Prevention of alcohol abuse-related birth effects--I. Public education efforts.

Maternal alcohol abuse during pregnancy can result in a pattern of anomalies in children called 'fetal alcohol syndrome' (FAS) and more recently, 'fetal alcohol abuse syndrome (FAAS)'. FAAS as well as individual alcohol-related anomalies, called 'alcohol abuse-related birth effects' (AARBEs), are widely considered to be totally preventable, because they stem from a behaviour that is presumably modifiable. However, current strategies to reduce their occurrence are more palliative than preventive, because their underlying premise, viz. that raising public awareness of the potential dangers of commonly used substances such as alcohol is enough to reduce their use, lacks empirical support. Moreover, in some cases they are also counter-productive. After considering the relevant literature, this review contends that 'universal' public education efforts will only be effective in reducing FAAS and AARBEs if they focus on the cause of these disorders, which is alcohol abuse rather than the currently open-ended message that any amount of alcohol consumption during pregnancy constitutes a danger to an unborn child. This argument lays the ground work for an alternative and more pragmatic strategy set forth in the following paper for preventing FAAS and AARBEs.