Study shows global estimates of Fetal Alcohol Spectrum Disorder among children

Globally, nearly eight out of every 1,000 children in the general population is estimated to have Fetal Alcohol Spectrum Disorder (FASD), according to a new study by the Centre for Addiction and Mental Health (CAMH).

In addition, it is estimated that one out of 13 women who consumed any alcohol at any point or frequency during pregnancy delivered a child with FASD.

The study, published today in JAMA Pediatrics, estimates the prevalence—or the frequency that FASD occurs—for children from birth to age 16 in 187 countries.

"FASD prevalence estimates are essential to effectively prioritize and plan health care for children with FASD, who are often misdiagnosed," says Dr. Svetlana Popova, Senior Scientist in CAMH's Institute for Mental Health Policy Research. "Most of these children will require lifelong care, so the earlier they have access to appropriate therapy and supports, the better their long-term health and social outcomes will be."

FASD is an umbrella term that describes a range of effects that can occur in someone whose mother consumed alcohol during pregnancy. As the fetus develops, the brain is particularly vulnerable to alcohol's damaging effects, which can lead to physical, mental, behavioral and learning disabilities.

For many countries, these are the first-ever estimates of FASD. Some notable figures:

• The U.S. has 15 cases of FASD per 1,000 children
• Canada has eight cases of FASD per 1,000 children
• The European Region has the highest levels worldwide, at nearly 20 cases of FASD per 1,000 children
• The Eastern Mediterranean Region has the lowest FASD prevalence
• In 76 countries, more than one out of 100 young people has FASD.

The researchers also found that FASD occurred more frequently among children in care (such as foster care or orphanages), in the criminal justice system, in psychiatric care and aboriginal young people, compared to the general population.

"There is a need for targeted screening and diagnosis for these high-risk populations, as well as interventions to prevent alcohol use among mothers of children with FASD in relation to subsequent pregnancies," says Dr. Popova.

The study was a meta-analysis, which involved reviewing all existing studies in order to determine FASD levels by country. For countries lacking studies, the estimate was based on data prediction methods. This involved using data on the prevalence of alcohol use during pregnancy by country, determined in another 2017 study published by Dr. Popova's team in the Lancet Global Health.

There are existing measures that could be adopted to help prevent alcohol consumption during pregnancy and thus, FASD, says Dr. Popova. These include public health messages about the risks of drinking alcohol during pregnancy, and routine screening by health care professionals to detect alcohol consumption before or at early stages pregnancy. Brief interventions to address problems with alcohol should be provided to all women of child-bearing age where appropriate.