Fetal alcohol spectrum disorders and their persisting sequelae in adult life

INTRODUCTION: The present review describes the different variants of Fetal Alcohol Spectrum Disorders (FASD) as a consequence of maternal alcohol abuse during pregnancy. According to international findings, some 3000 to 4000 affected newborns may be expected annually in Germany. Detection of these individuals in clinical practice is insufficient. METHOD: Selective review of the literature and report of own findings based on longitudinal studies. RESULTS: Key features of FASD are short stature, microcephaly, various dysmorphic features, in severe cases amongst others consisting of congenital heart disease and dysplasias of the skeleton and urogenital system, varying degrees of developmental delay including mental retardation, and a positive history of maternal alcohol abuse during pregnancy. Longitudinal studies in young adulthood show that independent of the severity of FASD the key features remain associated with limitations of an independent life-style. DISCUSSION: Pathogenesis of FASD is not sufficiently clear and there is no causal treatment. Thus, besides prevention and information, early diagnosis, installation of fostering or adoption, and intensive psychosocial care including selection of appropriate schooling, occupational counselling and supportive care in adulthood are mandatory.