Topic Editor: Mary J. O'Connor, PhD, University of California at Los Angeles, USA
Topic funded by: Margaret & Wallace McCain Family Foundation
Alcohol consumption in women of childbearing age has maintained around 55% worldwide in the last 20 years, including roughly 11% of pregnant women who reported consuming alcohol in the previous month. Other research has found that 30% of women admit consuming alcohol at some point during pregnancy, and 8% report having had more than four drinks on one occasion. Although most women reduce their consumption once they find out they are expecting, many of them do not know about the pregnancy before the fourth or sixth week of gestation and continue drinking during that period. Although experts advice women to avoid alcohol during pregnancy or while trying to conceive, drinking continues to be reported by women perhaps due to persistent confusion about the effects of alcohol on fetal development.
Despite its entirely preventable nature, prenatal alcohol exposure (PAE) remains the leading cause of congenital abnormalities, intellectual impairment, and other developmental problems in children. Complications due to maternal alcohol consumption during pregnancy affect families and children from all ethnic and economic backgrounds.
One of the most severe birth defects caused by PAE is Fetal Alcohol Syndrome (FAS). FAS is an enduring and irreversible condition marked by a set of distinctive facial traits (e.g., small openings to the eyes, thin upper lip, flattened area above the upper lip) as well as growth retardation and central nervous system dysfunction. On average, approximately 1 - 3 per 1,000 viable infants are born with FAS, and these rates increase to 10 - 15 per 1,000 in at-risk groups such as the foster care population.
Given that most children exposed to alcohol during the prenatal period do not exhibit all of these defects, the term Fetal Alcohol Spectrum Disorders (FASDs) has been introduced in recent years to incorporate the range of deficits associated with PAE. The prevalence of FASDs in the general population is estimated at 9.1 per 1,000 live births.
Aside from the direct devastating effects prenatal exposure to alcohol has on children and families, it also represents a significant financial burden for governments and communities. For instance, the lifetime cost for the care of one child with FAS is estimated at $2 million in special medical, health and educational resources.
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