The continuum of fetal alcohol spectrum disorders in a community in South Africa: Prevalence and characteristics in a fifth sample. May, P., A., Marais, A., de Vries, M., M., Kalberg, W., O., Buckley, D., Hasken, J., M., Adnams, C., M., Barnard, R., Joubert, B., Cloete, M., Tabachnick, B., Robinson, L., K., Manning, M., A., Jones, K., L., Bezuidenhout, H., Seedat, S., Parry, C., D., H., & Hoyme, H., E. Drug and Alcohol Dependence, 168:274-286, 2016.
The continuum of fetal alcohol spectrum disorders in a community in South Africa: Prevalence and characteristics in a fifth sample [link]Website  abstract   bibtex   
BACKGROUND: The prevalence and characteristics of the continuum of diagnoses within fetal alcohol spectrum disorders (FASD) were researched in a fifth sample in a South African community. METHODS: An active case ascertainment approach was employed among all first grade learners in this community (n=862). Following individual examination by clinical geneticists/dysmorphologists, cognitive/behavioral testing, and maternal interviews, final diagnoses were made in multidisciplinary case conferences. RESULTS: Physical measurements, cardinal facial features of FAS, and total dysmorphology scores clearly differentiated diagnostic categories in a consistent, linear fashion, from severe to mild. Neurodevelopmental delays and behavioral problems were significantly worse for each of the FASD diagnostic categories, although not as consistently linear across diagnostic groups. Alcohol use was documented by direct report from the mother in 71% to 100% of cases in specific diagnostic groups. Significant distal maternal risk factors in this population are: advanced maternal age at pregnancy; low height, weight, and body mass index (BMI); small head circumference; low education; low income; and rural residence. Even when controlling for socioeconomic status, prenatal drinking correlates significantly with total dysmorphology score, head circumference, and five cognitive and behavioral measures. In this community, FAS occurs in 59-79 per 1,000 children, and total FASD in 170-233 per 1,000 children, or 17% to 23%. CONCLUSIONS: Very high rates of FASD continue in this community where entrenched practices of regular binge drinking co-exist with challenging conditions for childbearing and child development in a significant portion of the population.
@article{
 title = {The continuum of fetal alcohol spectrum disorders in a community in South Africa: Prevalence and characteristics in a fifth sample},
 type = {article},
 year = {2016},
 identifiers = {[object Object]},
 keywords = {Adolescent,Adult,African Continental Ancestry Group,Alcohol Drinking,Alcohol abuse,Alcoholism,Binge drinking,Child Development,Children with FASD,Educational Status,Female,Fetal Alcohol Spectrum Disorders,Fetal alcohol spectrum disorders (FASD),Humans,Infant, Newborn,Linear Models,Male,Maternal Age,Maternal risk for FASD,Microcephaly,Mothers,Pregnancy,Pregnancy Complications,Prenatal alcohol use,Prevalence,Risk Factors,Rural Population,South Africa,Young Adult},
 pages = {274-286},
 volume = {168},
 websites = {http://files/1204/May et al. - 2016 - The continuum of fetal alcohol spectrum disorders .pdf,http://www.ncbi.nlm.nih.gov/pubmed/27736681},
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 abstract = {BACKGROUND: The prevalence and characteristics of the continuum of diagnoses within fetal alcohol spectrum disorders (FASD) were researched in a fifth sample in a South African community. METHODS: An active case ascertainment approach was employed among all first grade learners in this community (n=862). Following individual examination by clinical geneticists/dysmorphologists, cognitive/behavioral testing, and maternal interviews, final diagnoses were made in multidisciplinary case conferences. RESULTS: Physical measurements, cardinal facial features of FAS, and total dysmorphology scores clearly differentiated diagnostic categories in a consistent, linear fashion, from severe to mild. Neurodevelopmental delays and behavioral problems were significantly worse for each of the FASD diagnostic categories, although not as consistently linear across diagnostic groups. Alcohol use was documented by direct report from the mother in 71% to 100% of cases in specific diagnostic groups. Significant distal maternal risk factors in this population are: advanced maternal age at pregnancy; low height, weight, and body mass index (BMI); small head circumference; low education; low income; and rural residence. Even when controlling for socioeconomic status, prenatal drinking correlates significantly with total dysmorphology score, head circumference, and five cognitive and behavioral measures. In this community, FAS occurs in 59-79 per 1,000 children, and total FASD in 170-233 per 1,000 children, or 17% to 23%. CONCLUSIONS: Very high rates of FASD continue in this community where entrenched practices of regular binge drinking co-exist with challenging conditions for childbearing and child development in a significant portion of the population.},
 bibtype = {article},
 author = {May, Philip A and Marais, Anna-Susan and de Vries, Marlene M and Kalberg, Wendy O and Buckley, David and Hasken, Julie M and Adnams, Colleen M and Barnard, Ronel and Joubert, Belinda and Cloete, Marise and Tabachnick, Barbara and Robinson, Luther K and Manning, Melanie A and Jones, Kenneth Lyons and Bezuidenhout, Heidre and Seedat, Soraya and Parry, Charles D H and Hoyme, H Eugene},
 journal = {Drug and Alcohol Dependence}
}
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