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Fetal Alcohol Spectrum Disorder: A Significant Global Problem

A study of the global prevalence of fetal alcohol spectrum disorder (FASD) estimates that it affects as many as 8 out of 10,000 children, highlighting the need to improve public education about the potential harm of drinking alcohol during pregnancy.

Drinking alcohol during pregnancy may harm the developing fetus. A wide range of resulting health problems have been observed including defects of the heart, kidneys or bones, problems with brain development, low IQ, and hyperactivity. This group of conditions is known as fetal alcohol spectrum disorder (FASD). Affected children may have mild to severe health problems. However, it is not possible to predict the severity from the amount or timing of their mother’s alcohol consumption. There is no safe amount or safe time of alcohol consumption for a pregnant woman.

It is important to know the prevalence of a condition in order to look at patterns of occurrence.  This helps to direct the focus of resources for prevention and treatment. Researchers in Toronto have completed a comprehensive analysis of the available data on FASD to estimate its global prevalence in children and young people. They recently published their findings in JAMA Pediatrics.

The research team reviewed the medical literature to identify high-quality studies that reported the prevalence of FASD among children and youth in the general population. A total of 24 studies including 1,416 children and youth (0-16 years) were included in the analysis.

They found that the global prevalence of FASD among children and youth in the general population was estimated to be around eight affected children per 1000 people. The WHO European Region had the highest prevalence, approximately 20 per 1000 people, and the WHO Eastern Mediterranean Region had the lowest, approximately 0.1 per 1000 people. At a country level, South Africa had the highest prevalence of FASD (111 per 1000 population), followed by Croatia (55.3 per 1000 population), and Ireland (47 per 1000 population).

Using selected studies, the team also looked at the prevalence of FASD amongst special populations, compared to the general population. They estimated that FASD was 15.6-24.6 times higher in Aboriginal populations, 5.2-67.7 times higher among children in care, 30.3 times higher in a correctional population, 23.7 times higher in a population with low socioeconomic status and 18.5 times higher among a population in psychiatric care.

The estimates of the global prevalence of FASD show that it is a significant health problem. It has an impact on large numbers of children and youth and a high cost of health services. Fetal alcohol spectrum disorder is a largely preventable condition. The researchers suggest there is a need for wider public education about the potential harm of drinking during pregnancy. They also suggest a screening system to identify problem drinking before and during pregnancy. These strategies could be widely implemented at relatively little cost.

Written by Julie McShane, Medical Writer


Lange S, Probst C, Gmel G, et al. Global prevalence of fetal alcohol spectrum disorder among children and youth. A systematic review and meta-analysis. JAMA Pediatrics, published online August 21, 2017. Doi:10.1001/jamapediatrics.2017.1919.

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