Fetal Alcohol Spectrum Disorder: Risk for Diabetes and Congenital Heart Defects
Excessive use of alcohol can be a cause for many disease and injury conditions. These include amongst many others, myocardial infarction, diabetes mellitus, atrial fibrillation, nonischaemic cardiomyopathy, fetal alcohol spectrum disorder (FASD), congenital heart defects (CHD) and liver cirrhosis. Even low levels of prenatal alcohol ethanol) exposure, such as in a single dose, can produce birth defects termed fetal alcohol syndrome (FAS) which is the highest marker on the spectrum. Diabetes is regarded as a major cause of cardiovascular disease whilst prenatal alcohol exposure (PAE) can range from no observable adverse effects to mortality. CHD are stated to be the most prevalent cause of mortality in individuals with FASD. The dimension of the problems is still greatest in the Western world although it is stated to be the leading cause of mental retardation in North America. FASD is a neurodevelopmental disability which can be occasioned when a pregnant woman consumes alcohol. The diagnostic criteria for FASD includes growth impairment, abnormal facial features and neurocognitive impairments. The most frequently reported abnormal facial features in FASD are thin upper lip, indistinct or smooth philtrum and short palpebral fissure length. Other features are microganthia, low set ears, ptosis, absent or indistinct philtral ridge, epicanthal folds, cleft palate, flat nasal bridge and midface hypoplasia. The neurocognitive features commonly reported in FASD are microcephaly, intellectual disability, attention-deficit hyperactivity disorder (ADHD) and behavioural impairments. Central nervous system (CNS) injury is also seen and is debilitating. Structural abnormalities of the CNS can include microcephaly, agenesis/absence of the corpus callosum and multiple severe brain malformations. This review article seeks to address the association of FASD with diabetes and CHD.