FASD 2013 EPIDEMIOLOGY of Fetal Alcohol Spectrum Disorders and Prenatal Alcohol Exposure (PDF)

Current analysis of FASD epidemiology and
the prevalence of maternal alcohol consumption
during pregnancy in the last five years from
2008/2009 to 2012 show from an active case
search that in elementary schools, at least one child
with FASD per class (1:21-25) must be expected
(Italy, MAY 2011; Croatia, PETKOVIC 2010).
Population-based studies on the state or federal level
reveal a significantly lower frequency (Germany,
Paditz 2012; Saxony-Anhalt/Deutschland, GOETZ
& RISSMANN 2012 in this volume; Israel,
Senecky 2009). Several indicators, such as maternal
alcohol consumption in 14% of women from Israel,
indicate that the real rate of incidence is higher.
The range of incidence of prenatal alcohol exposure
is found in national, cross-regional, or multicenter
surveys of between 2.5% in Canada and
54% in Russia (PubMed 949 studies 2008-2012,
including 21 studies from 13 countries with such
surveys). Mono-centric studies showed similar rates
of incidence between 6-29.5% (results from seven
countries).
Interviews with women from Australia (Aboriginal),
New Zealand (Niue), the USA (Hispanic/
Latina) and Ukraine indicate that prenatal alcohol
exposure is not only based on a lack of information
about embryo and fetal toxic effects of alcohol, but
that questions of self-image and the partnership
between men and women contribute significantly
to whether a woman enters into the vicious cycle
of alcohol consumption or not. In the same way, it
was found in Canada that the risk of maternal alcohol
consumption during pregnancy was increased
24-fold with the chronic abdominal pain of Colitis
Ulcerosa. Alcoholism and smoking increased this
risk "only" five or twofold, respectively (THAN &
JOHNSON 2010).
Epidemiology thus represents an essential tool for
the detection of initial conditions at the regional or
national level, as well as for the evaluation of the
effects of intervention, including the assessment of
relevant resources that are required for the care of
people with FASD. International comparisons are a
contributor, in that the experiences of other countries
are taken up, as well as benchmark projects are
initiated.
Epidemiology relies on well-defined diagnoses. A
list of differential diagnostics for FASD with
more than 25 relevant diagnoses pointed to the
possibility of false positive results. Geneticists from
Manchester (UK) found in 8.75% (7/80) of questionable
FASD cases, other diagnoses for which
existing symptoms could be held responsible
(DOUZGOU 2012). Subtle clinical observations
offered similar results in 1957 and 1968 in France
in FAS first accounts from ROQUETTE and
LEMOINE; also likely, set against the background
of France in the 50s and 60s of the 20th century,
France exhibited the highest alcohol consumption
world-wide, as well as that, in this period, the incidence
of congenital syphilis in numerous countries
declined significantly.