The continuum of fetal alcohol spectrum disorders in four rural communities in South Africa: Prevalence and characteristics. May, P., A., de Vries, M., M., Marais, A., Kalberg, W., O., Adnams, C., M., Hasken, J., M., Tabachnick, B., Robinson, L., K., Manning, M., A., Jones, K., L., Hoyme, D., Seedat, S., Parry, C., D., H., & Hoyme, H., E. Drug and Alcohol Dependence, 159:207-218, 2016.
The continuum of fetal alcohol spectrum disorders in four rural communities in South Africa: Prevalence and characteristics [link]Website  abstract   bibtex   
BACKGROUND: Prevalence and characteristics of the continuum of diagnoses within fetal alcohol spectrum disorders (FASD) were researched in previously unstudied rural, agricultural, lower socioeconomic populations in South Africa (ZA). METHODS: Using an active case ascertainment approach among first grade learners, 1354 (72.6%) were consented into the study via: height, weight, and/or head circumference ≤ 25th centile and/or random selection as normal control candidates. Final diagnoses were made following: examination by pediatric dysmorphologists/geneticists, cognitive/behavioral testing, and maternal risk factor interviews. RESULTS: FASD children were significantly growth deficient and dysmorphic: physical measurements, cardinal facial features of FAS, and total dysmorphology scores clearly differentiated diagnostic categories from severe to mild to normal in a consistent, linear fashion. Neurodevelopmental delays were also significantly worse for each of the FASD diagnostic categories, although not as consistently linear across groups. Alcohol use is well documented as the proximal maternal risk factor for each diagnostic group. Significant distal maternal risk factors in this population are: low body weight, body mass, education, and income; and high gravidity, parity, and age at birth of the index child. In this low SES, highly rural region, FAS occurs in 93-128 per 1000 children, PFAS in 58-86, and, ARND in 32-46 per 1000. Total FASD affect 182-259 per 1000 children or 18-26%. CONCLUSIONS: Very high rates of FASD exist in these rural areas and isolated towns where entrenched practices of regular binge drinking co-exist with challenging conditions for childbearing and child development.
@article{
 title = {The continuum of fetal alcohol spectrum disorders in four rural communities in South Africa: Prevalence and characteristics},
 type = {article},
 year = {2016},
 identifiers = {[object Object]},
 keywords = {Adult,Alcohol Drinking,Alcohol abuse,Child,Child Development,Children with FASD,Female,Fetal Alcohol Spectrum Disorders,Fetal alcohol spectrum disorders (FASD),Humans,Maternal risk for FASD,Mothers,Neuropsychological Tests,Pregnancy,Prenatal alcohol use,Prevalence,Risk Factors,Rural Population,South Africa},
 pages = {207-218},
 volume = {159},
 websites = {http://files/1195/May et al. - 2016 - The continuum of fetal alcohol spectrum disorders .pdf,http://www.ncbi.nlm.nih.gov/pubmed/26774945},
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 abstract = {BACKGROUND: Prevalence and characteristics of the continuum of diagnoses within fetal alcohol spectrum disorders (FASD) were researched in previously unstudied rural, agricultural, lower socioeconomic populations in South Africa (ZA). METHODS: Using an active case ascertainment approach among first grade learners, 1354 (72.6%) were consented into the study via: height, weight, and/or head circumference ≤ 25th centile and/or random selection as normal control candidates. Final diagnoses were made following: examination by pediatric dysmorphologists/geneticists, cognitive/behavioral testing, and maternal risk factor interviews. RESULTS: FASD children were significantly growth deficient and dysmorphic: physical measurements, cardinal facial features of FAS, and total dysmorphology scores clearly differentiated diagnostic categories from severe to mild to normal in a consistent, linear fashion. Neurodevelopmental delays were also significantly worse for each of the FASD diagnostic categories, although not as consistently linear across groups. Alcohol use is well documented as the proximal maternal risk factor for each diagnostic group. Significant distal maternal risk factors in this population are: low body weight, body mass, education, and income; and high gravidity, parity, and age at birth of the index child. In this low SES, highly rural region, FAS occurs in 93-128 per 1000 children, PFAS in 58-86, and, ARND in 32-46 per 1000. Total FASD affect 182-259 per 1000 children or 18-26%. CONCLUSIONS: Very high rates of FASD exist in these rural areas and isolated towns where entrenched practices of regular binge drinking co-exist with challenging conditions for childbearing and child development.},
 bibtype = {article},
 author = {May, Philip A and de Vries, Marlene M and Marais, Anna-Susan and Kalberg, Wendy O and Adnams, Colleen M and Hasken, Julie M and Tabachnick, Barbara and Robinson, Luther K and Manning, Melanie A and Jones, Kenneth Lyons and Hoyme, Derek and Seedat, Soraya and Parry, Charles D H and Hoyme, H Eugene},
 journal = {Drug and Alcohol Dependence}
}

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