Why Rates of Fetal Alcohol Spectrum Disorders Are Higher Than We Thought
Rates of fetal alcohol spectrum disorders are higher than previously thought, with a new study suggesting that as many as 1 in 20 babies are born with the condition. The research, published in the Journal of the American Medical Association indicates this may actually be a conservative estimate and may actually be closer to 1 in 10. This is significantly higher than the existing estimates, which were that it affected 1 in 100 births.
Fetal alcohol spectrum disorders are actually a range of serious, chronic conditions caused by exposure to alcohol during fetal development. Typically, they involve damage to the central nervous system as well as having physical effects that could later lead to a wide range of permanent and lifelong health consequences. According to the Centers for Disease Control, some of the features of FASD include the child having a small head, being below average weight and height and having learning difficulties and behavioral problems.
In fact, because FASD frequently involves a combination of symptoms or conditions, it can be difficult to properly diagnose. In a statement, Dr. Christina Chambers, coprincipal investigator of the study and professor of pediatrics at UC San Diego School of Medicine, said that estimating FASD rates has always been complex because of challenges in obtaining accurate information on alcohol use during pregnancy as well as in identifying the physical and neurobehavioral characteristics of the disorders. As a result, it has been difficult to know the actual rate of FASD prevalence.
"Our results suggest that the rate of FASD in children in the United States is as high or higher than autism spectrum disorders," said Chambers. For comparison, the CDC estimates the frequency of autism spectrum disorders at 14.6 per 1,000 8-year-olds.
To conduct the study, researchers evaluated more than 6,000 first-graders in the Pacific Southwest, Midwest, Rocky Mountain and Southeast regions of the U.S. and found that 1 to 5 percent of the children had FASD. And of the 222 children diagnosed with FASD in the study, only two had a previous diagnosis despite the fact that many parents and guardians of the participants were aware of the children's learning and behavioral challenges.
"Our findings suggest that FASD is a critical health problem that often goes undiagnosed and misdiagnosed," Chambers said in a statement. "Prenatal alcohol exposure is the leading preventable cause of birth defects and neurological abnormalities in the United States. It can cause a range of developmental, cognitive and behavioral problems, which may be recognized at any time during childhood and can last a lifetime."
Out of more than 8,000 pregnant people who took part in a survey by the U.S. Behavioral Risk Factor Surveillance System, 10 percent reported recent drinking and 3 percent reported at least one binge episode within the previous 30 days. (It does not, however, take into account when during the pregnancy the binge occurred; for example, if it happened before the person was aware they were pregnant.) Though there have been conflicting studies regarding how much — if any — alcohol is safe to drink during pregnancy, the CDC and health officials like the Surgeon General recommend skipping the adult beverages completely. The highest risk for gestating a fetus with FASD is a pattern of binge drinking during pregnancy — so, not necessarily a single glass of wine at an event.
The main takeaway from this research, though, is that FSAD is far more common than we previously thought, meaning that more screening, prevention and treatment options are required to help stop this pattern.