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Cited by 541Prenatal Substance Exposure EffectsFetal and Pediatric Neurological DisordersSubstance Abuse Treatment and Outcomes

Comorbidity of fetal alcohol spectrum disorder: a systematic review and meta-analysis

Popova, Svetlana, Lange, Shannon, Shield, Kevin, Mihic, Alanna, Chudley, Albert E, Mukherjee, Raja A S, Bekmuradov, Dennis, Rehm, Jürgen·2016·The Lancet
DOI 10.1016/s0140-6736(15)01345-8
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Abstract

Background Fetal alcohol spectrum disorder (FASD) is related to many comorbidities because of the permanent effects of prenatal alcohol exposure on the fetus. We aimed to identify the comorbid conditions that co-occur in individuals with FASD and estimate the pooled prevalence of comorbid conditions occurring in individuals with fetal alcohol syndrome (FAS).Methods We did a systematic literature search of studies reporting on the comorbidity and cause of death in individuals with FASD using multiple electronic bibliographic databases, searching for studies published up to July, 2012. We included original research published in a peer-reviewed journal in the English language. We used the following criteria for determining study quality: use of an established FASD diagnostic guideline, study setting, method of data collection, and sample size. All comorbid disease conditions were coded according to the International Classification of Diseases, tenth revision (ICD-10). To estimate the pooled prevalence of comorbid conditions found to co-occur in individuals with FAS, we did meta-analyses assuming a random-effects model.Findings Of 5068 studies found, 127 met eligibility criteria for data extraction. From those studies, we identified 428 comorbid conditions co-occurring in individuals with FASD, spanning across 18 of 22 chapters of the ICD-10. The most prevalent disease conditions were within the sections of congenital malformations, deformities, and chromosomal abnormalities, and mental and behavioural disorders. 33 studies reported data for frequency in a total of 1728 participants with FAS. The five comorbid conditions with the highest pooled prevalence (between 50% and 91%) included abnormal results of function studies of peripheral nervous system and special senses, conduct disorder, receptive language disorder, chronic serous otitis media, and expressive language disorder.Interpretation The high prevalence of comorbid conditions in individuals with FASD highlights the importance of assessing prenatal alcohol exposure as a substantial clinical risk factor for comorbidity. The harmful effects of alcohol on a developing fetus represent many cases of preventable disability, and thus, alcohol use during pregnancy should be recognised as a public health problem globally.Funding Public Health Agency of Canada.

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  • The most severe and important form of FASD in terms of public health, fetal alcohol syndrome (FAS), is characterized by clear morphological changes, functional deficits and high prevalence of comorbidities.

    “The most severe and important form of FASD in terms of public health, fetal alcohol syndrome (FAS), is characterized by clear morphological changes, functional deficits and high prevalence of comorbidities 57.”

    From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [57]

  • The overwhelming majority of FAS deaths are coded as resulting from comorbidities and are not coded to FAS as a cause of death.

    “the overwhelming majority of these deaths are coded as resulting from comorbidities 57, and are not coded to FAS as a cause of death.”

    From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [57]

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Authors
Popova, S., Lange, S., Shield, K., Mihic, A., Chudley, A. E., Mukherjee, R. A. S., Bekmuradov, D., & Rehm, J.
Affiliations
  • Centre for Addiction and Mental Health (CA)
  • University of Toronto (CA)
  • University of Manitoba (CA)
  • Surrey and Borders Partnership NHS Foundation Trust (GB)
  • Toronto Metropolitan University (CA)
Corresponding author
Popova, Svetlana
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2016-03
Volume
387
Issue
10022
Pages
978-987
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(15)01345-8
OpenAlex
W2222884808
Cited by
541
References
174
Citations by year
2026: 37 · 2025: 43 · 2024: 46 · 2023: 58 · 2022: 52 · 2021: 77 · 2020: 78 · 2019: 50 · 2018: 41 · 2017: 39 · 2016: 19 · 2015: 1
FWCI
7.62
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
Funders
Public Health Agency of Canada
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Fetal and Pediatric Neurological Disorders
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords
fetal alcohol spectrum disorders, fetal alcohol syndrome, comorbidities, prenatal alcohol exposure, conduct disorder, receptive language disorders, expressive language disorder, congenital malformations, mental and behavioral disorders, causes of death
MeSH terms
Humans, Comorbidity, Prevalence, Fetal Alcohol Spectrum Disorders

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