brain, spinal cord and peripheral nervous system. Although the timing and order of each developmental event is relatively well understood now through the study of birth defects, it remains nothing short of amazing that the end result of this process is a unique individual.

The neuron -- the basic constituent of all nervous tissue -- is unique in that it possesses the specialized properties for the initiation and conduction of electrical impulses that are essential requirements for a functional nervous system. This all occurs through specialized intercellular connections that elicit an electrical potential in the receiving neurons. The organization of the nervous system and its literally hundreds of billions of connections usually occurs flawlessly. Sometimes nature errors and the result is a birth defect. More commonly, however, some mothers make poor behavior choices that result in the permanent damage of their child's mind.

In 1973, researchers in the United States published a landmark report describing a constellation of physical, cognitive and behavioral abnormalities known as Fetal Alcohol Syndrome (FAS). The abnormalities resulting from FAS include mental retardation, distinctly abnormal facial development, growth deficiencies and organ deformities. FAS results from the mother's use of ethanol (alcohol) during her pregnancy. The alcohol circulates through the woman's bloodstream and crosses the placenta, affecting the fetus. The alcohol interferes with the ability of the fetus to receive sufficient oxygen and nourishment for normal cell development, especially in the nervous system.

In 1991, the Journal of the American Medical Association reported that FAS is the leading known cause of mental retardation and that at least 5,000 infants are born each year with this condition. Thirty to 40 percent of babies whose mothers drink heavily throughout pregnancy will have FAS.

When a pregnant woman drinks alcohol, her baby does too and it is not clear what amount of alcohol must be consumed before damage occurs. Newborns do not always show the effects caused by alcohol at birth. It can take a few years before the effects become apparent.

There is no cure for Fetal Alcohol Syndrome, but it is the only cause of birth defects that is completely preventable. Because we are not sure if any amount of alcohol is safe in pregnancy, it is recommended that pregnant women or women contemplating pregnancy abstain from using alcohol, in any amount, during pregnancy.

World Wide Web Resources

The National Organization on Fetal Alcohol Syndrome

www.nofas.org/

The National Organization on Fetal Alcohol Syndrome (NOFAS) is committed to raising public awareness of fetal alcohol syndrome and to developing and implementing innovative ideas in prevention, education, intervention, and advocacy in communities throughout the nation.

Missouri Division of Alcohol and Drug Abuse

www.well.com/user/woa/fsfas.htm

This agency provides a fact sheet on fetal alcohol syndrome, including the estimated incidence in the state of Missouri.

Dr. Scott Gibbs is a Cape Girardeau neurosurgeon and editor-in-chief of Mosby's Medical Surfari. You may e-mail questions to him at drgibbs@semissourian.com or write in care of the Southeast Missourian, P.O. Box 699, Cape Girardeau, Mo., 63702-0699.