The mechanism by which the abnormalities of the fetal alcohol syndrome are produced is unknown, but it is thought to be due to a direct teratogenic effect. There is no general agreement regarding the limits of vulnerability of the fetus in terms of gestational age. To date, this syndrome has been described only in children of mothers who drank alcohol frequently during their pregnancy. Fetal alcohol syndrome results in low birth weight and small head circumference. Cranial and joint deformities are common, and the children feed poorly and are "colicky" and tremulous. The infant mortality rate associated with this
condition is high, and survivors suffer an increased risk of mental retardation. Many, but not all, of the mothers of affected babies suffered from withdrawal seizures, delirium tremens, or hepatic encephalopathy during the pregnancy. Infants with fetal alcohol syndrome have a higher incidence of various congenital brain malformations.
Because addicts often abuse several drugs, it is important to consider that an irritable, tremulous, small baby may also result from use during pregnancy of crack cocaine or other agents. There are no laboratory tests of value to support or refute the diagnosis of fetal alcohol syndrome. Maternal education regarding the toxic effects of alcohol is of paramount importance in preventing the fetal alcohol syndrome. There is no safe minimum amount of alcohol consumption that can be guaranteed not to be toxic to a fetus, so mothers-to-be are urged to abstain entirely from alcohol throughout their pregnancy. There is no direct treatment for the effects of the fetal alcohol syndrome, although proper postnatal nutrition and care will help affected babies as they do unaffected ones. Approximately one in six babies born with this syndrome die. Of the remainder, about half suffer permanent physical or mental handicaps.
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