Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 May 12;14(5):522.
doi: 10.3390/ijerph14050522.

Replication of High Fetal Alcohol Spectrum Disorders Prevalence Rates, Child Characteristics, and Maternal Risk Factors in a Second Sample of Rural Communities in South Africa

Affiliations
Free PMC article

Replication of High Fetal Alcohol Spectrum Disorders Prevalence Rates, Child Characteristics, and Maternal Risk Factors in a Second Sample of Rural Communities in South Africa

Philip A May et al. Int J Environ Res Public Health. .
Free PMC article

Abstract

Background: Prevalence and characteristics of fetal alcohol syndrome (FAS) and total fetal alcohol spectrum disorders (FASD) were studied in a second sample of three South African rural communities to assess change. Methods: Active case ascertainment focused on children with height, weight and/or head circumference ≤25th centile and randomly-selected children. Final diagnoses were based on dysmorphology, neurobehavioral scores, and maternal risk interviews. Results: Cardinal facial features, head circumference, and total dysmorphology scores differentiated specific FASD diagnostic categories in a somewhat linear fashion but all FASD traits were significantly worse than those of randomly-selected controls. Neurodevelopmental delays were significantly worse for children with FASD than controls. Binge alcohol use was clearly documented as the proximal maternal risk factor for FASD, and significant distal risk factors were: low body mass, education, and income; high gravidity, parity, and age at birth of the index child. FAS rates continue to extremely high in these communities at 9-129 per 1000 children. Total FASD affect 196-276 per 1000 or 20-28% of the children in these communities. Conclusions: Very high rates of FASD persist in these general populations where regular, heavy drinking, often in a binge fashion, co-occurs with low socioeconomic conditions.

Keywords: South Africa; alcohol abuse; binge drinking; children with FASD; fetal alcohol spectrum disorders (FASD); maternal risk for FASD; microcephaly; prenatal alcohol use; prevalence.

Conflict of interest statement

The authors declare no conflict of interest. The funding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

Figures

Figure 1
Figure 1
Sampling methodology for prevalence of FASD in three rural communities in a South African community: A second sample.
Figure 2
Figure 2
Diagnostic guidelines for specific fetal alcohol spectrum disorders (FASD), according to the Institute of Medicine, as clarified by Hoyme et al., 2005 [3].
Figure 3
Figure 3
Average occipitofrontal (head) circumference (OFC) by measurement (cm) and age-specific percentile and total dysmorphology scores by diagnostic category for a second sample in three rural South African communities.
Figure 4
Figure 4
Final prevalence rates (per 1000) of FASD diagnostic groups and controls in three rural communities South Africa: A second sample.

Similar articles

See all similar articles

Cited by 15 articles

See all "Cited by" articles

References

    1. Jones K.J., Smith D.W. Recognition of the fetal alcohol syndrome in early infancy. Lancet. 1973;302:999–1001. doi: 10.1016/S0140-6736(73)91092-1. - DOI - PubMed
    1. Stratton K.R., Howe C.J., Battaglia F.C. Fetal Alcohol Syndrome Diagnosis, Epidemiology, Prevention, and Treatment. Institute of Medicine, National Academy Press; Washington, DC, USA: 1996.
    1. Hoyme H.E., May P.A., Kalberg W.O., Kodituwakku P., Gossage J.P., Trujillo P.M., Buckley D.G., Miller J., Khaole N., Viljoen D.L., et al. A practical clinical approach to diagnosis of fetal alcohol spectrum disorders: Clarification of the 1996 Institute of Medicine criteria. Pediatrics. 2005;115:39–47. doi: 10.1542/peds.2004-0259. - DOI - PMC - PubMed
    1. Hoyme H.E., Kalberg W.O., Elliott A.J., Blankenship J., Buckley D., Marais A.S., Manning M.A., Robinson L.K., Adam M.P., Abdul-Rahman O., et al. Updated clinical guidelines for diagnosing fetal alcohol spectrum disorders. Pediatrics. 2016;138:e20154256. doi: 10.1542/peds.2015-4256. - DOI - PMC - PubMed
    1. Streissguth A.P., O’Malley K. Neuropsychiatric implications and long-term consequences of fetal alcohol spectrum disorders. Sem. Clin. Neuropsychol. 2000;47:177–190. doi: 10.1053/scnp.2000.6729. - DOI - PubMed
Feedback