Study: Fetal alcohol syndrome more common than previously throught

Feb 12 2018

Study: Fetal alcohol syndrome more common than previously throught

More American children than previously believed may be living with neurological damage caused by alcohol their mothers drank while pregnant, according to a new study. Fetal alcohol syndrome and other alcohol-related pediatric disorders may be at least as common as autism among American children, the study indicates.

The study, published in the journal JAMA, estimates that fetal alcohol syndrome and other alcohol-related disorders are at least as common as autism among American children. Various types of fetal alcohol spectrum disorders (FASDs) have been linked to certain kinds of cognitive, behavioral and physical problems that hamper children’s development and ability to learn.

Between 2010 and 2016, the researchers evaluated about 3,000 children in schools in four communities across the United States and interviewed many of their mothers. Based on their data, they estimated conservatively that fetal alcohol spectrum disorders affect 1.1 to 5 percent of children in the country, up to five times previous estimates. About 1.5 percent of children are currently diagnosed with autism, according to the Centers for Disease Control and Prevention.

“This is an equally common, or more common, disorder and one that’s completely preventable and one that we are missing,” said Christina Chambers, M.D., one of the study authors and a professor of pediatrics at the University of California-San Diego. “If it truly is affecting a substantial proportion of the population, then we can do something about it. We can provide better services for those kids, and we can do a better job of preventing the disorders to begin with,” Chambers told the New York Times. 

The most severe FASD is fetal alcohol syndrome, which causes a range of physical defects such as small head circumference and brain size; deformities of joints, limbs and fingers; slow physical growth before and after birth; vision difficulties or hearing problems; heart defects; and problems with kidneys and bones.

Problems with the brain and central nervous system may include: poor coordination or balance; intellectual disability, learning disorders and delayed development; poor memory; trouble with attention and with processing information; difficulty with reasoning and problem-solving; mood swings, and more.

A less severe condition is alcohol-related neuro-developmental disorder, in which children have neurological but not physical characteristics caused by their mothers’ prenatal alcohol consumption.

Chambers said the researchers are studying the mothers’ survey responses to see if they can identify relationships between the timing and amount of drinking during pregnancy and the type and severity of children’s impairment. Scientists have been uncertain how common these alcohol-related disorders are because some of the effects are also caused by other diagnoses.

Survey results can also be affected by mothers’ reluctance to admit they drank alcohol during their pregnancy.

“When you identify a kid with FASD, you’ve just identified a mom who drank during pregnancy and harmed her child,”  Susan Astley, M.D., director of the Fetal Alcohol Syndrome Diagnostic and Prevention Network at the University of Washington, told the Times. She was not involved in the study.

Astley said several factors affected the reliability of the study data. For example, only 60 percent of eligible families in the schools allowed their children to be evaluated and more than a third of those children’s mothers declined to answer questions about drinking during pregnancy.

“If we could generate accurate estimates of FASD, we’d all benefit,” Dr. Astley said. “But the major limitations in the study design render the results, for the most part, uninterpretable.”

Identifying children with alcohol-related impairments can make it easier for teachers and psychologists to help them, according to experts. The diagnosis can help teachers understand that a child’s behavior problems are “not because this child is disobedient, it’s because of some neurological disorder,” said Svetlana Popova, M.D.,a senior scientist at the Centre for Addiction and Mental Health’s Institute for Mental Health Policy Research in Toronto, and co-author of an editorial about the new study.