February 07, 2018
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Up to 5% of first graders may have fetal alcohol spectrum disorders

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Christina Chambers

It is estimated that the prevalence of fetal alcohol spectrum disorders — which include fetal alcohol syndrome, partial fetal alcohol syndrome and alcohol-related neurodevelopmental disorder — in first graders falls between 1.1% and 5% in four regions within the United States.

“If children are affected by prenatal alcohol, there can be measurable effects in cognitive and/or behavioral performance [by the time they reach first grade],” Christina Chambers, PhD, MPH, from the department of pediatrics at the University of California, San Diego, told Infectious Diseases in Children.

To determine how common fetal alcohol spectrum disorders are in first graders within four regions of the U.S., the researchers conducted a study in which they implemented active case ascertainment methods with a cross-sectional design. The prevalence of fetal alcohol spectrum disorders between 2010 and 2016, as well as factors that contribute to the continuum — including dysmorphic features, physical growth, neurobehavioral development and exposure to alcohol during pregnancy — were examined.

All children were located within the Rocky Mountain, Midwestern, Southeastern and Pacific Southwestern regions of the U.S.

Fetal alcohol spectrum disorders may affect between 1.1% to 5% of American children.
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Of the 6,639 children who participated in the study in the study, 222 were recognized as having a fetal alcohol spectrum disorder.  When conservative prevalence estimates were calculated, rates were observed between 11.3 (95% CI, 7.8-15.8) and 50.0 (95% CI, 39.9-61.7) per 1,000 children. Weighted prevalence estimates revealed a range between 31.1 (95% CI, 16.1-54.0) and 98.5 (95% CI, 57.5-139.5) per 1,000 children.

“Pediatricians should be aware that fetal alcohol spectrum disorder is not uncommon and should consider routinely asking mothers of their patients about alcohol use during pregnancy. They should also be aware of steps for evaluation of a child who may be affected and possible interventions,” Chambers said. “Obstetricians should educate patients who have the potential to become pregnant or who are planning pregnancy to avoid alcohol and, at a minimum, not drink in a binge pattern. Once pregnant, the surgeon general’s advice to avoid alcohol entirely is still sound advice.” – by Katherine Bortz

Disclosures: The authors report no relevant financial disclosures.