Alcohol's fetal harm lasts a lifetime.

Alcohol's fetal harm lasts a lifetime

Pregnant women who abuse alcohol may hand down a lifetime legacy of disabling mental and behavioral problems to their offspring, according to the first systematic study of the long-term consequences of fetal alcohol syndrome (FAS).

Adolescents and adults assigned a diagnosis of FAS during childhood often appear alert and verbal, but they cannot live independently, hold down jobs or succeed at school because of poor concentration, social withdrawal, impulsiveness, report psychologist Ann P. Streissguth of the University of Washington in Seattle and her colleagues. Mental retardation also persists among a majority of those with FAS, they point out. However, the debilitating behavioral problems plague those with normal and low IQs alike.

FAS, a mix of physical, mental and behavioral abnormalities afflicting many babies born to mothers who drink heavily during pregnancy, represents the leading known cause of mental retardation in the United States.

"[FAS] is not just a childhood disorder," Streissguth's team writes in the April 17 JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION. "There is a predictable long-term progression of the disorder into adulthood."

The researchers studied 38 males and 23 females ranging in age from 12 to 40 diagnosis before age 12; the other 18 had prior diagnoses of "possible fetal alcohol effects." American Indians made up three-quarters of the sample.

Study participants displayed little evidence of the facial abnormalities (such as malformed lips and misaligned teeth) and low body weight typical of children with FAS. But many remained short for their age, with unusually small heads. One 29-year-old woman stood only 4 feet tall.

IQs for the group ranged from 20 (severely retarded) to 105 (normal).

Academic achievement fluctuated from second- to fourth-grade levels, with arithmetic deficits most common. Nearly the entire sample lived under some type of supervision, usually with parents, relatives, or adoptive or foster parents. According to caretaker reports, every participant exhibited significant behavioral problems, such as consistently poor judgment and concentration. Problems with lying, cheating and stealing also turned up frequently.

The long-term problems associated with FAS make these individuals unsuitable for current job training programs, the researchers argue. Prenatal brain damage may permanently disrup the ability to concentrate, think abstractly and function independently, even among those with normal intelligence, the scientists add. Nevertheless, they call for the development of more effective remedial programs for adult FAS victims.