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 Fetal alcohol spectrum disorder is an umbrella term for a range of
physical, psychological, behavioral and cognitive problems that can
develop in children whose mothers drink during pregnancy. The most
severe form, fetal alcohol syndrome, can cause stunted growth,
learning disabilities, bone and joint deformities, heart defects,
and hyperactivity.
Even though early diagnosis and treatment can sometimes reduce the
severity of fetal alcohol spectrum disorders, the vast majority of
cases remain undiagnosed. Prior estimates, which suggested that only
1 in 100 kids is affected, may have grossly underestimated the
problem, researchers note in JAMA.
“The earlier that interventions are initiated, the more effective
they are likely to be - especially during the early years when there
is still relative plasticity of the brain,” said Christina Chambers
of the University of California San Diego School of Medicine and
Rady Children’s Hospital San Diego, who co-led the study.
“There is no cure for fetal alcohol spectrum disorders, but there
are definitely intervention strategies that have been demonstrated
to help,” Chambers said by email.
The current study focused on 13,146 first-grade students in four
communities in the Rocky Mountain, Midwestern, Southeastern and
Pacific Southwestern regions of the U.S. This included 6,054
children who were screened for growth, development, or both, as well
as 585 children who were randomly selected to receive detailed
clinical exams for physical abnormalities linked to fetal alcohol
spectrum disorder.
Overall, researchers identified 222 cases of fetal alcohol spectrum
disorders, including 27 severe cases that met the criteria for fetal
alcohol syndrome.
Only two of these kids had already been diagnosed with fetal alcohol
spectrum disorders, even though many of their parents and guardians
were aware that their children faced learning and behavioral
challenges.
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For a conservative estimate of the extent of the problem, the
researchers assumed that no additional cases would be found in first
graders who weren’t included in the study. On this basis, the
proportion of kids with fetal alcohol spectrum disorders ranged from
a low of 1.1 percent in the Midwestern community to a high of 5
percent in the Rocky Mountain group.
When researchers ran the numbers again, this time assuming that the
rates found in the study reflected the rates in the communities, the
condition appeared more common.
Now, the proportion of kids with fetal alcohol spectrum disorders
ranged from a low of 3.1 percent in the Southeastern group to 9.9
percent for the Rocky Mountain community.
One limitation of the study is that children who received permission
from their parents to participate might have differed from kids who
didn’t, in ways that influenced whether they might have fetal
alcohol spectrum disorders, the authors note. It’s also possible
that results from these four communities might not reflect the
prevalence of fetal alcohol spectrum disorders elsewhere.
Still, the results suggest that the fetal alcohol spectrum disorders
are widespread, and that many women may be unaware of the risk, said
Dr. Svetlana Popova, co-author of an accompanying editorial and a
researcher at the Center for Addiction and Mental Health at the
University of Toronto.
“It is not safe to drink any amount or type of alcohol, at any time
during pregnancy, when trying to get pregnant, or when
breastfeeding,” Popova said by email. “Although it has been shown
that a high blood alcohol concentration is the most harmful to a
developing fetus, which is achieved by drinking a large amount of
alcohol over a short period of time, low amounts have also been
shown to have negative consequences.”
SOURCES: http://bit.ly/2FQWRMd and http://bit.ly/2FShp72 JAMA,
online February 6, 2018.
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