Health Effects of Alcohol on the Foetus

The harmful effects of drinking alcohol during pregnancy on the foetus appear to depend on how much alcohol the mother consumes during her pregnancy. In addition, factors such as poor nutrition, other drug use, homelessness and poor physical health also contribute to poor outcomes and must be taken into account in the history of the mother and when evaluating the health of the foetus and infant.

These problems range from mild to severe. The extent of alcohol-related harm may not become evident until the child is older and behavioural and learning problems become evident.

Foetal Alcohol Spectrum Disorders (FASD) are associated with foetal exposure to alcohol. The expression of FASD is found in children whose mothers have a history of chronic heavy alcohol use and/or frequent heavy episodic (i.e., binge) alcohol use in pregnancy. Symptoms range from mild to severe and may involve physical, neurological and behavioural problems. 

Babies affected by FASD can experience a range of serious health and developmental problems, including: 

• significant learning difficulties 
• intellectual disability 
• poor eyesight and hearing 
• poor coordination and motor skills 
• defects of the face and bones 
• heart, liver and kidney defects 
• slow physical growth after birth. 

No blood or laboratory tests are currently available to help diagnose foetal alcohol spectrum disorders. Diagnosis therefore relies on a specialist’s assessment of the child’s growth and development, any characteristic facial features and physical disorders, central nervous system dysfunction (including intellectual ability), combined with confirmation, where possible,  that the mother consumed alcohol during her pregnancy. 

Neonatal withdrawal occurs because the flow of alcohol from the mother’s bloodstream through the placenta stops suddenly after delivery. When there is concern that a pregnant woman may be alcohol dependent or regularly drinks heavily, it is important to closely monitor the newborn for onset of alcohol withdrawal. Signs and symptoms of alcohol withdrawal in a newborn baby include: 

• tremor 
• irritability 
• seizures 
• bloated abdomen 
• vomiting. 

Emergency medical treatment and/or evacuation of the newborn will be needed if there are severe signs or symptoms of neonatal alcohol withdrawal. 

A specialist service should be consulted and arrangements made for assessment and diagnosis of foetal alcohol syndrome if such expertise is unavailable locally. It is also necessary to sensitively prepare the mother, father and family for the need for future support and assessment of any of the less recognisable foetal alcohol spectrum disorders.