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Nearly eight in 1,000 infants worldwide born with fetal alcohol spectrum disorder
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Globally, approximately 8 in every 1,000 infants are born with fetal alcohol spectrum disorder, with the highest prevalence noted in South Africa, Croatia and Ireland, according to a study published in JAMA Pediatrics.
Shannon Lange, MPH, from the Center for Addiction and Mental Health in Toronto, and colleagues suggest that there is a need to create a standardized public health initiative in which screening protocols and the harms of prenatal alcohol exposure are highlighted.
“In much of the world, no prevalence estimates of fetal alcohol spectrum disorder exist, which may influence prioritization of health care expenditures for care related to [the condition],” the researchers wrote. “Until recently, a meaningful estimate of FASD prevalence was not possible. However, the publication of more representative rates of prenatal alcohol exposure and improved data on the prevalence of FASD in some settings now allows for estimates of FASD globally.”
To estimate the prevalence of FASD by country, WHO region and globally, the researchers gathered and analyzed original quantitative studies that assessed prevalence rates in the general population. All studies used active case ascertainment or clinic-based methods, in addition to clarifying the diagnostic guideline or case definition.
For data extraction, Lange and colleagues conducted country-specific random effects meta-analyses. Estimates for countries with one or no empirical studies were created through the ratio of pregnant women who consumed alcohol per one infant with FASD.
It was estimated through 24 unique studies, which assessed 1,416 unique children and youth diagnosed with FASD, that the global prevalence of the condition is 7.7 per 1,000 population (95% CI, 4.9-11.7 per 1,000). The highest prevalence was observed within the WHO European region (19.8 per 1,000 population; 95% CI, 14.1-28.0 per 1,000), and the lowest was within the WHO Eastern Mediterranean region (0.1 per 1,000 population; 95% CI, 0.1-0.5 per 1,000).
The countries with the highest prevalence rates included South Africa (111.1 per 1,000 population; 95% CI, 71.1-158.4 per 1,000), Croatia (53.3 per 1,000 population; 95% CI, 30.9-81.2 per 1,000), Ireland (47.5 per 1,000 population; 95% CI, 28.0-73.6 per 1,000), Italy (45.0 per 1,000 population; 95% CI, 35.1-56.1 per 1,000), and Belarus (36.6 per 1,000; 95% CI, 23.7-53.2 per 1,000).
“With the current level of awareness and extremely limited access to diagnostic services, very few of these affected children and youth will ever be diagnosed with FASD,” the researchers wrote. “As a result, the focus of care will often be on a comorbid condition —eg, attention-deficit/hyperactivity disorder or conduct disorder. This focus diminishes the likelihood of care organized around their developmental course, prevention of exposure in their younger siblings and anticipation of long-term impairments.” – by Katherine Bortz
Disclosure: The researchers report no relevant financial disclosures.
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