Magazine article Clinical Psychiatry News

Incidence of Fetal Alcohol Disorders Higher Than Thought

Magazine article Clinical Psychiatry News

Incidence of Fetal Alcohol Disorders Higher Than Thought

Article excerpt


Fetal alcohol spectrum disorders could affect up to 1 in 20 children, a cross-sectional study shows.

Philip A. May, PhD, of the University of North Carolina, and his coauthors assessed 6,639 first-grade children from four communities in the Rocky Mountain, Midwestern, Southeastern, and Pacific Southwestern regions of the United States.

In their report, published in JAMA, they identified 222 cases of fetal alcohol spectrum disorders, representing conservative prevalence estimates ranging from 11.3 to 50 cases per 1,000 children (JAMA. 2018;319[5]:474-82. doi: 10.1001/jama.2017.21896).

Of these children, 27 met the criteria for fetal alcohol syndrome, 104 met the criteria for partial fetal alcohol syndrome, and 91 met the criteria for alcohol-related neurodevelopmental disorder. "These prevalence estimates are consistent with mounting evidence that harmful fetal alcohol exposure is common in the United States today and highlight the public health burden due to fetal alcohol spectrum disorders," the authors wrote. (See related commentary on p. 5.)

The finding was much higher than previous estimates of the prevalence of fetal alcohol spectrum disorders in the United States. The authors pointed out that routine surveillance methods may have previously underestimated the prevalence because so many children are either misdiagnosed or not diagnosed at all. But even two previous U.S. single-site, active-case ascertainment studies found prevalence rates of 10 and 24 per 1,000 children.

"This consortium study, to our knowledge, was the first to apply active case ascertainment, common methodology a single classification system, and expert in-person evaluation for a continuum of fetal alcohol spectrum disorders including alcohol-related neurodevelopmental disorder to a large number of children from communities across the United States," the authors wrote. …

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