Approaching the Prevalence of the Full Spectrum of Fetal Alcohol Spectrum Disorders in a S outh A frican Population‐Based Study
Open accessAbstract
Background: The prevalence and characteristics of fetal alcohol spectrum disorders ( FASD ) were determined in this fourth study of first‐grade children in a S outh A frican community. Methods: Active case ascertainment methods were employed among 747 first‐grade pupils. The detailed characteristics of children within the continuum of FASD are contrasted with randomly selected, normal controls on (i) physical growth and dysmorphology; (ii) cognitive/behavioral characteristics; and (iii) maternal risk factors. Results: The rates of specific diagnoses within the FASD spectrum continue to be among the highest reported in any community in the world. The prevalence (per 1,000) is as follows: fetal alcohol syndrome ( FAS )—59.3 to 91.0; partial fetal alcohol syndrome ( PFAS )—45.3 to 69.6; and alcohol‐related neurodevelopmental disorder ( ARND )—30.5 to 46.8. The overall rate of FASD is therefore 135.1 to 207.5 per 1,000 (or 13.6 to 20.9%). Clinical profiles of the physical and cognitive/behavioral traits of children with a specific FASD diagnosis and controls are provided for understanding the full spectrum of FASD in a community. The spectral effect is evident in the characteristics of the diagnostic groups and summarized by the total (mean) dysmorphology scores of the children: FAS = 18.9; PFAS = 14.3; ARND = 12.2; and normal controls, alcohol exposed = 8.2 and unexposed = 7.1. Documented drinking during pregnancy is significantly correlated with verbal ( r = −0.253) and nonverbal ability ( r = −0.265), negative behaviors ( r = 0.203), and total dysmorphology score ( r = 0.431). Other measures of drinking during pregnancy are significantly associated with FASD , including binge drinking as low as 3 drinks per episode on 2 days of the week. Conclusions: High rates of specific diagnoses within FASD were well documented in this new cohort of children. FASD persists in this community. The data reflect an increased ability to provide accurate and discriminating diagnoses throughout the continuum of FASD .
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The prevalence of fetal alcohol syndrome is very high in the setting.
“in a setting with a very high prevalence of fetal alcohol syndrome (Chersich et al., 2012; May et al., 2013).”
From Effectiveness of Nurse-Practitioner-Delivered Brief Motivational Intervention for Young Adult Alcohol and Drug Use in Primary Care in South Africa: A Randomized Clinical Trial (2014) · cites this paper as May et al., 2013
Studies by May and co-workers give some indication of the full spectrum of FASD.
“Studies by May and co‐workers 59, 60, 61 give some indication of the full spectrum of FASD.”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [59]
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- Authors
- May, P. A., Blankenship, J., Marais, A., Gossage, J. P., Kalberg, W. O., Barnard, R., De Vries, M., Robinson, L. K., Adnams, C. M., Buckley, D., Manning, M., Jones, K. L., Parry, C., Hoyme, H. E., & Seedat, S.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- University of New Mexico (US)
- Stellenbosch University (ZA)
- Department of Psychiatry, Faculty of Health Sciences Stellenbosch University Tygerberg South Africa
- University at Buffalo, State University of New York (US)
- University of Cape Town (ZA)
- Stanford University (US)
- University of California San Diego (US)
- South African Medical Research Council (ZA)
- University of South Dakota (US)
- Corresponding author
- May, Philip A.
- ORCID
- Venue
- Alcoholism: Clinical and Experimental Research
- Publisher
- Wiley
- Published
- 2012-12-14
- Volume
- 37
- Issue
- 5
- Pages
- 818-830
- ISSN
- 0145-6008 (ISSN-L)
- 1530-0277
- PMC
- PMC3610844
- OpenAlex
- W2112189831
- Cited by
- 234
- References
- 40
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 8 · 2023: 12 · 2022: 19 · 2021: 13 · 2020: 15 · 2019: 21 · 2018: 24 · 2017: 24 · 2016: 33 · 2015: 19 · 2014: 29 · 2013: 3
- FWCI
- 14.20
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Alcoholism Clinical and Experimental Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute on Alcohol Abuse and Alcoholism (R01AA009440, R01/UO1 AA01115134, R01AA011685, U01AA011685, U01AA015134)
- National Institute on Minority Health and Health Disparities
- 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, prevalence, fetal alcohol syndrome, partial fetal alcohol syndrome, alcohol-related neurodevelopmental disorder, prenatal alcohol exposure, binge drinking, dysmorphology, first grade students, South Africa
- MeSH terms
- Alcohol Drinking, Child, Child, Preschool, Female, Humans, Male, Pregnancy, Severity of Illness Index, South Africa, Prevalence, Fetal Alcohol Spectrum Disorders
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