Criteria for designation of fetal alcohol syndrome:
(1) 4 or more facial features (facial score >= 4)
(2) evidence of growth retardation
Facial features:
(1) broad nasal bridge: palpable widening of the nasal bones
(2) depressed nasal bridge: significant depression of the nasal bridge to the level of the eyes seen on a lateral view
(3) anteverted nares: increased exposure of the nostrils from pulling up of the nasal tip
(4) long vertical upper lip: increased distance between the base of the nasal septum and the vermilion
(5) hypoplastic philtrum: flattened or absent lateral ridges of the philtrum (the vertical groove in the median portion of the upper lip)
(6) thin vermilion: narrowing of the pigmented region of the upper lip
facial score =
= number of facial features present
Evidence of growth retardation: one or more of the following 2 SD or more below the mean for gestational age and gender:
(1) birth weight
(2) birth length
(3) head circumference
