October 29, 2014 — As many as one in 20 children in the U.S. could have health or behavioral problems stemming from their mothers' alcohol consumption during pregnancy, according to a new study in Pediatrics, HealthDay/Philadelphia Inquirer reports.
The study estimated that between 2.4% and 4.8% of U.S. children have a fetal alcohol spectrum disorder, which can range from behavioral issues and difficulties completing tasks to fetal alcohol syndrome, the most severe type of FASD. Fetal alcohol syndrome is characterized by abnormalities in facial features and brain structure, as well as growth and behavioral problems.
The researchers assessed first graders from a nationally representative Midwestern town to identify children who had developmental problems or were below the 25th percentile for weight, height or head circumference (Haelle, HealthDay/Philadelphia Inquirer, 10/27).
The researchers considered four diagnoses on the FASD spectrum: fetal alcohol syndrome, partial fetal alcohol syndrome, alcohol-related neurodevelopmental disorder and alcohol-related birth defects.
The researchers found that between six and nine first graders per 1,000 had fetal alcohol syndrome, while 11 to 17 per 1,000 had partial fetal alcohol syndrome.
According to Medscape, the rates in the new study are "substantially higher" than previous estimates among the general population in the U.S., Canada and Europe. For example, CDC has estimated that 0.2 to 1.5 per 1,000 children have fetal alcohol syndrome, while the Institute of Medicine has estimated that 0.5 to three per 1,000 have fetal alcohol syndrome.
One reason for the difference could be that previous studies determined prevalence using passive methods, such as surveillance, which can lead to underestimates, whereas the new study used "active case ascertainment methods," Medscape reports.
Maternal Risk Factors
The researchers also interviewed the children's mothers to assess maternal risk factors. They found that late recognition of pregnancy, the amount of alcohol the mother consumed three months prior to pregnancy and the amount of alcohol the father consumed to be the most predictive of whether a child would have FASD (Beth Nierengarten, Medscape, 10/27).
Lana Popova, a senior scientist at the Centre for Addiction and Mental Health and an assistant professor of epidemiology and social work at the University of Toronto, said that "women are receiving mixed messages about alcohol use during pregnancy through their family or friends, health care providers and public health campaigns." She also noted that alcohol use, binge drinking and alcohol consumption during pregnancy all "appear to be increasing among young women in a number of countries."
Other factors that contribute to FASD rates include insufficient access to effective treatment programs for substance use disorders and high unintended pregnancy rates, Popova said (HealthDay/Philadelphia Inquirer, 10/27).