Prevalence of Fetal Alcohol Spectrum Disorders in Child Care Settings: A Meta-analysis

Abstract

BACKGROUND: Children often enter a child-care system (eg, orphanage, foster care, child welfare system) because of unfavorable circumstances (eg, maternal alcohol and/or drug problems, child abuse/neglect). Such circumstances increase the odds of prenatal alcohol exposure, and thus this population can be regarded as high risk for fetal alcohol spectrum disorders (FASD). The primary objective was to estimate a pooled prevalence for fetal alcohol syndrome (FAS) and FASD in various child-care systems based on data from existing studies that used an active case ascertainment method. METHODS:A systematic literature review, using multiple electronic bibliographic databases, and meta-analysis of internationally published and unpublished studies that reported the prevalence of FAS and/or FASD in all types of child-care systems were conducted. The pooled prevalence estimates and 95% confidence intervals (CIs) were calculated by using the Mantel-Haenszel method, assuming a random effects model. Sensitivity analyses were performed for studies that used either passive surveillance or mixed methods. RESULTS:On the basis of studies that used active case ascertainment, the overall pooled prevalence of FAS and FASD among children and youth in the care of a child-care system was calculated to be 6.0% (60 per 1000; 95% CI: 38 to 85 per 1000) and 16.9% (169 per 1000; 95% CI: 109 to 238 per 1000), respectively. CONCLUSIONS:The results confirm that children and youth housed in or under the guardianship of the wide range of child-care systems constitute a population that is high-risk for FASD. It is imperative that screening be implemented in these at-risk populations.

Fetal Alcohol Spectrum Disorders

“…Any history of adoption, especially from an environment of socioeconomic impoverishment, whether domestic or international, and any history of involvement with a US child social services system can indicate a higher likelihood of having had PAE and a need for careful screening for FASD. 21,49,81 A history of involvement with child protective services related to parental substance use or to child neglect, abuse, or abandonment is a strong marker for risk, as is a history of any out-of-home or foster care placement, including kinship care. 81 Many people are not aware of the requirement for health care providers to report FASD to child protective service systems.…”

Effects of a Single Dose of Ethanol on Survival Rate and Angiogenesis of Chick Embryo

“…Alcohol is consumed frequently irrespective of gender. Some females consume alcohol even in pregnancy, which might result into Fetal Alcohol Syndrome (FAS) (Popova, Lange et al 2011;Lange, Shield et al 2013). Individuals suffering from FAS exhibit the spectrum of defects including Physical and Mental retardation, cognitive, behavioral and learning disabilities with identifiable facial dysmorphology (Popova, Lange et al 2011;Lange, Shield et al 2013).…”

“…Some females consume alcohol even in pregnancy, which might result into Fetal Alcohol Syndrome (FAS) (Popova, Lange et al 2011;Lange, Shield et al 2013). Individuals suffering from FAS exhibit the spectrum of defects including Physical and Mental retardation, cognitive, behavioral and learning disabilities with identifiable facial dysmorphology (Popova, Lange et al 2011;Lange, Shield et al 2013). A number of studies report the use of animal models in the understanding of complexity of FAS and effects of EtOH on various developmental defects have been extensively studied on different animal models including mice (Nakatsuji and Johnson 1984), chick (Tufan, Abban et al 2007), Xenopus (Nakatsuji 1983) and zebrafish (Bilotta, Barnett et al 2004).…”

Fetal alcohol spectrum disorders in South Africa

“…While relatives often play a role in childcare in South Africa, formal placement in foster care was a strong marker for FAS at all sites. This is well described elsewhere (Lange et al, 2013), but has not been evident in previous South African studies, and may reflect improving social services.…”