S. Surgeon General issued the first health advisory recommending that women who are pregnant or planning a pregnancy should not drink alcohol, and this advisory was repeated in 1990 and 1995.
At the extreme end of the spectrum of prenatal exposure effects, FAS is a clinical diagnosis applied to children who have been exposed to alcohol during gestation and exhibit deficits in growth, physical structure (i.e., morphology), and the central nervous system (CNS). To meet the clinical case definition, the child must have symptoms in each of the following three categories: (1) growth deficiency in both the prenatal and postnatal periods: (2) abnormalities in facial and skull structure, including small eye openings (i.e., short palpebral fissures), alterations in nose and forehead structure, an absent or elongated groove between the upper lip and nose (i.e., philtram), a thin upper lip, a flattened midface, and underdevelopment of the upper or lower jaw; and (3) CNS deficits, such as mental retardation and behavioral problems (Sokol and Clarren 1989). Of these symptoms, the facial abnormalities are the most characteristic of FAS, whereas the CNS anomalies have the most significant effect on overall development. Separately, each of these features is defined as an alcohol-related birth defect (ARBD) or a fetal alcohol effect.
The features associated with FAS may change with age, complicating the diagnosis. Before age 2, CNS dysfunction is diffic