A major new review of the world literature has found that Fetal Alcohol Spectrum Disorder (FASD) is 10 to 40 times higher in certain susceptible groups than the general population. These groups include children in care, people in correctional services or special education services, Aboriginal populations, and people using specialized clinical services.
FASD is a serious, lifelong, disabling condition that affects individuals from all racial, ethnic and socioeconomic backgrounds. It is caused by alcohol consumed during pregnancy. Alcohol is a toxic substance that can readily cross the placenta, resulting in permanent damage to the brain and other organs of the developing embryo and fetus. An estimated one in every 13 infants prenatally exposed to any level or type of alcohol will develop FASD; about 630,000 infants are born with FASD in the world each year.
This study used data from 69 studies representing 17 countries across North and South America, Europe, Asia, and Australasia. The studies included five sub-populations: children in care, people in correctional services, Aboriginal populations, people in special education services, and people using specialized clinical services (genetic clinics and clinics for developmental disabilities or psychiatric care).
The estimated prevalence of FASD in these groups ranged from 10 to 40 times higher than the 7.7 per 1,000 global FASD prevalence in the general population. For example, FASD prevalence among children in care was 32 times higher in the United States and 40 times higher in Chile; prevalence among adults in the Canadian correctional system was 19 times higher; and prevalence among special education populations in Chile was over 10 times higher.
Lead author Dr Svetlana Popova says, "Public policy and clinical care for people with FASD needs to recognise the severity of the problem globally. Routine screening protocols should be established to identify people with FASD in child welfare, special education, justice system and other settings to provide appropriate support and early interventions. Service staff should be trained in FASD awareness, identification, and interventions to provide better care. Women should completely abstain from any type of alcohol during their entire pregnancy and while trying to get pregnant."
This review was restricted by the limited number of studies, some of which were dated and had methodological weaknesses. Countries need to conduct rigorous epidemiological studies to understand the size and severity of this serious but preventable alcohol-related neurodevelopmental disorder.
Peer reviewed: Yes
Type of study: Review
Subject of study: People
Funding: Government/research council
This paper is free to download for one month after publication from the Wiley Online Library: https://onlinelibrary.wiley.com/doi/10.1111/add.14598 (after the embargo has lifted) or by contacting Jean O'Reilly, Editorial Manager, Addiction, email@example.com, tel +44 (0)20 7848 0452.
To speak with lead author Dr. Svetlana Popova: contact her through CAMH Public Affairs (Canada) by email (firstname.lastname@example.org) or telephone (+1 416-595-6015).
This study was funded by the Centre for Addiction and Mental Health (CAMH), Canada's largest mental health teaching hospital and one of the world's leading research centres in its field. CAMH is fully affiliated with the University of Toronto and is a Pan American Health Organization/World Health Organization Collaborating Centre.
Full citation for article: Popova S, Lange S, Shield K, Burd L, and Rehm, J. (2019) Prevalence of Fetal Alcohol Spectrum Disorder among Special Sub-populations: A Systematic Review and Meta-analysis. Addiction 111: doi:10.1111/add.14598.
Addiction is a monthly international scientific journal publishing peer-reviewed research reports on alcohol, substances, tobacco, and gambling as well as editorials and other debate pieces. Owned by the Society for the Study of Addiction, it has been in continuous publication since 1884. Addiction is the number one journal in the 2017 ISI Journal Citation Reports ranking in the substance abuse category (science edition).