THERE has been concern since antiquity that the ingestion of alcohol by the pregnant woman could damage her unborn child. Modern scientific warnings about gestational alcoholism began with Sullivan in 1899,1 Rouquette in 1957,2 and Lemoine et al in 1967,3 who all noted the increased rates of stillbirth, growth deficiency, and malformations among the offspring of alcoholic women. Alcohol teratogenesis was brought to widespread public attention by Jones et al4 in 1973. These authors believed that alcohol could produce a specific recognizable pattern of malformation, which they termed "fetal alcohol syndrome" (FAS). Over the last eight years, maternal consumption of alcohol has become recognized through extensive human and animal studies as a major fetal health hazard—a leading known cause of mental retardation.
Variability in phenotype occurs in most dysmorphic syndromes. By clinical appearance alone, both false-positive and false-negative cases are found in conditions that