For every child born with full-blown FAS, as many as ten more may be born with milder degrees of alcohol-related damage. These are often referred to as fetal alcohol effects or fetal alcohol spectrum disorders, says Dr. Diane Ashton, MD, associate medical director of the March of Dimes. "These are kind of partial manifestations of FAS. Sometimes these manifest themselves as learning difficulties, poor school performance, poor impulse control, or problems with organ development."
FAS was first identified in 1973. In 1981, the US Surgeon General issued an advisory that suggested that pregnant women limit the amount of alcohol that they drink. By now, most women are aware that heavy drinking during pregnancy can harm their baby. However, recent research has found alcohol-related effects resulting from much smaller amounts than were previously thought to be harmful. "Of course, if you drink heavily or binge drink you're at a greater risk for your baby suffering the adverse effects of alcohol use during pregnancy," says Dr. Mengel, "but even lower-level drinking has been shown to cause adverse effects."
In one study, children whose mothers drank as little as once per week during pregnancy were more likely to have behavior problems at six and seven years of age than children of non-drinkers. Another recent study showed that the offspring of rhesus monkeys given the equivalent of one to two drinks per day during pregnancy had permanent changes in their dopamine systems (a component of the central nervous system that helps to regulate many areas of the brain).
Complicating the issue further, different bodies metabolize alcohol in different ways depending on their genetic makeup, says Dr. Ashton. So what might be a safe amount of wine for one pregnant woman could be dangerous for another.
Awareness is Evolving
Cara Stevens is pregnant with her second child, and she's abstaining from alcohol until after the baby is born. However, she did ask her doctor about it. "The response was, 'If you are going to drink, a glass here and there is OK, but never more than that'," says Stevens, of Baton Rouge, Louisiana.