Worldwide FAS affects an estimated 0.097% of live babies born each year¹. The UN estimates births for 2003 to be 128.6 million which gives us the figure of 127,742. This is comparable and on occasion greater than worldwide rates of Down Syndrome and Spina Bifida. ARND and ARBD affect nearly 1% of children born each year² or over one and a quarter million children. Alcohol and it's abuse is a widely used teratogen (something that causes birth defects) and it is estimated that up to 60% women drink alcohol at some point during pregnancy. Roughly 20% of those women have babies that are affected by that drinking in some way³. That's 12% of world-wide births or aproximately 15.4 million estimated for 2003.

What do these acronyms stand for?

FAS

FAS stands for Fetal (or Foetal) Alcohol Syndrome. A mother drinking while pregnant does not always result in a child with FAS, although there is no known safe level of alcohol consumption during pregnancy (see last paragraph). Most of the children and subsequent adults affected by alcohol exposure before birth do not have the physical facial abnormalities and growth retardation identified with FAS (“dysmorphic” or asymmetrical malformations of the face, the eye, and the ear and significantly low birth weight and growth ), yet they have brain and other impairments that are just as significant. So from that point we get the further definitions:

ARND

ARND stands for alcohol-related neurodevelopmental disorder which is evidence of central nervous system dysfunction or simply put, a change in brain function. People who have been affected may have a pattern of behavioral and learning problems, including difficulties with memory, attention and judgment. There may be mathematical deficiencies, difficulty with abstractions and problems with generalizing from one situation to another. They may demonstrate poor attention and concentration skills, memory deficits, and impaired judgment, comprehension, and abstract reasoning. Hyperactivity and impulsive behaviour are common. There can have social conduct problems such as lying, stealing, stubbornness, and argumentative behavior as common traits. Lack of social functioning can be common in addition to failure to consider consequences for actions. Often there is lack of response to appropriate social cues, the inability to form two-way friendships, the seeking of social isolation, sullenness, moodiness, teasing and bullying. Various aspects of these symptoms or even all of them are present even into adulthood. All these symptoms can exibit themselves without any outward physical deformity, since well less than half of those affected have few or no facial or physical abnormalities. However a large percentage do, which brings us to the next definition.

ARBD

ARBD stands for alcohol-related birth defects. This is generally held to include deformed facial features, prenatal, and postnatal growth abnormalities along with mental retardation. Approximately 80% of children with FAS have microcephaly (basically a small head, whether pronounced or subtle) and behavioral abnormalities which may not be immediately or physically apparent. As many as 50% of affected children also exhibit identifiable facial anomalies, such as facial distortions, cleft palate, and micrognathia, which is a underdeveloped lower jaw that can lead to dental problems later in life. Heart defects, hemangiomas (birth marks or skin discolouration) and eye or ear abnormalities are also common (unusual skin growths or discolourations).

How common is all this and should we be concerned? Taking Canada as an example, some of that country's statistics are not far from the world-wide average, although some northern regions and some aboriginal groups have a much higher instance than the rest of the world, as high as 0.7%.⁴ In fact those communities allowed for a more controled environment for statistical analysis due to their isolation.

Only 0.2% of Canadian babies are born each year with Fetal Alcohol Syndrome⁵. One percent of Canadian babies per year are born with Alcohol Related Neurodevelopmental Disorder⁶. However, the comprehensive lifetime cost of just one baby with FAS could be as much as $6 million CDN ($4 million US, £ 3 million UK). The cost to Canadian taxpayers for Fetal Alcohol Syndrome is estimated to be $300 million CDN ($200 million US, £145 million UK) each year⁷. In addition there is the unseen cost of the significant segment of the population who have minor or undiagnosed symptoms of this syndrome.

FASD

Internationally the statistics are equally alarming. In the UK the dangers are well known. More commonly known there as the total of all three disorders, Foetal Alcohol Spectrum Disorder or FASD it is estimated to have a prevalence of around 1 in 300. With 621,469 births in England and Wales alone in 2003 that makes 186,441 children affected. The UK site that statistic came from is full of more information.

HOW MUCH ALCOHOL IS SAFE DURING PREGNANCY?

In 1997 the Royal College of Obstetricians and Gynaecologists conducted a large study including 400,000 American women, all of whom had consumed alcohol during pregnancy. Not a single case of fetal alcohol syndrome occurred and no adverse effects on children were found when consumption was under 8.5 drinks per week⁸. Note, however that this was a study of FAS and not FASD. There is no "magic number" for amount consumed other than a few generally agreed on rules. Negative effects appear to be related to higher blood alcohol content levels (greater consumption in single instances)⁹. It appears to be very important never to consume more than one drink in any one day while pregnant and that in fact is the reccomendation of both the Royal College of Obstetricians and Gynaecologists in the UK, the Institute of Medicine of the National Academy of Sciences in the US, and the Centre on Substance Abuse in Canada. In addition it is generally agreed that the first trimester is the most dangerous for consumption. It should be noted that several other organisations like some Midwife organisations¹⁰ and individual doctors' groups¹¹ reccomend abstention.