Fetal alcohol spectrum disorders are caused by drinking alcohol during pregnancy.[1] Surveys from the United States have found about 10% of pregnant women have drunk alcohol in the last month, and 20% to 30% drank at some point during the pregnancy.[10] About 3.6% of pregnant American women are alcoholics.[11] The risk of problems depends on the amount consumed and the frequency of consumption as well as when during pregnancy the alcohol is consumed.[10] Other risk factors include an older mother, smoking, and poor diet.[12][10] There is no known safe amount or safe time to drink during pregnancy.[1][13] While drinking small amounts of alcohol does not cause abnormalities in the face, it may cause behavioral issues.[11] Alcohol crosses the blood–brain barrier and both directly and indirectly affects a developing baby.[14] Diagnosis is based on signs and symptoms in the person.[1]