Prevalence of Fetal Alcohol Spectrum Disorders in 4 US Communities

May, Philip A.; Chambers, Christina D.; Kalberg, Wendy O.; Zellner, Jennifer; Feldman, Haruna S.; Buckley, David; Kopald, David; Hasken, Julie M.; Xu, Ronghui; Honerkamp‐Smith, Gordon; Taras, Howard; Manning, Melanie A.; Robinson, Luther K.; Adam, Margaret P; Abdul‐Rahman, Omar; Vaux, Keith K.; Jewett, Tamison; Elliott, Amy J.; Kable, Julie A.; Akshoomoff, Natacha; Falk, Daniel E.; Arroyo, Judith A.; Hereld, Dale; Riley, Edward P.; Charness, Michael E.; Coles, Claire D.; Warren, K. S.; Jones, Kenneth Lyons; Hoyme, H. Eugene

doi:10.1001/jama.2017.21896

Cited by 602 publications

(301 citation statements)

References 27 publications

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“…Alcohol, tobacco, and illicit drugs are preferably avoided since maternal use is associated with increased risk of pregnancy complications and poor infant outcomes . Recent findings have demonstrated the underestimation of the prevalence of fetal alcohol spectrum disorders, as well as the negative effects of even low alcohol intake during pregnancy on the craniofacial development of newborns . With regard to preconception intake of folic acid, previous studies have shown that prevalence estimates might differ between different pregnant populations …”

Section: Introductionmentioning

confidence: 99%

Health products’ and substance use among pregnant women visiting a tertiary hospital in Belgium: A cross‐sectional study

Ceulemans

Calsteren

Allegaert

et al. 2019

Pharmacoepidemiology and Drug

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Purpose To investigate the prevalence and type of health products used among pregnant women visiting a tertiary hospital in Belgium, as well as who advises these products, where women buy these products, which determinants are associated with medication and pregnancy vitamin intake, and preconception lifestyle changes such as folic acid intake and substance use. Methods A cross‐sectional study was performed at the outpatient obstetrics clinics of the University Hospital Leuven, Belgium between November 2016 and March 2017. All pregnant women 18 years and older and understanding Dutch, French, or English were asked to participate in an online survey. Results In total, 379 pregnant women participated. Prevalence of medication use during the preceding week was 52%. Paracetamol (14%), levothyroxine (13%), and antacids (9%) were the most frequently used medicines. Pregnancy vitamins were used by 86% of women, and 97% had used a pregnancy vitamin somewhere during pregnancy. Only 56% initiated folic acid supplementation at least 1 month before pregnancy. Preconception use of folic acid among women following assisted reproductive technology was 73%. Inappropriate use of health products was observed among 3% of women. Prevalence of alcohol use and/or smoking during the preceding week was 6%. Alcohol and smoking cessation mainly occurred after pregnancy diagnosis. Conclusion Pregnant women living in Belgium frequently use medicines, pregnancy vitamins, and other health products. Preconception lifestyle changes such as folic acid intake and alcohol and smoking cessation are poorly implemented. Public campaigns and interventions are needed to improve preconception care and counselling.

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Section: Introductionmentioning

confidence: 99%

Health products’ and substance use among pregnant women visiting a tertiary hospital in Belgium: A cross‐sectional study

Ceulemans

Calsteren

Allegaert

et al. 2019

Pharmacoepidemiology and Drug

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“…A very recent prevalence study in the general US population provided a conservative estimate of 11.3–50 per 1000 children . The prevalence rate of FASD amongst the general population in Australia is currently unknown.…”

Section: Prevalencementioning

confidence: 99%

Responding to fetal alcohol spectrum disorder in Australia

Shelton

Reid

Till

et al. 2018

J Paediatrics Child Health

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Fetal alcohol spectrum disorder (FASD) is a significant public health issue in Australia that is poorly diagnosed, chronic and costly. FASD is a diffuse acquired brain injury secondary to prenatal alcohol exposure. The prevalence rate of FASD among the general population in Australia is currently unknown; however, an Australian study in a selected high‐risk population reported some of the highest rates of FASD in the world. A common misconception among clinicians is that a child must have ‘the face’ of FASD to have the disorder. This is incorrect. The three sentinel facial features only occur in the minority of individuals with FASD. FASD should be considered as a ‘whole body’ disorder as increased susceptibility to chronic health problems suggests suboptimal in utero environments places the individual at risk of later disease. Clinicians are reluctant to consider FASD as a possible diagnosis because of the concern of inducing stigma; however, this concern is neither supported by the evidence nor patient stories. The Australian Guide to the Diagnosis of FASD is now available to assist health professionals in providing timely and accurate diagnoses, which can lead to improved outcomes via evidence‐based intervention and is an important first step in future prevention.

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“…Fetal alcohol spectrum disorders (FASD) encompass the range of physical, cognitive, and behavioral deficits due to prenatal alcohol exposure. Recent estimates suggest a prevalence of ~2–5% among school-age children (May et al, 2014; May et al, 2015; May et al, 2018), identifying FASD as a serious public health concern.…”

Section: Introductionmentioning

confidence: 99%

Executive Functioning Correlates With Communication Ability in Youth With Histories of Heavy Prenatal Alcohol Exposure

Doyle

Moore

Coles

et al. 2018

J Int Neuropsychol Soc

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Objective: Caregivers of youth with heavy prenatal alcohol exposure report impaired communication, which can significantly impact quality of life. Using data collected as part of the Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CIFASD), we examined whether cognitive variables predict communication ability of youth with histories of heavy prenatal alcohol exposure. Method: Subjects (ages 10–16) comprised two groups: adolescents with heavy prenatal alcohol exposure (AE) and non-exposed controls (CON). Selected measures of executive function (NEPSY, D-KEFS), working memory (CANTAB), and language were tested in the child, while parents completed communication ratings (VABS-II). Separate multiple regression analyses determined which cognitive domains predicted communication ability. A final, global model of communication comprised the three cognitive models. Results: Spatial Working Memory and Inhibition significantly contributed to communication ability across groups. Twenty Questions performance related to communication ability in the CON group only while Word Generation performance related to communication ability in the AE group only. Effects remained significant in the global model, with the exception of Spatial Working Memory. Conclusions: Both groups displayed a relation between communication and Spatial Working Memory and Inhibition. Stronger communication ability related to stronger verbal fluency in the AE group and Twenty Questions performance in the CON group. These findings suggest that alcohol-exposed adolescents may rely more heavily on learned verbal storage or fluency for daily communication while non-exposed adolescents may rely more heavily on abstract thinking and verbal efficiency. Interventions aimed at aspects of executive function may be most effective at improving communication ability of these individuals.

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Prevalence of Fetal Alcohol Spectrum Disorders in 4 US Communities

Abstract: Estimated prevalence of fetal alcohol spectrum disorders among first-graders in 4 US communities ranged from 1.1% to 5.0% using a conservative approach. These findings may represent more accurate US prevalence estimates than previous studies but may not be generalizable to all communities.

Cited by 602 publications

References 27 publications

Health products’ and substance use among pregnant women visiting a tertiary hospital in Belgium: A cross‐sectional study

Health products’ and substance use among pregnant women visiting a tertiary hospital in Belgium: A cross‐sectional study

Responding to fetal alcohol spectrum disorder in Australia

Executive Functioning Correlates With Communication Ability in Youth With Histories of Heavy Prenatal Alcohol Exposure

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