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Review
. 2023 Dec 20;11(1):5.
doi: 10.3390/children11010005.

Fetal Alcohol Spectrum Disorders and Inadequacy of Care: Importance of Raising Awareness in Clinical Practice

Sigita Lesinskienė  1 , Emilijus Žilinskas  2 , Algirdas Utkus  3 , Rūta Marčiukaitytė  2 , Gabrielė Vasiliauskaitė  2 , Rugilė Stankevičiūtė  2 , Odeta Kinčinienė  4
Affiliations
Review

Fetal Alcohol Spectrum Disorders and Inadequacy of Care: Importance of Raising Awareness in Clinical Practice

Sigita Lesinskienė et al. Children (Basel). .

Abstract

Prenatal alcohol exposure is one of the major avoidable causes of developmental disruption and health abnormalities in children. Fetal alcohol spectrum disorders (FASDs), a significant consequence of prenatal alcohol exposure, have gained more attention recently. This review aims to provide a narrative approach to the scientific literature on the history, clinical presentation, diagnosis, and management of FASDs. A literature search in PubMed, ScienceDirect, and Google Scholar online databases was conducted. The dates of publications ranged from 2000 to 2023. FASD presentations tend to persist into adulthood, which, combined with environmental factors, potentially lead to secondary psychosocial problems and disabilities. This review covers different aspects of FASDs regarding the concept of the umbrella term and public health, somatic, and psychiatric perspectives. FASD management remains an obstacle to health professionals, and mental health problems are underestimated. Its management involves a multi-disciplinary team, which varies according to the patient's individual needs. FASD diagnosis and management have not been sufficiently established and tailored. Stigma, cultural contexts, knowledge gaps, and the heterogeneity of clinical manifestations are significant barriers to an accurate diagnostic process. Further development of early interventions and the elaboration of complex treatment approaches are needed.

Keywords: fetal alcohol spectrum disorders; fetal alcohol syndrome; prenatal alcohol exposure.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Proposed pathway of biopsychosocial consequences of FASDs. Alcohol has direct teratogenic effects on the fetal nervous system. Strengthened by a negative environment in childhood, the latter neurobehavioral consequences may lead to one’s maladaptive functioning (such as difficulties in communication, daily living skills, and socialization). Children with FASDs face difficulties at school and suffer from other diseases, such as ADHD. This leads to negative social consequences such as unemployment, alcohol and drug abuse, and problems with the law.
Figure 2
Figure 2
Difficulties in assessment of prenatal alcohol exposure (PAE), diagnosis of FASDs, and post-diagnosis care.
See this image and copyright information in PMC

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