From the desk of: David Horita, Ph.D.
THE STUDY
In a recently published paper1, NRI investigator Phil May and colleagues showed that the prevalence of fetal alcohol syndrome (FAS) and partial fetal alcohol syndrome (PFAS) is two to three times higher than previously estimated.
Dr. May’s study differs from most FAS prevalence studies in its use of active case ascertainment testing methods to estimate prevalence. This technique includes developmental testing of the child and detailed one-on-one interviews of the mother. The interview questions covered alcohol use during pregnancy, but also asked questions related to secondary factors, such as overall drinking history, marital status; socioeconomic status, and diet/nutrition. This approach is much more labor-intensive than the more common survey approach that relies on self-reported alcohol use information. However, it is also more accurate: self-reported alcohol usage surveys often underestimate FAS because of the stigma of drinking during pregnancy.
This study estimated prevalence of FAS as 3-8 per 1,000 and PFAS as 8-18 per 1000 children in the community. This suggests that up to 2.5 % of children in the US have some degree of FAS. These numbers are significantly higher than previous estimates2 of less than 1 %. In concordance with other studies, May and colleagues found correlations between maternal drinking and child physiology – children with FAS and PFAS were shorter, had lower weight and distinct facial characteristics. Additionally, FAS and PFAS children scored lower on IQ tests and in reading, spelling, and arithmetic ability, and they exhibited more communication, socialization, and behavior disorders than non-FAS children.
WHY IS THIS IMPORTANT?
Knowing the prevalence of FAS and PFAS guides prioritizing prevention and intervention efforts. Numerous studies have placed the economic cost of FAS and associated disorders at over $1 million per case per lifetime3. These costs include increased medical treatments, increased educational costs, decreased worker productivity, and increased societal costs (youths with FAS are estimated to be nineteen times more likely to be in prison than youths without FAS4). Across the US, the difference in prevalence of 1 vs 2.5 % translates to a difference of several billion dollars per year in real costs. Dr. May’s research clarifies the social and economic value of FAS prevention efforts.
There is no cure for FAS. The finding that 2-3 times more children in the US show FAS symptoms than previously estimated underscores the importance of FAS research that could lead to treatments. For instance, other ongoing NRI studies are investigating the potential of nutritional supplements to ameliorate symptoms in young children with FAS5.
David Horita joined the NRI in 2013 as a grant writer. He assists faculty by identifying funding opportunities and writing/editing research proposals. David developed research and writing experience in metabolism and cell signaling during his 13 years as a faculty member in Biochemistry at Wake Forest University School of Medicine. He did postdoctoral work at the NCI/NIH and obtained a Ph.D. in physical chemistry from the University of Wisconsin and a B.A. in chemistry from Carleton College.
References:
1May PA, Keaster C, Bozeman R, Goodover J, Blankenship J, Kalberg WO, Buckley D, Brooks M, Hasken J, Gossage JP, Robinson LK, Manning M, Hoyme HE (2015). Prevalence and characteristics of fetal alcohol syndrome and partial fetal alcohol syndrome in a Rocky Mountain Region City. Drug Alcohol Depend 155:118-2
2https://www.cdc.gov/ncbddd/fasd/data.html
3Popova S, Stade B, Lange S, Bekmuradov D, Rehm J (2012). Economic impact of fetal alcohol syndrome (FAS) and fetal alcohol spectrum disorders (FASD). Public Health Agency of Canada. Ottawa, Ontario, CA
4Popova S, Stade B, Lange S, Rehm J (2012). A model for estimating the economic impact of fetal alcohol spectrum disorder. J Popul Ther Clin Pharmacol 191:e51-e65
5Wozniak JR, Fuglestad AJ, Eckerle JK, Fink BA, Hoecker HL, Boys CJ, Radke JP, Kroupina MG, Miller NC, Brearley AM, Zeisel SH, Georgieff MK (2015). Choline supplementation in children with fetal alcohol spectrum disorders: a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr (in press)
