Global Prevalence of Fetal Alcohol Spectrum Disorder Among Children and Youth: A Systematic Review and Meta-analysis
Shannon Lange,Shannon Lange,Charlotte Probst,Charlotte Probst,Gerrit Gmel,Gerrit Gmel,Jürgen Rehm,Larry Burd,Svetlana Popova +8 more
TLDR
The global prevalence of FASD among children and youth in the general population was estimated to be 7.7 per 1000 population (95% CI, 4.9-11.6 per 1000), and the global mean prevalence weighted by the number of live births in each country was estimated as mentioned in this paper.Abstract:
Importance Prevalence estimates are essential to effectively prioritize, plan, and deliver health care to high-needs populations such as children and youth with fetal alcohol spectrum disorder (FASD). However, most countries do not have population-level prevalence data for FASD. Objective To obtain prevalence estimates of FASD among children and youth in the general population by country, by World Health Organization (WHO) region, and globally. Data Sources MEDLINE, MEDLINE in process, EMBASE, Education Resource Information Center, Cumulative Index to Nursing and Allied Health Literature, Web of Science, PsychINFO, and Scopus were systematically searched for studies published from November 1, 1973, through June 30, 2015, without geographic or language restrictions. Study Selection Original quantitative studies that reported the prevalence of FASD among children and youth in the general population, used active case ascertainment or clinic-based methods, and specified the diagnostic guideline or case definition used were included. Data Extraction and Synthesis Individual study characteristics and prevalence of FASD were extracted. Country-specific random-effects meta-analyses were conducted. For countries with 1 or no empirical study on the prevalence of FASD, this indicator was estimated based on the proportion of women who consumed alcohol during pregnancy per 1 case of FASD. Finally, WHO regional and global mean prevalence of FASD weighted by the number of live births in each country was estimated. Main Outcomes and Measures Prevalence of FASD. Results A total of 24 unique studies including 1416 unique children and youth diagnosed with FASD (age range, 0-16.4 years) were retained for data extraction. The global prevalence of FASD among children and youth in the general population was estimated to be 7.7 per 1000 population (95% CI, 4.9-11.7 per 1000 population). The WHO European Region had the highest prevalence (19.8 per 1000 population; 95% CI, 14.1-28.0 per 1000 population), and the WHO Eastern Mediterranean Region had the lowest (0.1 per 1000 population; 95% CI, 0.1-0.5 per 1000 population). Of 187 countries, South Africa was estimated to have the highest prevalence of FASD at 111.1 per 1000 population (95% CI, 71.1-158.4 per 1000 population), followed by Croatia at 53.3 per 1000 population (95% CI, 30.9-81.2 per 1000 population) and Ireland at 47.5 per 1000 population (95% CI, 28.0-73.6 per 1000 population). Conclusions and Relevance Globally, FASD is a prevalent alcohol-related developmental disability that is largely preventable. The findings highlight the need to establish a universal public health message about the potential harm of prenatal alcohol exposure and a routine screening protocol. Brief interventions should be provided, where appropriate.read more
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Meta-analysis of prevalence
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Prevalence of Fetal Alcohol Spectrum Disorders in 4 US Communities
Philip A. May,Philip A. May,Christina D. Chambers,Christina D. Chambers,Wendy O. Kalberg,Jennifer A. Zellner,Haruna S. Feldman,David Buckley,David Kopald,Julie M. Hasken,Ronghui Xu,Gordon Honerkamp-Smith,Howard Taras,Melanie A. Manning,Luther K. Robinson,Margaret P. Adam,Omar A. Abdul-Rahman,Keith K. Vaux,Tamison Jewett,Amy J. Elliott,Julie A. Kable,Natacha Akshoomoff,Daniel E. Falk,Judith A. Arroyo,Dale Hereld,Edward P. Riley,Michael E. Charness,Michael E. Charness,Michael E. Charness,Claire D. Coles,Kenneth R. Warren,Kenneth L. Jones,Kenneth L. Jones,H. Eugene Hoyme,H. Eugene Hoyme +34 more
TL;DR: Estimated prevalence of fetal alcohol spectrum disorders among first-graders in 4 US communities ranged from 1.1% to 5.0% using a conservative approach, which may represent more accurate US prevalence estimates than previous studies but may not be generalizable to all communities.
Journal ArticleDOI
Clinical presentation, diagnosis, and management of fetal alcohol spectrum disorder
Jeffrey R. Wozniak,Edward P. Riley,Michael E. Charness,Michael E. Charness,Michael E. Charness +4 more
TL;DR: Diagnosis remains challenging because of the poor reliability of self-reported maternal drinking histories, an absence of sensitive biomarkers, and the infrequency of diagnostic dysmorphic facial features among individuals with fetal alcohol spectrum disorder.
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Arcsine-based transformations for meta-analysis of proportions: Pros, cons, and alternatives
Lifeng Lin,Chang Xu +1 more
TL;DR: The pros and cons of arcsine‐based transformations are explained, the alternatives that may be generally superior to the currently popular practice are discussed, and generalized linear mixed models and Bayesian models are discussed.
Journal ArticleDOI
Fetal alcohol spectrum disorder and youth justice: A prevalence study among young people sentenced to detention in Western Australia
Carol Bower,Rochelle Watkins,Raewyn Mutch,Rhonda Marriott,Jacinta Freeman,Natalie R. Kippin,Bernadette Safe,Carmela Pestell,Candy S.C. Cheung,Helen Shield,Lodewicka Tarratt,Alex Springall,Jasmine B. Taylor,Noni Walker,Emma Argiro,Susan Leitao,Sharynne Hamilton,Carmen Condon,Hayley M. Passmore,Roslyn Giglia +19 more
TL;DR: A high prevalence of FASD and severe neurodevelopmental impairment is documented in a representative sample of young people in detention in Western Australia, the majority of which had not been previously identified.
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