Fetal alcohol spectrum disorders: an overview of current evidence and activities in the UK

Abstract

Estimates for the UK suggest that alcohol consumption during pregnancy and prevalence of fetal alcohol spectrum disorder (FASD)—the most common neurodevelopmental condition—are high. Considering the significant health and social impacts of FASD, there is a public health imperative to prioritise prevention, interventions and support. In this article, we outline the current state of play regarding FASD knowledge and research in the UK, which is characterised by a lack of evidence, a lack of dedicated funding and services, and consequently little policy formulation and strategic direction. We highlight progress made to date, as well as current knowledge and service gaps to propose a way forward for UK research.

Review of evidence for environmental causes of uveal coloboma

“…Maternal alcohol consumption during pregnancy is associated with a range of both physical and neuropsychologic deficits, called fetal alcohol spectrum disorder. Altered neurologic development is most associated with this disorder, and though they are less common, growth retardation and characteristic facial abnormalities, including smooth philtrum, thin upper lip, and shortened palpebral fissures, can also be present 121,158 . Children with this disorder can therefore present with a wide variety of findings ranging from mild cognitive impairment to significant physical and neurologic impairment.…”

A brief overview of fetal alcohol syndrome for health professionals

“…British Medical Association (2007b) suggest that the reason for this is complex and suggest the following: (Table 1) In the UK, there have been several estimates of children with FASD ranging from 3.2% (Wise, 2019) to 6.0% -17% (May et al, 2015. It has also been stated that there are no reliable estimates of prevalence of FASD in the UK (Schölin et al, 2021b). Alcohol use in women during pregnancy within the UK may provide some indication of the incidence of FASD, however these figures are also not seen as fully representative, as they are commonly reliant on self-reporting (Mukherjee et al, 2013).…”

“…Alcohol exposure in the second and third trimesters can result in ongoing damage to the brain (Popova et al, 2017). Recent government advice reflects the evidence base (Schölin, 2021b), the current advice from the Chief Medical Officer is no alcohol during pregnancy (Department of Health, 2016). However, an unplanned or undetected pregnancy could result in the woman not being aware that she is pregnant and therefore unknowingly expose the fetus to alcohol (Schölin et al, 2021b).…”

“…Fetal Alcohol Syndrome affects individuals and families in a variety of ways including neurological (Lamb, et al, 2019) social (Lees at al, 2021) and physical complications (May et al, 2015), it is important to raise awareness, consider preventative strategies, and the possibility of mitigating further damage (Stade et al, 2009). Prevalence of FASD is difficult to determine (Schölin et al, 2021b).…”

Prevalence of Fetal Alcohol Spectrum Disorder (FASD) in Greater Manchester, UK: an active case ascertainment study

“…Where a UK cohort with high levels of exposure (79% of mothers drank during the pregnancy, with 25% at binge levels) was used, 6–17% of children screened positive for features of FASD (McQuire et al, 2019). However, the lack of direct evidence of prevalence contributes to under-investment in diagnostic, treatment and prevention services (Scholin et al, 2021).…”