washington times

Fetal alcohol spectrum disorders more widespread in U.S. than thought

fetal alcohol

Study sheds light on vast numbers of undiagnosed youth

Original Source: washingtontimes.com

More children are suffering from fetal alcohol spectrum disorders (FASD) than previously thought, according to a new study shedding light on vast numbers of undiagnosed youth with symptoms ranging from stunted growth, organ and brain damage to cognitive and behavioral issues.

About 1 percent of children was believed to have FASD, but the study says that as much as 10 percent actually could be affected.

“We hope this leads to a call to action, that there is a need for broader access to and availability of clinical services for children with an FASD,” Dr. Christina Chambers, the study’s co-author, said Wednesday in a call with reporters.

Fetal alcohol spectrum disorders describes a range of developmental problems from drinking alcohol during pregnancy, including fetal alcohol syndrome and disorders in brain development.

“FASD is a significant public health problem, and strategies to expand screening, diagnosis, prevention and treatment are needed to address it,” said Dr. Patricia Powell, deputy director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), which funded the study.

Published this month in the Journal of the American Medical Association, the study is one of the most thorough investigations into the topic, with a sufficiently large sample size to extrapolate for the U.S. population.

Researchers enrolled more than 13,000 first-graders in four U.S. regions — the Rocky Mountains, the Midwest, the Southeast and the Pacific Southwest. Among these communities, populations ranged in size from 60,000 to as much as 1.4 million.

More than 6,500 children and their families consented to a multipronged assessment, which included face-to-face interviews with experts who evaluated the children on their growth, brain function and development, behavior and mother’s drinking history, among other factors.

The researchers identified 222 children who fit the criteria for FASD, of which only two previously had received a formal diagnosis.

These findings are consistent with earlier research that suggested as many as 80 percent of children with FASD are unrecognized, misdiagnosed or not diagnosed at all, said Dr. Chambers, a pediatrics professor at the University of California-San Diego and director of clinical research for the university’s Department of Pediatrics and Rady Children’s Hospital.

“We have a huge opportunity to provide a way to identify children at a younger age when interventions may be even more beneficial,” she said, adding that “we think that this study points to the really critical need for better and more effective prevention efforts.”

Based on the findings, the researchers said that a conservative estimate of FASD prevalence in the U.S. is between 1 percent and 5 percent of children. Extrapolating for the larger U.S. population raises that estimate to between 3.1 percent to 9.9 percent.

FASD rates were highest in the Rocky Mountains and the Pacific Southwest and lowest in the Midwest and the Southeast.

“[FASD] are the leading preventable cause of developmental difficulties in the U.S.,” said study co-author Dr. Kenneth Warren, a senior adviser to NIAAA on fetal alcohol spectrum disorders.

Dr. Warren said that key features of these disorders are difficult to recognize, which adds to the problem of identifying overall prevalence.

However, the latest study collected data on these characteristics in greater detail, such as growth deficits, unique facial features, small head circumference, and cognitive and behavioral deficits, as well as organ or skeletal defects.

These data will be analyzed in subsequent publications, the researchers said.

In addition, the researchers collected data on the mothers of children with and without FASD.

“We did capture quantity and frequency and timing of alcohol consumption in pregnancy,” Dr. Chambers said.

A future report will dive deeper into these factors, including self-reported alcohol consumption during pregnancy, nutrition, other pregnancy variables and high-risk behaviors — at least two episodes of binge-drinking, history of alcohol abuse, or other drug exposure. Despite anecdotes of acceptable, small amounts of alcohol during pregnancy, the overriding medical advice is complete abstinence for expectant mothers.

Research is limited on the precise details on how the developing fetus is affected by certain amounts of alcohol consumed during specific times of the pregnancy.

At least half of pregnancies are unplanned, according to the Centers for Disease Control and Prevention, and most women won’t know their pregnant for up to four to six weeks.

“There are many other important details and learnings that we can gather from the data that families and teachers and schools were willing to collaborate with us to produce,” said Dr. Chambers.

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