It sounds simple: Women who drink while pregnant may give birth to children with defects, so women should not drink during pregnancy. Yet in the 20 years since it was first described in the medical literature, fetal alcohol syndrome (FAS) has proved to be a stubborn problem, with consequences as serious as those of the more widely publicized "crack babies." This volume discusses FAS and other possibly alcohol-related effects from two broad perspectives: diagnosis and surveillance, and prevention and treatment. In addition, it includes several real-life vignettes of FAS children. The committee examines fundamental concepts for setting diagnostic criteria in general, reviews and updates the diagnostic criteria for FAS and related conditions, and explores current research findings and problems associated with FAS epidemiology and surveillance. In addition, the book describes an integrated multidisciplinary approach to research on the prevention and treatment of FAS. The committee * Discusses levels of preventive intervention. * Reviews available data about women and alcohol abuse and treatment among pregnant women. * Explores the psychological and behavioral consequences of FAS at different ages. * Examines the current state of knowledge about medical and therapeutic interventions, education efforts, and family support programs. This volume will be of special interest to physicians, nurses, mental health practitioners, school and public health officials, policymakers, researchers, educators, and anyone else involved in serving families and children, especially in high risk populations.

Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment

An update on incidence of FAS: FAS is not an equal opportunity birth defect.

This evidence-based review focuses on the impact of potentially modifiable, non-communicable lifestyle factors on reproductive performance in the general population and the infertile population undergoing assisted reproductive technology (ART) treatment. The impact of several lifestyle factors including; age, weight, smoking, diet, exercise, psychological stress, caffeineconsumption,alcohol consumptionandexposure toenvironmental pollutants areincluded in the review. The databases of Medline, PubMed and Cinahl were searched to identify relevant publications. There is strong evidence that age, weight and smoking impact on general health and adversely on reproductive performance. However there is a need for further research focusing specifically on the relationship between diet and various levels of exercise on reproductive performance. There are several other factors such as psychological stress, caffeine consumption, alcohol consumption and exposure to environmental pollutants that have been implicated but the evidence is equivocal. It is concluded that lifestyle modification can assist couples to conceive spontaneously or optimize their chances of conception with ART treatment.

The impact of lifestyle factors on reproductive performance in the general population and those undergoing infertility treatment: a review

Dose–response relationship between alcohol consumption before and during pregnancy and the risks of low birthweight, preterm birth and small for gestational age (SGA)—a systematic review and meta‐analyses

Systematic review of effects of low-moderate prenatal alcohol exposure on pregnancy outcome.

In this prospective study of alcohol and other substance use during pregnancy, a cohort of 650 women was interviewed at each trimester of pregnancy Data are presented concerning the status of 595 live singleton births A relationship was demonstrated between prenatal maternal alcohol use and growth and morphologic abnormalities in the offspring Low birth weight, decreased head circumference and length, and an increased rate of fetal alcohol effects were all found to be significantly correlated with exposure to alcohol during the first 2 months of the first trimester

Prenatal Exposure to Alcohol: Effect on Infant Growth and Morphologic Characteristics

Prenatal marijuana use and neonatal outcome.

In this prospective study of alcohol and other substance use during pregnancy, a cohort of women was interviewed at each trimester of pregnancy and when the offspring were 8 months of age. Data are presented concerning the outcome for 461 infants. A significant relationship was found between alcohol use during pregnancy and the growth and morphology of the offspring at the 8-month follow-up observation. Alcohol use during the second and third trimesters of pregnancy and continuous use of alcohol throughout pregnancy were significantly related to lower weight, length, and head circumference in the exposed infants at the follow-up observation. A significant increase in the risk of minor physical anomalies and fetal alcohol effects was also predicted by prenatal alcohol exposure.

Dorcie Jasperse

Papers

Prenatal Exposure to Alcohol: Effect on Infant Growth and Morphologic Characteristics

Prenatal marijuana use and neonatal outcome.

Effect of prenatal alcohol exposure on growth and morphology of offspring at 8 months of age.