Fetal Alcohol Spectrum Disorders (FASD): An under-recognized issue that may be on the rise

The open-access International Journal of Alcohol and Drug Research has released a special issue on Fetal Alcohol Spectrum Disorders (FASD), with the intention of increasing awareness of the negative effects of alcohol use in pregnancy and improving prevention, treatment and care for those living with FASD.

"In most countries, FASD is not well recognized by health professionals," says guest editor Dr. Svetlana (Lana) Popova, Senior Scientist in the Social and Epidemiological Research Department at the Centre for Addiction and Mental Health (CAMH). "If FASD were addressed more consistently and effectively at the policy and program level, this would alleviate its burden on individuals with FASD and their families, who require intensive support from health, social and remedial education services, as well as on society as a whole."

The term FASD refers to a group of disorders in which in pregnancy causes damage to the central nervous system of the fetus as well as other systems and organs. Individuals with FASD may have a broad array of physical defects as well as cognitive, behavioural, emotional and learning problems. These impairments are likely to have lifelong implications.

One reason for the lack of recognition of FASD is that, despite more than 40 years' worth of evidence, FASD is not officially recognized as a medical diagnosis, write Dr. Popova and co–guest editor, Dr. Christina Chambers of the University of California at San Diego (UCSD), in an editorial. After much effort, FASD was included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) in 2013—but only in the appendix as a condition warranting further research. The International Classification of Diseases (ICD) only recognizes Fetal Alcohol Syndrome.

Yet FASD may be on the rise in coming years, due to increasing rates of alcohol use, binge drinking and drinking during pregnancy among young women in a number of countries, and the fact that the majority of pregnancies in both developing and developed countries are unplanned, the editors note.

"FASD should be recognized as a growing public health issue, as alcohol's harmful effects on a fetus represent many cases of preventable disability globally," says Dr. Chambers, Professor of Pediatrics and Family and Preventive Medicine at UCSD. "The collection of research studies in this special issue clearly demonstrates the need for such recognition."

In addition to the 11 original research papers in the current issue, the journal published a previous special FASD issue with nine papers in November 2013. Some of the studies in the current issue include the following:

  • a survey of attitudes of women of child-bearing age in Russia, to develop initiatives to prevent alcohol use in pregnancy;
  • changes in during pregnancy in Australia over 10 years;
  • evaluation of a professional development program for elementary school teachers working with children with FASD in British Columbia, Canada, which suggests it has a positive effect on students' academic achievement and classroom behaviour;
  • assessing medical, neuropsychological and educational outcomes among adoptive children in the U.S., with and without FASD, who had been previously institutionalized in Europe;
  • substance abuse treatment participation and completion among U.S. women with and without FASD, with the goal of preventing "second-generation" FASD;
  • evaluation of a screening tool, supporting its use by family physicians in maternity clinics to identify alcohol misuse, problems, lack of social support and other lifestyle issues to provide women with additional prenatal support;
  • evaluation of an outreach program for Aboriginal youth with suspected FASD in British Columbia, Canada, which shows promising results; and
  • prevalence of smoking during pregnancy and its relationship with consumption among pregnant women in the Republic of Congo.

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