Challenges in the Clinical Management of Fetal Alcohol Spectrum Disorders (FASD): An Updated Review
DOI:
https://doi.org/10.12775/JEHS.2026.88.68705Keywords
FASD, prenatal alcohol exposure, neurodevelopmental disorders, executive functions, early interventionAbstract
Background: Fetal Alcohol Spectrum Disorder (FASD) remains one of the leading preventable causes of developmental disabilities and intellectual impairment worldwide. Despite its high prevalence, especially in the European region, it is frequently underdiagnosed or misidentified due to its complex clinical presentation and phenotypic overlap with other neurodevelopmental conditions.
Aim: The aim of this paper is to provide a comprehensive review of the current literature on fetal alcohol spectrum disorders (FASD), with particular emphasis on neurobiological mechanisms, diagnostic challenges and contemporary therapeutic strategies. The paper aims to systematise knowledge about clinical differences within the spectrum and to identify key factors influencing patient prognosis.
Material and Methods: The PubMed, Google Scholar and Scopus databases were analysed using the keywords: ‘FASD’, ‘fetal alcohol syndrome’, ‘pathophysiology’, “diagnosis” and ‘intervention’. The literature search was updated in January 2026 to include the most recent clinical guidelines and neurodevelopmental research.
Twenty-five English-language bibliographic items were included in the review, including meta-analyses, systematic reviews and current clinical guidelines.
Results: The analysis showed that prenatal alcohol exposure leads to permanent structural changes in the brain through oxidative stress and epigenetic disorders, resulting in profound deficits in executive functions. It was found that standardised coding systems significantly increase the accuracy of differential diagnosis in relation to ADHD and other neurodevelopmental disorders.
Conclusions: Early identification of disorders and the implementation of multidisciplinary support before the age of 6 are crucial for minimising the secondary effects of FASD. Total abstinence by pregnant women remains the only effective method of prevention, requiring ongoing public education.
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