Fetal alcohol syndrome: a review for Texas physicians.

Fetal alcohol syndrome (FAS) is commonly believed to be the leading known cause of mental retardation in the United States, although surveillance at state and national levels is problematic. The most serious consequence of fetal alcohol exposure is central nervous system (CNS) dysfunction. While the facial features of FAS become more subtle with age, growth deficits and, particularly, the CNS impairment appear to be permanent. Among factors that affect the risk and severity of fetal alcohol damage are the timing of the alcohol exposure, binge drinking that produces high blood alcohol concentrations, polydrug use, and genetic variations. From various studies, the incidence of FAS ranges from 0.2 to 3.0 affected birth per 1000 live births. The methods of measuring FAS occurrence are fraught with difficulties and inaccuracies, as are surveys of alcohol use by women during pregnancy. Still, indirect studies both in Texas and the United States suggest that the occurrence of FAS is increasing. A first, important step to reducing the incidence of FAS and related problems is to increase the awareness of physicians and other health care providers about the issues of FAS diagnosis, prevention, and treatment. Referral and information resources about FAS are provided.