Study Estimates 630K Infants Born With FASD Globally Each Year

One of every 13 women worldwide who consumed alcohol during pregnancy is estimated to have had a child with fetal alcohol spectrum disorder (FASD), according to a study published August 21 in JAMA Pediatrics. Based on these global estimates, some 630,000 infants with FASD are born each year.

The analysis also revealed FASD is notably more frequent among aboriginal populations, children in foster care and residing in orphanages, incarcerated populations, and those in psychiatric care.

These new prevalence estimates may help countries effectively plan strategies and allocate health care resources to people in need, the authors wrote.

Senior author Svetlana Popova, Ph.D., of the Centre for Addiction and Mental Health in Toronto and colleagues obtained their findings by developing estimates of drinking behavior during pregnancy for each country in the world using available data from the World Health Organization. They then used existing data from 24 individual FASD population studies spanning eight countries (Australia, Canada, Croatia, France, Italy, Norway, South Africa, and the United States) to calculate the country-by-country prevalence of FASD based on the drinking behavior data.

The study investigators calculated an overall worldwide prevalence of FASD of nearly 0.8 percent (7.7 cases per 1,000 children).

Among the 187 countries assessed in this study, 76 countries had prevalence rates exceeding 1 percent, including the United States with a prevalence of 1.5 percent. South Africa had the highest individual FASD prevalence at 111.1 cases per 1,000 children, followed by Croatia (53.3 per 1,000), Ireland (47.5 per 1,000), Italy (45.0 per 1,000), and Belarus (36.6 per 1,000).

Europe had the highest regional prevalence at 19.8 cases per 1,000 children, while the Middle East had the lowest prevalence at 0.1 per 1,000.

In addition to the general population data, Popova and colleagues found that FASD rates are elevated in several vulnerable groups, including aboriginal populations (as much as 25 times higher prevalence than the general population), correctional system populations (as much as 30 times higher), and children in foster care and residing in orphanages (as much as 68 times higher).

“The higher prevalence emphasizes that these high-risk populations deserve special attention for the planning and organization of targeted screening strategies, improved access to diagnostic services, and prevention of maternal alcohol consumption,” the authors wrote.

Popova did caution that the numbers calculated for most countries might be a rough estimate.

“Regional variations in the prevalence of FASD likely stem from not only differences in maternal drinking behaviors, but from political, ideological, cultural, and legal differences as well,” she told s.

“The current findings emphasize that FASD occurs throughout society, regardless of socioeconomic status, level of education, or ethnicity,” she continued. “A clear and consistent message needs to be relayed to pregnant women and women of childbearing age across the globe: There is no safe amount of alcohol or safe time to drink during pregnancy or when planning to become pregnant.”

Popova said that she hopes that these findings will encourage more countries to collect prevalence data on both alcohol use during pregnancy and FASD in both the general population and among at-risk populations. Such information could provide a clearer basis for public health policy, health care planning, surveillance, and evidence-based prevention strategies, she said.

This study did not receive any external funding. ■

The abstract of “Global Prevalence of Fetal Alcohol Spectrum Disorder Among Children and Youth: A Systematic Review and Meta-analysis” can be accessed here.