This document discusses the need to expand the definition of fetal alcohol spectrum disorder (FASD) to include preconceptual alcohol exposure from both parents. Currently, the definition of FASD only considers prenatal alcohol exposure from the mother during pregnancy. However, recent research suggests paternal preconception alcohol use and other environmental toxins can also impact fetal development and increase vulnerability to stress and alcohol drinking behaviors later in life through epigenetic mechanisms. The document lists several relevant research papers that studied the effects of preconceptual exposures from both parents on offspring development, behavior, and health outcomes. There is a call to raise more awareness about how preconception lifestyle factors can influence fetal and child development.

1. Preconceptual alcohol
The impact of preconceptual alcohol on the developing fetus,
and subsequent adult, has only recently become a topic of
interest. Much more research is required.
The present definition of FASD does not include preconceptual
alcohol.
There is a need for a wider definition to include both prenatal
and preconceptual alcohol, with and without the synergistic and
enhancing effects of other environmental toxins. An example
would be Alcohol Related Developmental Disabilities, with
subgroups such as fasd, as presently defined.
Some relevant papers
1- Paternal contribution to fetal alcohol syndrome. DOI:
10.1080/13556210410001716980
2- Preconception Substance Use: A Call to Raise Awareness of
Potential Adverse
Effects. DOI: 10.4172/2155-6105.1000e108
3- Review Article
Influence of paternal preconception exposures on their offspring:
through epigenetics to phenotype.
Am J Stem Cells 2016 ;5(1):11-18
4- Prenatal Ethanol Exposure and Neocortical Development: A
Transgenerational Model of FASD.
Cereb Cortex. 2017 Jul 6:1-14. doi: 10.1093/cercor/bhx168.

2. 5- Preconception care: caffeine, smoking, alcohol, drugs and other
environmental chemical/radiation exposure.
doi: 10.1186/1742-4755-11-S3-S6
6- Preconception Alcohol Increases Offspring Vulnerability to Stress.
Neuropsychopharmacology 41, 2782–2793 (2016)
7- Fathers’ Role in Alcohol-Exposed Pregnancies. DOI:
https://doi.org/10.1016/j.amepre.2016.02.009
8- Paternal Preconception Chronic Variable Stress Confers
Attenuated Ethanol Drinking Behavior Selectively to Male
Offspring in a Pre-Stress Environment Dependent Manner. doi:
10.3389/fnbeh.2018.00257
9- Paternal Preconception Every-Other-Day Ethanol Drinking Alters
Behavior and Ethanol Consumption in Offspring.
doi:10.3390/brainsci9030056
10- Genetic and Epigenetic Perspectives on the Role of
Fathers in Fetal Alcohol Spectrum Disorder
Vichithra Liyanage-Zachariah, PhDa; Kelly Harding, PhDa