Fetal alcohol syndrome: Where is the biological father?

Fetal alcohol syndrome (FAS) is a subtype of fetal alcohol spectrum disorder that appears in developing fetuses due to maternal consumption of alcohol during pregnancy. Currently, there is no known safe time or level of alcohol consumption during pregnancy to prevent FAS (CDC, 2022). FAS probably is most known for its impact on facial morphology, resulting in symptoms like small eye opening, small head circumference, thin upper lip, and smooth philtrum. In addition, infants with FAS may have growth restrictions, with weight and height below the 10th percentile compared to their peers. Depending on which brain region it affects, FAS can also cause cognitive and neurological impairments such as impairments in movement coordination, memory, and learning. People with FAS also exhibit irritability in infancy and attention deficit hyperactivity disorder (ADHD) in childhood (Oei, 2020). Although there is no effective treatment for FAS patients to fully recover, FAS is preventable by maternal alcohol abstinence during pregnancy (CDC, 2022).

The above is a summary of FAS based on the CDC and the current research focus in the field. Does anything sound strange to you? You might be thinking: where is the biological father? The concept of “during pregnancy” does not only include the time after conception but starts even months before conception (Abel, 2022). There is emerging research evidence showing that during this long timespan, not only maternal but also paternal prenatal alcohol consumption also leads to symptoms of FAS.

DAN methylation is a type of epigenetic change that changes the activity of a DNA segment without changing the sequence (Liyanage & Harding, 2019). Different studies have shown a relationship between an abnormal level of dopamine transporters (DAT), maternal alcohol consumption, and the risk of ADHD in children (Brookes et al., 2006). One study recruited 164 pairs of pregnant women and their spouses to fill out questionnaires regarding their alcohol intake history  (Lee et al., 2015). Based on their answer, these pairs were further divided into four groups: nondrinkers as the control group, father drinkers only, mother drinkers only, and parent drinkers. Data about the relative methylation changes of DAT gene promoters were collected from peripheral blood and cord blood DNA. Researchers found that fathers who reported heavy binge drinking had a decreased relative methylation level of the DAT promoter. In addition, infants whose fathers reported heavy binge drinking also had a decreased relative methylation level of the DAT promoter. These results indicate that prenatal alcohol consumption among biological fathers can not only impact fathers themselves but also pass on to infants, which might lead to ADHD symptoms in children with FAS.

Another study established a chronic alcohol drinking pattern among male rats for 70 days before the conception of abstinent females (Bedi et al., 2019). Results showed that compared to the control group, both female and male offspring had restricted fetal growth (e.g., fetal weight) and reduced placental efficiency at gestation day 16.5. This indicates that chronic paternal alcohol consumption could contribute to another symptom of FAS – – – growth restriction. The above are just two studies targeting a small subset of symptoms of FAS. Although more researchers also investigated the relationship between other FAS symptoms and paternal alcohol consumption during pregnancy, this body of literature is still very limited. In the future, more longitudinal studies recruiting human participants will help examine whether FAS symptoms will attenuate as children grow older. It is crucial for the field to look beyond the maternal role and also put the effort into investigating the role of biological fathers on FAS. Hopefully, people will stop thinking or saying it is all “the mother’s fault” when encountering the concept of FAS.


Abel, E. L. (2022). Fetal Alcohol Syndrome: From Mechanism to Prevention. CRC Press.

Bedi, Y., Chang, R. C., Gibbs, R., Clement, T. M., & Golding, M. C. (2019). Alterations in sperm-inherited noncoding RNAs associate with late-term fetal growth restriction induced by preconception paternal alcohol use. Reproductive Toxicology, 87, 11–20. https://doi.org/10.1016/j.reprotox.2019.04.006

Brookes, K.-J., Mill, J., Guindalini, C., Curran, S., Xu, X., Knight, J., Chen, C.-K., Huang, Y.-S., Sethna, V., Taylor, E., Chen, W., Breen, G., & Asherson, P. (2006). A common haplotype of the dopamine transporter gene associated with attention-deficit/hyperactivity disorder and interacting with maternal use of alcohol during pregnancy. Archives of General Psychiatry, 63(1), 74–81. https://doi.org/10.1001/archpsyc.63.1.74

CDC. (2022). Basics about FASDs. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/fasd/facts.html

Lee, B.-Y., Park, S.-Y., Ryu, H.-M., Shin, C.-Y., Ko, K.-N., Han, J.-Y., Koren, G., & Cho, Y.-H. (2015). Changes in the methylation status of DAT, SERT, and MeCP2 gene promoters in the blood cell in families exposed to alcohol during the periconceptional period. Alcoholism, Clinical and Experimental Research, 39(2), 239–250. https://doi.org/10.1111/acer.12635

Liyanage, V., & Harding, K. (2019). Genetic and Epigenetic Perspectives on the Role of Fathers in Fetal Alcohol Spectrum Disorder.

Oei, J. L. (2020). Alcohol use in pregnancy and its impact on the mother and child. Addiction (Abingdon, England), 115(11), 2148–2163. https://doi.org/10.1111/add.15036

8 thoughts on “Fetal alcohol syndrome: Where is the biological father?

  1. Hi Maggie – great post! I loved how you proposed your own questions throughout the writing and ended with recommendations for further research. The post had a really great beginning, middle, and end, and was easy to follow. I was wondering if any of these studies considered other factors from the father that could affect infants as an indirect consequence of being heavy drinkers such as poor diet or less sleep etc.


    1. In this article, I learned that paternal prenatal alcohol consumption also leads to symptoms of FAS, whereas people always ignore that and only blame mothers for drinking that causes children’s FAS. We should definitely be aware of the role of fathers because it is not only the mother’s responsibility to take care of the children. I really liked this post because it tells very alarming and interesting facts!


  2. Hi Maggie, I really enjoyed your post and found it interesting how you incorporated evidence of other possible risks and factors of FAS. Prior to reading your post, I was unaware that there are paternal influences that can influence the onset of FAS. Your post was straightforward to follow, and I enjoyed reading your discussions and the evidence you provided. It was fascinating to learn how FAS can pose a risk to ADHD, but it made me wonder if any other disorders are at risk? I really enjoyed this post!


  3. I really enjoyed this post, as I have never considered the fathers role in FAS. I also really liked the style of the post, with the first paragraph giving facts on FAS according to the CDC, and then providing more information on how this FAS does not provide information on the father. One suggestion, however, would be to make this paragraph a little bit shorter. While I was reading through it, I was a little confused at first as to how this connected to psychology, just because of its length, but then realized once I moved onto the next paragraph. Overall, I enjoyed this post and the small imagery added to the information without taking any attention away too much.


  4. This is a super interesting article, as I did not realize that pregnancy and FAS were affected by factors before conception, or paternally. It is still unclear how often or close to the time of conception a father must drink in order to affect the wellness of the baby, so research into this would be very insightful. I was also a bit confused as to how dopamine transporter levels connect to all of this, as mentioned in the beginning, and if the mother’s behavior affects the DAT as well. Very interesting topic overall!


  5. Great post, Shuran! I like that you discussed a very understudied/underconsidered topic and you explain challenging concepts really well. Just a note, it would be good to explain how DNA methylation affects gene expression. It typically turns off the expression of genes.


  6. Hi Maggie! This was super interesting to read. It makes me wonder if research on paternal alcohol consumption is limited due to social expectations or stigmas. Just like the pill is made for women, all of the prenatal care expectations also fall on the women. I think it makes sense that the father’s behaviors and drug intake could affect the fetus and there should be more people researching this to promote healthy babies. I was also slightly confused on how gene expression is changed and to what rate. For example, is it only binge drinking that does this?


  7. Hi! I really enjoyed your post about a topic that is not well known or even considered by many people. Your introduction paragraph was a bit lengthy, but your post was straightforward and easy to follow. I am curious as if you were able to find any studies that examined the neurobiological changes of the brain as a consequence of paternal alcohol use?


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