Philadelphia Medicine Winter-Spring 2021 - 18

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Fetal Alcohol Syndrome
Impacts
Families
Support systems face challenge of FASD
By Andy Andrews, Editor

ediatrician Dr. Renee Turchi wants people
to forget about the blame, and the shame,
about fetal alcohol spectrum disorder.

In her career, Turchi has seen many children
born as a result of a pregnant mother who
drinks alcohol.

As medical director of the Center for Children
with Special Health Care Needs at St. Christopher's Hospital for Children in Philadelphia,
Turchi wants others to know about the " trifecta "
of warnings to a pregnant woman who may want
to consume liquor:
There is no safe amount or type of alcohol
for an expectant mother to drink, and there is
no safe time.
According to the National Organization on
Fetal Alcohol Syndrome (www.nofas.org), any
amount of alcohol, even a glass of wine, passes
from the mother to the developing baby. Wine, beer, or distilled
spirits (vodka, rum, tequila, etc.) all pose a risk.

the numbers for those who have the spectrum
disorders.
However, the CDC notes that several different
approaches have been used to estimate how many
are living with fetal alcohol syndrome.
More specifically, fetal alcohol syndrome, or
FAS, is the most involved diagnosis, used when
several physical and developmental abnormalities
are present.
Using medical and other records, CDC
studies have identified 0.2 to 1.5 infants with
FAS for every 1,000 live births in certain areas
of the United States. The most recent CDC
study analyzed medical and other records and
found FAS in 0.3 out of 1,000 children from 7
to 9 years of age.
Studies using in-person assessment of schoolaged children in several U.S. communities report
higher estimates of FAS: 6 to 9 out of 1,000 children.

Serious effects

According to the CDC, few estimates for the full range of the
disorders are available. Based on the National Institutes of Healthfunded community studies using physical examinations, experts
estimate that the full range of FASDs in the United States and some
Western European countries might number as high as 1 to 5 per 100
school children (or 1% to 5% of the population).

The Institute of Medicine says, " Of all substances of abuse
(including cocaine, heroin, and marijuana), alcohol produces by far
the most serious neurobehavioral effects in the fetus. "

Disorder manifestations

Developing babies have the same blood alcohol concentration as
their mother, but they lack the ability to process or metabolize alcohol.

She sees too much blame and shame for what happens as a result
of the diagnosis. And Turchi said that has to stop.
Even though the spectrum disorder is " 100% preventable, " Turchi
said, the damage is real.
" The brain damage is irreversible, " she said.
The mission of the center that focuses on children with the
syndrome, she said, is " more about meeting them where they're at
and putting the supports in place to go at their pace, and helping
them learn the way their brain is wired to learn. "
The Centers for Disease Control and Prevention does not compile
18 Philadelphia Medicine : Winter-Spring 2021

Turchi said newborns can exhibit some classic manifestations of
fetal alcohol syndrome.
" Not everyone has all of the symptoms, or features, but (the
babies) tend to have a smooth philtrum, right above its lip, " Turchi
said. " They also have a thin upper lip. The lengths of the eyes are
smaller. Their heads tend to be a little bit smaller. Sometimes their
jaw can be a little bit smaller, kind of retracted. They also can have
extra folds in their ears. They can also have heart problems.
" They tend to not grow; they tend to be smaller. They usually
do not gain weight as well and tend to have developmental delays, "
Turchi said.

https://philamedsoc.org/ http://www.nofas.org

Philadelphia Medicine Winter-Spring 2021

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