Subpopulations Are Vulnerable to Fetal Alcohol Spectrum Disorder

JAMA. 2019;321(23):2273. doi:10.1001/jama.2019.7101
Fetal alcohol spectrum disorder (FASD) disproportionately affects certain vulnerable groups worldwide, according to a meta-analysis by an international group of researchers.
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Fetal alcohol spectrum disorder disproportionately affects vulnerable populations worldwide.

Nearly 10% of women around the world consume alcohol during pregnancy. As a result, about 630 000 infants each year are born with FASD, which includes a wide range of lifelong mental and physical disabilities.

The investigators focused on children with FASD who were living in care as adopted or foster children; being held in correctional services; belonging to indigenous populations; receiving special education services; and requiring specialized clinical services, such as psychiatric care. The researchers analyzed data from 69 studies that included 6177 individuals from 17 countries across North America and South America, Europe, Asia, and Australia.

The global prevalence of FASD in the 5 special subpopulations ranged from 10 to 40 times higher than the rate in the general population, which is 7.7 per 1000 people. In the United States, the prevalence of FASD among children in care was 32 times higher than in the general population. Reports from individual studies show that in Chile, 620 of every 1000 children with mental deficiencies had FASD.

The authors noted that their findings aren’t unexpected given the circumstances of children with FASD—parental alcohol or drug problems, abuse, or abandonment, which can increase the likelihood that a child was exposed prenatally to alcohol. Improving global educational efforts about the effects of alcohol during pregnancy, developing targeted interventions for women of childbearing age with substance use problems, and using screening protocols in settings such as child welfare and justice systems to identify children with FASD early are among the efforts needed to reduce FASD.

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