Academic journal article American Journal of Health Education

Educating Health Professionals about Fetal Alcohol Spectrum Disorders

Academic journal article American Journal of Health Education

Educating Health Professionals about Fetal Alcohol Spectrum Disorders

Article excerpt

ABSTRACT

Prenatal exposure to alcohol is a leading preventable cause of birth defects and developmental disabilities. Individuals exposed to alcohol during fetal development can have physical, mental, behavioral, and learning disabilities, with lifelong implications. These conditions are known as fetal alcohol spectrum disorders (FASDs). Health care professionals play a crucial role in identifying women at risk for an alcohol-exposed pregnancy and in identifying the effects of prenatal alcohol exposure among individuals. The Centers for Disease Control and Prevention's National Center on Birth Defects and Developmental Disabilities has funded four universities as FASD Regional Training Centers (RTCs). The RTCs, in collaboration with the CDC and the National Organization on Fetal Alcohol Syndrome, are developing, implementing, and evaluating educational curricula for medical and allied health students and practitioners and seeking to have the curricula incorporated into training programs at each grantee's university or college, into other schools throughout the region, and into the credentialing requirements of professional boards. This article highlights some of the innovative training approaches that the RTCs are implementing to increase knowledge regarding FASDs and the ability of health professionals to identify, treat, and prevent these conditions.

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Prenatal exposure to alcohol is a leading preventable cause of birth defects and developmental disabilities. The term fetal alcohol spectrum disorders (FASDs) describes the full continuum of effects that can occur in an individual exposed to alcohol in utero. (1) These effects include physical, mental, behavioral, and learning disabilities; all of these problems have lifelong implications. The term FASDs is not intended for use as a clinical diagnosis, but instead comprises several conditions, including fetal alcohol syndrome (FAS). FAS is characterized by specific facial features, growth deficiencies, and central nervous system (CNS) problems. (2) The majority of individuals with conditions related to prenatal alcohol exposure do not meet the diagnostic criteria for FAS. These nondysmorphic individuals, although having CNS problems, very often are not provided with appropriate services. (3)

Studies by the Centers for Disease Control and Prevention (CDC) have reported FAS prevalence rates in the United States ranging from 0.2 to 1.5 cases per 1,000 live births. (2) These rates are comparable to or higher than prevalence rates of other birth defects and developmental disabilities such as Down syndrome and spina bifida. (2) Other disabilities related to prenatal alcohol exposure are estimated to occur at rates approximately three times the rate of FAS. (4) The average lifetime cost for an individual with FAS in 2002 was $2 million. (5) Information is not available to estimate the cost for those with non-FAS prenatal alcohol-related conditions, but it is likely to be much higher.

Based on survey data from 2002, more than half of all women of childbearing age who were at risk of becoming pregnant reported alcohol use. These women were sexually active, not using effective measures to prevent pregnancy, and, therefore, at risk for an alcohol-exposed pregnancy. Furthermore, 12% of women at risk of becoming pregnant reported binge drinking (defined in this survey as five or more drinks on one occasion). Among pregnant women, 10% reported alcohol use and 1.9% reported binge drinking. (6)

Health care professionals play a crucial role in identifying women at risk for an alcohol-exposed pregnancy, and in identifying effects of prenatal alcohol exposure among individuals. However, despite the data regarding alcohol consumption among women of childbearing age and the prevalence of FAS, screening for alcohol use among female patients of childbearing age and diagnosis for FAS and related conditions are not yet common practices of care. …

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