[Patient with fetal alcohol spectrum disorder]. / Patiënte met foetale alcoholspectrumstoornis.

FETAL ALCOHOL SPECTRUM DISORDERS (FASDS) IS A CONDITION THAT IS PROBABLY OFTEN MISSED. THIS SYNDROME IS BASED ON FEATURES IN FOUR DOMAINS: 1. REDUCED HEIGHT AND WEIGHT GROWTH, 2. SPECIFIC FACIAL FEATURES, 3. PREDISPOSED CENTRAL NERVOUS SYSTEM ABNORMALITIES (INCLUDING MICROCEPHALY) OR FUNCTION (NEUROLOGICAL, PSYCHOLOGICAL AND/OR BEHAVIORAL PROBLEMS) AND 4. (SUSPECTED) PRENATAL ALCOHOL USE BY THE MOTHER. DUE TO PSYCHIATRIC AND BEHAVIORAL PROBLEMS PATIENTS MAY ALSO BE SEEN IN SPECIALIZED MENTAL HEALTH CARE. TO INCREASE THE CHANCE THAT THESE PATIENTS WILL RECEIVE AN APPROPRIATE AND EFFECTIVE TREATMENT, AWARENESS OF THIS SYNDROME IS ESSENTIAL. WE DESCRIBE THE CLINICAL PICTURE ON THE BASIS OF A CASE DESCRIPTION, PROVIDE RECENT LITERATURE AND FORMULATE RECOMMENDATIONS FOR CLINICAL PRACTICE.

Fetal alcohol spectrum disorders and access to regional center services in San Diego County.

BACKGROUND: Fetal alcohol spectrum disorders (FASD) are developmental disabilities that are estimated to occur in 2-5% of elementary school children and that negatively impact a child's ability to function without support. Timely diagnosis-informed interventions are crucial to optimizing the developmental trajectory of children with FASD. The true prevalence of FASD among children receiving services for developmental disabilities is unknown. METHODS: An FASD prevalence study was carried out between 2011 and 2014 among a sample of 5- to 7-year-old children who were receiving services provided by the California State Regional Center for Developmental Disabilities in San Diego County. Children whose parent or caregiver consented were evaluated using the Collaboration on Fetal Alcohol Spectrum Disorders Prevalence study assessment protocol and classification criteria. RESULTS: Among 216 eligible caregiver-child dyads, 44 completed assessments that were sufficient to obtain a classification for FASD, including fetal alcohol syndrome (FAS), partial FAS, alcohol-related neurodevelopmental disorder, or no fetal alcohol spectrum disorder. Fifteen children were classified as meeting the criteria for an FASD. A minimum FASD prevalence rate of 69.4 per 1000 (6.9%) among all eligible children was estimated. None of the children classified as FASD were receiving services because of an FASD diagnosis, and none had previously been diagnosed with FASD. Autism was the most common qualifying diagnosis for which children classified as FASD were receiving services. CONCLUSIONS: The 6.9% prevalence estimate among Regional Center clients was higher than the prevalence estimate of 2.3% in the same community among 5- to 7-year-old children in the general population, though the estimate was based on only 20% of eligible dyads. All children in the sample were receiving Regional Center services for another diagnosis. Barriers to eligibility for services for children with FASD may lead to less than optimum care for these children. Study findings support the facilitation of access to developmental services for children with FASD.

A Pilot Study Examining the Effects of Music Training on Attention in Children with Fetal Alcohol Spectrum Disorders (FASD).

Prior studies indicate differences in brain volume and neurophysiological responses of musicians relative to non-musicians. These differences are observed in the sensory, motor, parietal, and frontal cortex. Children with a fetal alcohol spectrum disorder (FASD) experience deficits in auditory, motor, and executive function domains. Therefore, we hypothesized that short-term music training in children with an FASD due to prenatal alcohol exposure may improve brain function. Children (N = 20) with an FASD were randomized to participate in either five weeks of piano training or to a control group. Selective attention was evaluated approximately seven weeks apart (pre-/post-music training or control intervention), examining longitudinal effects using the Attention Networks Test (ANT), a well-established paradigm designed to evaluate attention and inhibitory control, while recording EEG. There was a significant group by pre-/post-intervention interaction for the P250 ms peak of the event-related potential and for theta (4-7 Hz) power in the 100-300 ms time window in response to the congruent condition when the flanking stimuli were oriented congruently with the central target stimulus in fronto-central midline channels from Cz to Fz. A trend for improved reaction time at the second assessment was observed for the music trained group only. These results support the hypothesis that music training changes the neural indices of attention as assessed by the ANT in children with an FASD. This study should be extended to evaluate the effects of music training relative to a more closely matched active control and determine whether additional improvements emerge with longer term music training.

Access to oral health care for children with fetal alcohol spectrum disorder: a cross-sectional study.

BACKGROUND: Individuals with developmental disabilities, including Fetal Alcohol Spectrum Disorder (FASD), often suffer from poorer oral health than the general population as they experience challenges with accessing care. However, few studies have investigated access to oral health care specific to children diagnosed with FASD. Thus, the objective of this cross-sectional study is to examine the use of oral health care services by children diagnosed with FASD in Saskatchewan, Canada, and to identify perceived barriers that affect their access to oral health care. METHODS: Parents or caregivers for children with FASD under the age of 16 were recruited through community organizations. Between July 2020 and January 2021, 189 participants completed a 64-item questionnaire that assessed sociodemographic characteristics, oral health care utilization, and perceived barriers to care. RESULTS: Most children (85%) had visited the dentist within the last 24 months. 55% of children had required sedation for some treatment. 43% of caregivers experienced frustration trying to access care for their child. Common barriers were cost (63%), location (55%), the child's behaviour (78%) and caregiver anxiety (60%). 35% of caregivers believed their dentist lacked adequate knowledge of FASD. Univariate analysis reveals that income, caregiver education, residence location, and insurance status were significantly associated with reporting barriers. Multivariate logistic regression analysis reveals that caregivers who reported a high school education (OR=1.23; 95% CI 1.03 - 1.38); or public insurance (OR=1.33; 95% CI 1.24 - 1.42) or out-of-pocket payments (OR=1.37, 95% CI 1.20 - 1.46); or rural (OR=1.19, 95% CI 1.07 - 1.26) or remote (OR=1.23; 95% CI=1.12 - 1.31) residences were more likely to report difficulties accessing oral health care. CONCLUSION: Our findings indicate that children with FASD experience various barriers to accessing oral health care. Social determinants of health were significant variables that increased likelihood of barriers. Like other vulnerable populations, cost and clinic location are notable barriers. Oral health care providers' assessment and management of children with FASD are noteworthy for future research.

Fetal alcohol spectrum disorders: current state of diagnosis and treatment.

PURPOSE OF REVIEW: The purpose of this review is to describe recent findings on the clinical presentation, pathogenesis, and management of fetal alcohol spectrum disorders (FASDs). Alcohol causes a range of physical, developmental, and cognitive impairments on the developing fetus. Individuals exposed to alcohol prenatally have a wide variability in dysmorphic and neurologic features. Hence, a greater understanding of the mechanisms through which alcohol induces defects in the developing fetus is imperative in developing therapies that prevent alcohol-induced effects. RECENT FINDINGS: Current research has focused on leveraging technology to developing tools that can aid in the diagnostic process, defining patterns of neurocognition and neuroimaging specific to FASD, developing neurobehavioral and pharmacologic interventions, and expanding access to care. SUMMARY: FASDs are a common cause of neurodevelopmental impairment in school-age children, and their recognition is essential to provide early interventions in order to optimize the outcome for these individuals when they reach adulthood. Although previously thought to be the result of irreversible neurologic injury from prenatal alcohol exposure, recent evidence points to the benefits of applying principles regarding neuroplasticity in improving the lives for patients and their families.

A Systematic Review of Interventions to Improve Mental Health and Substance Use Outcomes for Individuals with Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorder.

Individuals with fetal alcohol spectrum disorder (FASD) experience remarkably high rates of mental health and substance use challenges, beginning early in life and extending throughout adulthood. Proactive intervention can help to mitigate some of these negative experiences. Although the literature on FASD intervention is growing, there is currently a lack of consolidated evidence on interventions that may improve mental health and substance use outcomes in this population. Informed by a life course perspective, we undertook a systematic review of the literature to identify interventions that improve mental wellness through all developmental stages for people with prenatal alcohol exposure (PAE) and FASD. A total of 33 articles were identified, most of which were focused on building skills or strategies that underlie the well-being of children with PAE and FASD and their families. Other interventions were geared toward supporting child and family wellness and responding to risk or reducing harm. There was a notable lack of interventions that directly targeted mental health and substance use challenges, and a major gap was also noted in terms of interventions for adolescents and adults. Combined, these studies provide preliminary and emerging evidence for a range of intervention approaches that may support positive outcomes for individuals with FASD across the life course.

[Fetal alcohol spectrum disorders in adults]. / Fetale Alkoholspektrumstörungen bei Erwachsenen.

Fetal alcohol spectrum disorders (FASD) are a common cause of a congenital developmental disability acquired in the womb due to alcohol consumption by the mother during pregnancy. The physical and mental consequences persist into adulthood. The 4­digit code is an evidence-based method for diagnosing the full spectrum of outcomes, i.e. the full picture of fetal alcohol syndrome (FAS), partial fetal alcohol syndrome (pFAS), alcohol-related neurodevelopmental disorder (ARND) and alcohol-related birth defects (ARBD). The four key diagnostic features are (1) growth disorder, (2) facial dysmorphia, (3) central nervous system (CNS) structural and functional abnormalities and (4) prenatal alcohol exposure. Even if the disorder cannot be cured, supportive therapeutic interventions can improve the quality of life and independence and psychiatric comorbidities can be treated.

Development of a referral pathway framework for foetal alcohol spectrum disorder in the Pilbara.

INTRODUCTION: This article describes the process of mapping referral pathways to develop a localised resource to enhance the journey to diagnosis, treatment and support for foetal alcohol spectrum disorder (FASD) in a regional community setting. METHODS: Over a 6-month period, a research officer engaged service providers in Port and South Hedland, Western Australia, using participatory action research methods. An iterative process included a service environment scan, interviews with service leaders and refinement of progressive drafts of the pathway through the Hedland FASD Network. A community reference group advised on cultural issues. RESULTS: Referral pathways for interagency sectors (health, education, justice) were developed. Three pathway schematics and a companion four-page referral protocol were endorsed. The pathways were disseminated to all service providers and consensus was reached to trial the pathways within existing service systems. CONCLUSION: The process of referral pathway development provided a service mapping and gapping exercise to facilitate service integration. Evaluation of the resource will be conducted using the RE-AIM framework. The referral pathways template has been adapted and trialled by health and other professionals in several sites across Australia. The model developed for FASD can be applied to other neurodevelopmental disorders.

Six-Month Follow-up of the Families on Track Intervention Pilot Trial for Children With Fetal Alcohol Spectrum Disorders and Their Families.

BACKGROUND: When the primary disabilities associated with fetal alcohol spectrum disorders (FASD) are not well supported, individuals are at higher risk for mental health problems and other secondary conditions. The Families on Track (FOT) intervention was designed to prevent secondary conditions and improve family functioning in children with FASD. Promising results from a pilot study demonstrated positive effects on child and caregiver outcomes immediately following the intervention. The objective of this study was to examine the sustainability of these effects 6 months postintervention. METHODS: Thirty children (ages 4 to 8) with prenatal alcohol exposure and their caregivers were enrolled in the original study. Families were randomized to the FOT intervention or an active comparison group that provided comprehensive assessment and individualized feedback. The intervention integrated a positive parenting curriculum and a child skills group. Families were assessed at baseline, postintervention, and 6-month follow-up visits. Follow-up data were available for 24 families on child and caregiver outcomes. Data were analyzed using effect size calculations and analysis-of-variance techniques. RESULTS: Relative to the comparison group, intervention families showed continued gains in parenting efficacy and maintained prior improvements in FASD knowledge over the follow-up period. Although intervention families reported a decrease in their needs being met over the follow-up period, they continued to report their needs being met to greater extent than those in the comparison group. Consistent with postintervention outcomes, children in both groups exhibited similar decreases in child disruptive behavior 6 months following the intervention. Unfortunately, positive gains seen at postintervention for child self-esteem and emotion regulation were attenuated at follow-up. CONCLUSIONS: This pilot study yielded promising effects on important areas of caregiver functioning. However, the intervention's impact on child functioning waned over time, suggesting the need for sustained or alternate child intervention.

Effects of Hyperbaric Oxygen Therapy on Brain Perfusion, Cognition and Behavior in Fetal Alcohol Spectrum Disorder-A Case Study.

A 15-year-old girl diagnosed with FASD underwent 100 courses of hyperbasic oxygen therapy (HBOT). Prior to HBOT, single motion emission compute tomographic begin imaging (SPECT) revealed areas of hypo-perfusion bilaterally in the orbitofrontal region, temporal lobes and right dorsolateral-frontal, as well the medial aspect of the left cerebellum. Following two sets of HBOT treatments (60 plus 40), over 6 months, there was improvement in perfusion to the left cerebellum as well as the right frontal lobe. This was paralleled by improvement in immediate cognitive tests and an increase in functional brain volume. A follow-up 18 months after HBOT showed sustained improvement in attention with no need for methylphenidate, as well as in math skills and writing.

A guideline for the prevention and management of Fetal Alcohol Spectrum Disorder in South Africa.

BACKGROUND: Fetal Alcohol Spectrum Disorder (FASD) is a public health problem globally, with South Africa having the highest recorded prevalence of all countries. Government programmes to prevent and manage FASD remain limited because of the lack of a specific policy. Herein, we developed a guideline to inform policy on the prevention and management of FASD in South Africa. METHODS: We applied a modified version of the World Health Organization's approach to guideline development in three phases. In the first phase, we designed the initial guideline prototype. To do this, we conducted an in-depth interview with policymakers and a focus group with relevant service providers on policy requirements for FASD, a document review of policies on FASD and a scoping review of various interventions for FASD. In phase 2, we refined the initially formulated guideline prototype through a discursive approach with seven local and international experts on FASD. Phase 3 involved refining the prototype using a modified Delphi approach. Forty-three and forty-one experts participated in rounds 1 and 2 of the Delphi approach, respectively. The acceptable consensus for each included policy statement was 85%. RESULTS: We identified three aspects of the proposed guideline, which are the approaches and guiding principles, the prevention measures and the management measures. The guideline proposes that a FASD policy should consider lifespan needs, be culturally diverse, collaborative, evidence-based, multi-sectoral and address social determinants of health contributing to FASD. The essential components of FASD prevention policy consist of awareness and education of the dangers of drinking alcohol, access to treatment for alcohol problems and training of service providers. The management components include capacity building related to diagnosis, educating parents regarding the needs and management, appropriate referral pathways, training of teachers regarding classroom management and support for parents and individuals with FASD. CONCLUSION: FASD in South Africa deserves urgent attention. Developing a specific policy to guide programmes could enhance and coordinate the efforts towards preventing and managing FASD. The guideline has the potential to assist policymakers in the development of a comprehensive and multi-sectoral policy for prevention and management of FASD, considering the consensus obtained from the experts.

Neural Stem Cells.

Neural stem cell (NSC) transplantation has provided the basis for the development of potentially powerful new therapeutic cell-based strategies for a broad spectrum of clinical diseases, including stroke, psychiatric illnesses such as fetal alcohol spectrum disorders, and cancer. Here, we discuss pertinent preclinical investigations involving NSCs, including how NSCs can ameliorate these diseases, the current barriers hindering NSC-based treatments, and future directions for NSC research. There are still many translational requirements to overcome before clinical therapeutic applications, such as establishing optimal dosing, route of delivery, and timing regimens and understanding the exact mechanism by which transplanted NSCs lead to enhanced recovery. Such critical lab-to-clinic investigations will be necessary in order to refine NSC-based therapies for debilitating human disorders.

To what extent is Fetal Alcohol Spectrum Disorder considered in policy-related documents in South Africa? A document review.

BACKGROUND: South Africa is considered to have the highest prevalence of fetal alcohol spectrum disorder (FASD) globally. Nevertheless, the extent to which the South African government has responded to the high FASD prevalence at the policy level is unclear. Herein, we aimed to identify targeted and generic clauses that could be attributed to the prevention and management of FASD in relevant South African policy documents. METHODS: We conducted a search of two search engines (PubMed and Google) and the websites of South African national and provincial departments from January to April 2018. A total of 33 policy documents were included in this review. Using content analysis, we sought documents that mention the terms 'fetal alcohol syndrome' and 'fetal alcohol spectrum disorder'. The Framework method was also used to thematically identify specific and generic clauses attributed to the prevention and management of FASD in South Africa. RESULTS: The content analysis indicated that 12 policy documents contained the searched terms. Findings from the thematic analysis showed that targeted and generic clauses for FASD exist in various policy documents. Some of the generic clauses focused on the regulation of liquor outlets, enforcement of liquor laws, and the general management of persons with mental and educational challenges. Specific clauses focused on creating platforms to improve the awareness, screening, identification and support for individuals with FASD. CONCLUSIONS: There is a noticeable increase in the number of policy documents that considered elements of FASD enacted in the last decade. Although this study revealed the existence of targeted and generic clauses that could be attributed to the prevention and management of FASD, the sustained high prevalence of FASD in South Africa, as reported in the literature, calls for more holistic and comprehensive approaches to tackle the FASD problem in South Africa.

Understanding and managing sleep disruption in children with fetal alcohol spectrum disorder.

Accumulating evidence has revealed high rates of sleep disruption among children with fetal alcohol spectrum disorder (FASD). Multiple animal and clinical studies have found a clear association between sleep problems and prenatal alcohol exposure, and recent research is beginning to characterize the types and extent of sleep disruption in FASD. Nevertheless, sleep disruption in children with FASD often goes unrecognized or is treated without referring to an evidence base. Children's disrupted sleep interferes with parental sleep and increases caregiver burden, which is of particular importance for families raising children with FASD, a group with very high levels of caregiving stress. The literature supporting an association between sleep problems and deficits in emotional, behavioral, and cognitive function in children is compelling, but needs further investigation in children with FASD. This paper will review the current state of knowledge on sleep in FASD and recommend a rational approach to sleep interventions for affected children and their families.

Skeletal muscle and fetal alcohol spectrum disorder.

Skeletal muscle is critical for mobility and many metabolic functions integral to survival and long-term health. Alcohol can affect skeletal muscle physiology and metabolism, which will have immediate and long-term consequences on health. While skeletal muscle abnormalities, including morphological, biochemical, and functional impairments, are well-documented in adults that excessively consume alcohol, there is a scarcity of information about the skeletal muscle in the offspring prenatally exposed to alcohol ("prenatal alcohol exposure"; PAE). This minireview examines the available studies addressing skeletal muscle abnormalities due to PAE. Growth restriction, fetal alcohol myopathy, and abnormalities in the neuromuscular system, which contribute to deficits in locomotion, are some direct, immediate consequences of PAE on skeletal muscle morphology and function. Long-term health consequences of PAE-related skeletal abnormalities include impaired glucose metabolism in the skeletal muscle, resulting in glucose intolerance and insulin resistance, leading to an increased risk of type 2 diabetes. In general, there is limited information on the morphological, biochemical, and functional features of skeletal abnormalities in PAE offspring. There is a need to understand how PAE affects muscle growth and function at the cellular level during early development to improve the immediate and long-term health of offspring suffering from PAE.

Ethical aspects of diagnosis and interventions for children with fetal alcohol Spectrum disorder (FASD) and their families.

BACKGROUND: Fetal alcohol spectrum disorders (FASD) is an umbrella term covering several conditions for which alcohol consumption during pregnancy is taken to play a causal role. The benefit of individuals being identified with a condition within FASD remains controversial. The objective of the present study was to identify ethical aspects and consequences of diagnostics, interventions, and family support in relation to FASD. METHODS: Ethical aspects relating to diagnostics, interventions, and family support regarding FASD were compiled and discussed, drawing on a series of discussions with experts in the field, published literature, and medical ethicists. RESULTS: Several advantages and disadvantages in regards of obtaining a diagnosis or description of the condition were identified. For instance, it provides an explanation and potential preparedness for not yet encountered difficulties, which may play an essential role in acquiring much needed help and support from health care, school, and the social services. There are no interventions specifically evaluated for FASD conditions, but training programs and family support for conditions with symptoms overlapping with FASD, e.g. ADHD, autism, and intellectual disability, are likely to be relevant. Stigmatization, blame, and guilt are potential downsides. There might also be unfortunate prioritization if individuals with equal needs are treated differently depending on whether or not they meet the criteria for a specific condition. CONCLUSIONS: The value for the concerned individuals of obtaining a FASD-related description of their condition - for instance, in terms of wellbeing - is not established. Nor is it established that allocating resources based on whether individuals fulfil FASD-related criteria is justified, compared to allocations directed to the most prominent specific needs.

Fetal Alcohol Spectrum Disorders: Characteristics, Complications, and Treatment.

Fetal Alcohol Spectrum Disorders (FASD) includes a continuum of disorders that occur in children as a result of their mothers' consumption of alcohol during pregnancy. The most severe of these disorders is Fetal Alcohol Syndrome (FAS). FASD presents differently in every child, but all children with FASD have intellectual and/or behavioral impairments. There is no cure for FASD, but research shows that early intervention and life-long support help those born with FASD to manage the difficulties that come with it. This paper examines the characteristics, complications, and treatment for FASD.

[Fetal alcohol spectrum disorders (FASD) ­ diagnosis, neuropsychological assessment, and symptom-orientated therapy]. / Fetale Alkoholspektrumstörungen ­ Diagnose, neuropsychologische Testung und symptomorientierte Förderung.

According to the GEDA study (Study of Health in Germany), 20 % of all pregnant women show moderate and 8 % risky alcohol consumption. Of the pregnant women, 12 % engage in binge drinking (≥ 5 drinks per occasion less than once per month, 4 % every month and 0.1 % at least every week). According to conservative estimates, approximately 1 % of all children are affected by intrauterine exposure to alcohol. In total, approximately 800,000 million people, thereof 130,000 children, suffer from a fetal alcohol spectrum disorder in Germany. Many of the affected children, however, remain undiagnosed or are properly diagnosed only very late. To date, professionals in the healthcare and social system have not been sufficiently informed about the symptoms and the necessary diagnosis. This review illustrates the medical and psychological possibilities and necessities regarding children and adolescents with FASD. Early diagnosis and living in a supportive and violence-free environment are the most important protective factors for the long-term outcome of patients with FASD.

Prenatal alcohol exposure alters synaptic activity of adult hippocampal dentate granule cells under conditions of enriched environment.

Prenatal alcohol exposure (PAE) results in fetal alcohol spectrum disorder (FASD), which is characterized by a wide range of cognitive and behavioral deficits that may be linked to impaired hippocampal function and adult neurogenesis. Preclinical studies in mouse models of FASD indicate that PAE markedly attenuates enrichment-mediated increases in the number of adult-generated hippocampal dentate granule cells (aDGCs), but whether synaptic activity is also affected has not been studied. Here, we utilized retroviral birth-dating coupled with whole cell patch electrophysiological recordings to assess the effects of PAE on enrichment-mediated changes in excitatory and inhibitory synaptic activity as a function of DGC age. We found that exposure to an enriched environment (EE) had no effect on baseline synaptic activity of 4- or 8-week-old aDGCs from control mice, but significantly enhanced the excitatory/inhibitory ratio of synaptic activity in 8-week-old aDGCs from PAE mice. In contrast, exposure to EE significantly enhanced the excitatory/inhibitory ratio of synaptic activity in older pre-existing DGCs situated in the outer dentate granule cell layer (i.e., those generated during embryonic development; dDGCs) in control mice, an effect that was blunted in PAE mice. These findings indicate distinct electrophysiological responses of hippocampal DGCs to behavioral challenge based on cellular ontogenetic age, and suggest that PAE disrupts EE-mediated changes in overall hippocampal network activity. These findings may have implications for future therapeutic targeting of hippocampal dentate circuitry in clinical FASD. © 2016 Wiley Periodicals, Inc.

An Update on Fetal Alcohol Syndrome-Pathogenesis, Risks, and Treatment.

Alcohol is a well-established teratogen that can cause variable physical and behavioral effects on the fetus. The most severe condition in this spectrum of diseases is known as fetal alcohol syndrome (FAS). The differences in maternal and fetal enzymes, in terms of abundance and efficiency, in addition to reduced elimination, allow for alcohol to have a prolonged effect on the fetus. This can act as a teratogen through numerous methods including reactive oxygen species (generated as by products of CYP2E1), decreased endogenous antioxidant levels, mitochondrial damage, lipid peroxidation, disrupted neuronal cell-cell adhesion, placental vasoconstriction, and inhibition of cofactors required for fetal growth and development. More recently, alcohol has also been shown to have epigenetic effects. Increased fetal exposure to alcohol and sustained alcohol intake during any trimester of pregnancy is associated with an increased risk of FAS. Other risk factors include genetic influences, maternal characteristics, for example, lower socioeconomic statuses and smoking, and paternal chronic alcohol use. The treatment options for FAS have recently started to be explored although none are currently approved clinically. These include prenatal antioxidant administration food supplements, folic acid, choline, neuroactive peptides, and neurotrophic growth factors. Tackling the wider impacts of FAS, such as comorbidities, and the family system have been shown to improve the quality of life of FAS patients. This review aimed to focus on the pathogenesis, especially mechanisms of alcohol teratogenicity, and risks of developing FAS. Recent developments in potential management strategies, including prenatal interventions, are discussed.