2. Foetal alcohol spectrum disorder
(FASD)
• It is known that prenatal exposure to alcohol can cause
abnormalities in the child (Mattson & Riley, 1998).
• Alcohol easily passes the placental barrier. It is considered that the
early stages of pregnancy are the most damaging to the foetus
(Heather, 2001).
• FASD is distinguished by facial and cranial deformities, intellectual
disability and behavioural problems such as hyperactivity (Knight,
2001) .
• There is also a risk of stillbirth (RCOG, 2015).
3. FASD advice
• NICE guidelines and the Royal College
of Obstetricians & Gynocologists (RCOG)
recommend that the mother should remain
abstinent throughout the pregnancy,
but especially in the first 3 months
(NICE 2008; RCOG 2015).
• Government guidelines in 2016 advised no
alcohol during pregnancy or if planning
a pregnancy (DH 2016).
• The early stages are the most sensitive
so this has implications for mums-to-be
before they realise they are pregnant.
4. FASD advice for service users
• The Government guidance advises women to avoid alcohol during
pregnancy to avoid any health risks to the unborn child (DH 2016).
It also advises women considering becoming pregnant to avoid
alcohol.
• “The risk of harm to the baby is likely to be low if a woman has
drunk only small amounts of alcohol before she knew she was
pregnant or during pregnancy” (DH 2016:5)
• People who have problems with their drinking should be advised to
aim for abstinence or at least a reduction of their intake. They are
likely to need support to do so.
5. Other problems associated with
alcohol use and pregnancy
(BMA 2007)
• Infertility - a decreased chance of becoming pregnant
• Miscarriage – alcohol consumption is associated with an increased
risk of miscarriage
• Sudden infant death syndrome - prenatal alcohol exposure may be
associated with an increased risk SIDS
• Pre-term deliveries and stillbirth –
– A high level of maternal alcohol consumption in early and late
pregnancy is associated with pre-term labour.
– Low-to-moderate levels are associated with an increased risk of
stillbirth.
6. Engaging and maintaining women
with problematic alcohol use
(Goodman, 2009)
• It is important to ensure that pregnant women keep in touch with
health and social care services.
• They will need the support and the health checks available,
especially from antenatal services.
• Women with problematic substance use are likely to feel judged and
fear that the baby will be taken away.
• Therefore it is vital that they feel supported and engaged in a
partnership with the practitioner, working towards the goal of a
healthy mum and baby.
7. References
British Medical Association (2007) Fetal Alcohol Spectrum Disorders. BMA Board of Science.
Department of Health (2016) UK Chief Medical Officers’ Alcohol Guidelines Review. Summary
of the proposed new guidelines. Available online at:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/489795/summary
.pdf
Goodman (2009) Social work with Drug and Substance Misusers. Exeter, Learning Matters.
Heather, N. (2001) Int. Handbook of Alcohol Dependence and Problems. Wiley, Chichester.
Knight, R (2001). Neurological consequences of alcohol use. In: Heather (op cit).
Mattson & Riley (1998) A review of the neurobehavioural deficits in children with fetal alcohol
syndrome or prenatal exposure to alcohol. Alcoholism: Clinical & Experimental Research. 22;
279-294.
NICE (2008) Ante Natal Care. CG62. available at:
http://www.nice.org.uk/guidance/cg62/chapter/1-recommendations#lifestyle-considerations
RCOG (2015) Information for you: Alcohol & Pregnancy. Available at:
https://www.rcog.org.uk/globalassets/documents/patients/patient-information-
leaflets/pregnancy/pi-alcohol-and-pregnancy.pdf
