Prevalence and Characteristics of Fetal Alcohol Spectrum Disorders

American Academy of Pediatrics (AAP) - Tập 134 Số 5 - Trang 855-866 - 2014
Philip A. May1,2,3, Amy Baete4, Jaymi Russo4, Amy Elliott3,4, Jason Blankenship1, Wendy O. Kalberg1, David Buckley1, Marita Brooks1, Julie M. Hasken2, Omar Abdul‐Rahman5, Margaret P Adam6, Luther K. Robinson7, Melanie Manning8, H. Eugene Hoyme3,4
1Center on Alcoholism, Substance Abuse, and Addictions (CASAA), The University of New Mexico, Albuquerque, New Mexico
2Department of Nutrition, Gillings School of Global Public Health, Nutrition Research Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;
3Department of Pediatrics, Sanford School of Medicine, The University of South Dakota, Sioux Falls, South Dakota
4Sanford Research, Sioux Falls, South Dakota;
5Department of Pediatrics, University of Mississippi, Jackson, Mississippi;
6Department of Pediatrics, University of Washington, Seattle, Washington
7Dysmorphology and Clinical Genetics, State University of New York at Buffalo, Buffalo, New York;
8Departments of Pathology and Pediatrics, Stanford University, Stanford, California; and

Tóm tắt

OBJECTIVES:

To determine the prevalence and characteristics of fetal alcohol spectrum disorders (FASD) among first grade students (6- to 7-year-olds) in a representative Midwestern US community.

METHODS:

From a consented sample of 70.5% of all first graders enrolled in public and private schools, an oversample of small children (≤25th percentile on height, weight, and head circumference) and randomly selected control candidates were examined for physical growth, development, dysmorphology, cognition, and behavior. The children’s mothers were interviewed for maternal risk.

RESULTS:

Total dysmorphology scores differentiate significantly fetal alcohol syndrome (FAS) and partial FAS (PFAS) from one another and from unexposed controls. Alcohol-related neurodevelopmental disorder (ARND) is not as clearly differentiated from controls. Children who had FASD performed, on average, significantly worse on 7 cognitive and behavioral tests and measures. The most predictive maternal risk variables in this community are late recognition of pregnancy, quantity of alcoholic drinks consumed 3 months before pregnancy, and quantity of drinking reported for the index child’s father. From the final multidisciplinary case findings, 3 techniques were used to estimate prevalence. FAS in this community likely ranges from 6 to 9 per 1000 children (midpoint, 7.5), PFAS from 11 to 17 per 1000 children (midpoint, 14), and the total rate of FASD is estimated at 24 to 48 per 1000 children, or 2.4% to 4.8% (midpoint, 3.6%).

CONCLUSIONS:

Children who have FASD are more prevalent among first graders in this Midwestern city than predicted by previous, popular estimates.

Từ khóa


Tài liệu tham khảo

Jones, 1973, Recognition of the fetal alcohol syndrome in early infancy., Lancet, 302, 999, 10.1016/S0140-6736(73)91092-1

Robinson, 1987, Clinical profile and prevalence of fetal alcohol syndrome in an isolated community in British Columbia., CMAJ, 137, 203

May, 1983, Epidemiology of fetal alcohol syndrome among American Indians of the Southwest., Soc Biol, 30, 374

May, 2001, Estimating the prevalence of fetal alcohol syndrome. A summary., Alcohol Res Health, 25, 159

May, 2009, Prevalence and epidemiologic characteristics of FASD from various research methods with an emphasis on recent in-school studies., Dev Disabil Res Rev, 15, 176, 10.1002/ddrr.68

Centers for Disease Control and Prevention (CDC), 1997, Surveillance for fetal alcohol syndrome using multiple sources — Atlanta, Georgia, 1981-1989., MMWR Morb Mortal Wkly Rep, 46, 1118

Centers for Disease Control and Prevention (CDC), 1995, Update: trends in fetal alcohol syndrome—United States, 1979-1993., MMWR Morb Mortal Wkly Rep, 44, 249

Stratton, 1996, Fetal Alcohol Syndrome Diagnosis, Epidemiology, Prevention, and Treatment

Sampson, 1997, Incidence of fetal alcohol syndrome and prevalence of alcohol-related neurodevelopmental disorder., Teratology, 56, 317, 10.1002/(SICI)1096-9926(199711)56:5<317::AID-TERA5>3.0.CO;2-U

May, 2000, Epidemiology of fetal alcohol syndrome in a South African community in the Western Cape Province., Am J Public Health, 90, 1905, 10.2105/AJPH.90.12.1905

May, 2007, The epidemiology of fetal alcohol syndrome and partial FAS in a South African community., Drug Alcohol Depend, 88, 259, 10.1016/j.drugalcdep.2006.11.007

May, 2013, Approaching the prevalence of the full spectrum of fetal alcohol spectrum disorders in a South African population-based study., Alcohol Clin Exp Res, 37, 818, 10.1111/acer.12033

Viljoen, 2005, Fetal alcohol syndrome epidemiology in a South African community: a second study of a very high prevalence area., J Stud Alcohol, 66, 593, 10.15288/jsa.2005.66.593

Urban, 2008, Fetal alcohol syndrome among grade 1 schoolchildren in Northern Cape Province: prevalence and risk factors., S Afr Med J, 98, 877

May, 2006, Epidemiology of FASD in a province in Italy: Prevalence and characteristics of children in a random sample of schools., Alcohol Clin Exp Res, 30, 1562, 10.1111/j.1530-0277.2006.00188.x

May, 2011, Prevalence of children with fetal alcohol spectrum disorders in communities near Rome, Italy: rates are substantially higher than previous estimates., Int J Environ Res Public Health, 8, 2331, 10.3390/ijerph8062331

Petković, 2010, FAS prevalence in a sample of urban schoolchildren in Croatia., Reprod Toxicol, 29, 237, 10.1016/j.reprotox.2009.11.006

Petković, 2013, Prevalence of fetal alcohol syndrome and maternal characteristics in a sample of schoolchildren from a rural province of Croatia., Int J Environ Res Public Health, 10, 1547, 10.3390/ijerph10041547

Adnams, 2001, Patterns of cognitive-motor development in children with fetal alcohol syndrome from a community in South Africa., Alcohol Clin Exp Res, 25, 557, 10.1111/j.1530-0277.2001.tb02250.x

Kodituwakku, 2006, Neurobehavioral characteristics of children with fetal alcohol spectrum disorders in communities from Italy: Preliminary results., Alcohol Clin Exp Res, 30, 1551, 10.1111/j.1530-0277.2006.00187.x

Aragón, 2008, Neuropsychological characteristics of Italian children with fetal alcohol spectrum disorders., Alcohol Clin Exp Res, 32, 1909, 10.1111/j.1530-0277.2008.00775.x

Kalberg, 2013, A practical testing battery to measure neurobehavioral ability among children with FASD., Int J Alcohol Drug Res, 2, 51, 10.7895/ijadr.v2i3.83

Viljoen, 2002, Characteristics of mothers of children with fetal alcohol syndrome in the Western Cape Province of South Africa: a case control study., J Stud Alcohol, 63, 6, 10.15288/jsa.2002.63.6

May, 2005, Maternal risk factors for fetal alcohol syndrome in the Western cape province of South Africa: a population-based study., Am J Public Health, 95, 1190, 10.2105/AJPH.2003.037093

May, 2008, Maternal risk factors for fetal alcohol syndrome and partial fetal alcohol syndrome in South Africa: a third study., Alcohol Clin Exp Res, 32, 738, 10.1111/j.1530-0277.2008.00634.x

US Census Bureau. State & County Quick Facts. Available at: http://quickfacts.census.gov/qfd/index.html#. Accessed April 1, 2014

LaVallee, 2011, Surveillance Report #92: Apparent Per Capita Alcohol Consumption: National, State, And Regional Trends, 1977–2009

United Health Foundation. America’s Health Rankings. Available at: www.americashealthrankings.org. Accessed April 1, 2014

US counties. Available at: www.city-data.com/countyDir.html. Accessed April 1, 2014

Office of Health Statistics, 2013, The Health Behaviors of South Dakotans 2011

Hoyme, 2005, A practical clinical approach to diagnosis of fetal alcohol spectrum disorders: clarification of the 1996 institute of medicine criteria., Pediatrics, 115, 39, 10.1542/peds.2004-0259

Alvik, 2006, Alcohol consumption, smoking and breastfeeding in the first six months after delivery., Acta Paediatr, 95, 686, 10.1080/08035250600649266

May, 2011, Maternal risk factors predicting child physical characteristics and dysmorphology in fetal alcohol syndrome and partial fetal alcohol syndrome., Drug Alcohol Depend, 119, 18, 10.1016/j.drugalcdep.2011.05.009

Ervalahti, 2007, Relationship between dysmorphic features and general cognitive function in children with fetal alcohol spectrum disorders., Am J Med Genet A, 143A, 2916, 10.1002/ajmg.a.32009

Elliott, 2007, Differential Ability Scales, 2nd ed.

Sparrow, 2006, Vineland Adaptive Behavior Scales, 2nd ed.

Sobell, 2001, Cross-cultural evaluation of two drinking assessment instruments: alcohol timeline followback and inventory of drinking situations., Subst Use Misuse, 36, 313, 10.1081/JA-100102628

Sobell, 1988, Reliability of a timeline method: assessing normal drinkers’ reports of recent drinking and a comparative evaluation across several populations., Br J Addict, 83, 393, 10.1111/j.1360-0443.1988.tb00485.x

Kaskutas, 2000, An alternative to standard drinks as a measure of alcohol consumption., J Subst Abuse, 12, 67, 10.1016/S0899-3289(00)00042-0

Kaskutas, 2001, Pre-pregnancy drinking: how drink size affects risk assessment., Addiction, 96, 1199, 10.1046/j.1360-0443.2001.968119912.x

Kaskutas, 2008, Accuracy of photographs to capture respondent-defined drink size., J Stud Alcohol Drugs, 69, 605, 10.15288/jsad.2008.69.605

King, 1994, Enhancing the self-report of alcohol consumption in the community: two questionnaire formats., Am J Public Health, 84, 294, 10.2105/AJPH.84.2.294

Alvik, 2006, Alcohol consumption before and during pregnancy comparing concurrent and retrospective reports., Alcohol Clin Exp Res, 30, 510, 10.1111/j.1530-0277.2006.00055.x

Czarnecki, 1990, Five-year reliability of self-reported alcohol consumption., J Stud Alcohol, 51, 68, 10.15288/jsa.1990.51.68

Hannigan, 2010, A 14-year retrospective maternal report of alcohol consumption in pregnancy predicts pregnancy and teen outcomes., Alcohol, 44, 583, 10.1016/j.alcohol.2009.03.003

Tabachnick, 2013, Using Multivariate Statistics, 6th ed.

May, 2011, Maternal risk factors for fetal alcohol spectrum disorders: not as simple as it might seem., Alcohol Res Health, 34, 15

Feldman, 2012, Prenatal alcohol exposure patterns and alcohol-related birth defects and growth deficiencies: a prospective study., Alcohol Clin Exp Res, 36, 670, 10.1111/j.1530-0277.2011.01664.x

May, 2013, Maternal factors predicting cognitive and behavioral characteristics of children with fetal alcohol spectrum disorders., J Dev Behav Pediatr, 34, 314, 10.1097/DBP.0b013e3182905587

Abel, 1998, Fetal Alcohol Abuse Syndrome, 10.1007/978-1-4757-5217-5

Balachova, 2012, Women’s alcohol consumption and risk for alcohol-exposed pregnancies in Russia., Addiction, 107, 109, 10.1111/j.1360-0443.2011.03569.x

Floyd, 1999, Alcohol use prior to pregnancy recognition., Am J Prev Med, 17, 101, 10.1016/S0749-3797(99)00059-8

Mallard, 2013, Maternal factors associated with heavy periconceptional alcohol intake and drinking following pregnancy recognition: a post-partum survey of New Zealand women., Drug Alcohol Rev, 32, 389, 10.1111/dar.12024

Parackal, 2013, Prevalence and correlates of drinking in early pregnancy among women who stopped drinking on pregnancy recognition., Matern Child Health J, 17, 520, 10.1007/s10995-012-1026-7

Russell, 1991, Measures of maternal alcohol use as predictors of development in early childhood., Alcohol Clin Exp Res, 15, 991, 10.1111/j.1530-0277.1991.tb05200.x

Skagerström, 2013, Prevalence of alcohol use before and during pregnancy and predictors of drinking during pregnancy: a cross sectional study in Sweden., BMC Public Health, 13, 780, 10.1186/1471-2458-13-780

Alvik, 2005, Consistency of reported alcohol use by pregnant women: anonymous versus confidential questionnaires with item nonresponse differences., Alcohol Clin Exp Res, 29, 1444, 10.1097/01.alc.0000175014.31463.9a

Alvik, 2006, Alcohol use before and during pregnancy: a population-based study., Acta Obstet Gynecol Scand, 85, 1292, 10.1080/00016340600589958

Ortega-García, 2012, Head circumference at birth and exposure to tobacco, alcohol and illegal drugs during early pregnancy., Childs Nerv Syst, 28, 433, 10.1007/s00381-011-1607-6

Bryanton, 2014, Incidence of prenatal alcohol exposure in Prince Edward Island: a population-based descriptive study., CMAJ Open, 2, E121, 10.9778/cmajo.20140011

Manich, 2012, [Validity of a maternal alcohol consumption questionnaire in detecting prenatal exposure], An Pediatr (Barc), 76, 324, 10.1016/j.anpedi.2011.09.016

Morini, 2013, Testing ethylglucuronide in maternal hair and nails for the assessment of fetal exposure to alcohol: comparison with meconium testing., Ther Drug Monit, 35, 402, 10.1097/FTD.0b013e318283f719

Pichini, 2012, Assessment of prenatal exposure to ethanol by meconium analysis: results of an Italian multicenter study., Alcohol Clin Exp Res, 36, 417, 10.1111/j.1530-0277.2011.01647.x