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Fetal alcohol spectrum disorders (FASDs) are a group of cond
Transcript of Fetal alcohol spectrum disorders (FASDs) are a group of cond
FASD - the basics
FASDs are caused by a woman drinking alcohol during pregnancy. Alcohol in the mother’s blood passes to the baby through the umbilical cord. When a woman drinks alcohol, so does her baby.
HOW MUCH IS SAFE?
There is no known safe amount of alcohol during pregnancy or when trying to get pregnant. There is also no safe time to drink during pregnancy. Alcohol can cause problems for a developing baby throughout pregnancy, including before a woman knows she’s pregnant.
To prevent FASDs, a woman should not drink alcohol while she is pregnant, or when she might get pregnant. This is because a woman could get pregnant and not know for up to 4 to 6 weeks.
If a woman is drinking alcohol during pregnancy, it is never too late to stop drinking. Because brain growth takes place throughout pregnancy, the sooner a woman stops drinking the safer it will be for her and her baby.
FASDs are completely preventable if a woman does not drink alcohol during pregnancy.
FASDs refer to the whole range of effects that can happen to a person whose mother drank alcohol during pregnancy. These conditions can affect each person in different ways, and can range from mild to severe.
A person with an FASD might have:
Abnormal facial features, such as a smooth ridge between the nose and upper lip (this ridge is called the philtrum)
Small head size
Low body weight
Difficulty with attention
Difficulty in school (especially with math)
Speech and language delays
Intellectual disability or low IQ
Poor reasoning and judgment skills
Sleep and sucking problems as a baby
Vision or hearing problems
Problems with the heart, kidneys, or bones
Types of FASDs
Different terms are used to describe FASDs, depending on the type of symptoms.
Fetal Alcohol Syndrome (FAS):
FAS represents the most involved end of the FASD spectrum. Fetal death is the most extreme outcome from drinking alcohol during pregnancy. People with FAS might have abnormal facial features, growth problems, and central nervous system problems. People with FAS can have problems with learning, memory, attention span, communication, vision, or hearing. They might have a mix of these problems. People with FAS often have a hard time in school and trouble getting along with others.
Alcohol-Related Neurodevelopmental Disorder (ARND):
People with ARND might have intellectual disabilities and problems with behavior and learning. They might do poorly in school and have difficulties with math, memory, attention, judgment, and poor impulse control.
Alcohol-Related Birth Defects (ARBD):
People with ARBD might have problems with the heart, kidneys, or bones or with hearing. They might have a mix of these.
Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE):
ND-PAE was first included as a recognized condition in the Diagnostic and Statistical Manual 5 (DSM 5) of the American Psychiatric Association (APA) in 2013. A child or youth with ND-PAE will have problems in three areas:
(1) thinking and memory, where the child may have trouble planning or may forget material he or she has already learned,
(2) behavior problems, such as severe tantrums, mood issues (for example, irritability), and difficulty shifting attention from one task to another, and
(3) trouble with day-to-day living, which can include problems with bathing, dressing for the weather, and playing with other children.
The term FASDs is not meant for use as a clinical diagnosis.
There are guidelines for FAS only.
Prenatal alcohol exposure; although confirmation is not required to make a diagnosis
Central nervous system problems (e.g., small head size, problems with attention and hyperactivity, poor coordination)
Lower-than-average height, weight, or both
Abnormal facial features (e.g., smooth ridge between nose and upper lip)
To diagnose FAS, doctors look for:
FASDs last a lifetime.
There is no cure for FASDs, but research shows that early intervention treatment services can improve a child’s development.
There are many types of treatment options, including medication to help with some symptoms, behavior and education therapy, parent training, and other alternative approaches.
No one treatment is right for every child.
Good treatment plans will include close monitoring, follow-ups, and changes as needed along the way.
Involvement in special education and social services
Absence of violence
Loving, nurturing, and stable home environment during the school years
Diagnosis before 6 years of age
Also, “protective factors” can help reduce the effects of FASDs and help people with these conditions reach their full potential.
Protective factors include:
What about just small amounts of alcohol?
According to the CDC and the U.S. Surgeon General, “There is no known safe amount of alcohol to drink while pregnant. There is also no known safe time during pregnancy or safe type of alcohol.”
According to the American Academy of Pediatrics: “There is no safe amount of alcohol when a woman is pregnant. Evidence-based research has found that drinking even small amounts of alcohol while pregnant can increase the risk of miscarriage, stillbirth, prematurity, or sudden infant death syndrome.”
Chief Medical Officer for England: Although the risk of harm to the baby is low if they have drunk small amounts of alcohol before becoming aware of the pregnancy, there is no ‘safe’ level of alcohol to drink when you are pregnant.
Any amount of alcohol, even the alcohol in one glass of wine, passes through the placenta from the mother to the growing baby.
Developing babies lack the ability to process or metabolize alcohol through the liver or other organs.
The embryo or fetus has the same blood alcohol concentration as the mother.
Alcohol is a teratogen, a toxic substance to a developing baby, and can interfere with healthy development causing brain damage and other birth defects.
These children have subtle behavioral and learning problems that are often undiagnosed or they misdiagnosed as Autism or Attention Deficit Disorder instead of one of the Fetal Alcohol Spectrum Disorders.
Experts estimate that the full range of FASDs in the United States and some Western European countries might number as high as 2 to 5 per 100 school children (or 2% to 5% of the population).
Because alcohol-related disabilities are widely misdiagnosed and undiagnosed passive surveillance or clinic-based methods that make no special effort to find FASD are known to substantially underestimate prevalence rates.
Active case surveillance methods that look for FASD among specific populations are far more accurate and produce significantly higher rates, although rates from these studies can not necessarily be generalized for the entire population.
According to the National Institute on Alcohol Abuse and Alcoholism, a component of the National Institutes of Health, the prevalence of FAS in the general population ranges from 0.2 to 7 cases per 1,000 children, and 2% to 5% for the entire of FASD.
The global prevalence of FASD among children and youth in the general population was estimated to be 7.7 per 1000 population.
The WHO European Region had the highest prevalence (19.8 per 1000 population). Of 187 countries,
was estimated to have the highest prevalence of FASD at 111.1 per 1000 population, followed by
at 53.3 per 1000 population and
at 47.5 per 1000 population.
A study by The Lancet linking drinking rates during pregnancy to rates of FAS found that nine of the world's ten worst countries are in Europe. Ireland came first by a considerable distance with an estimated 60 percent of mothers drinking alcohol during pregnancy.
Belarus came second with a prevalence estimate of 46.6 percent while Denmark was third with 45.8 percent.
FAS was first described in the French medical literature by Paul Lemoine and colleagues in a 1968 study of children of alcohol-dependent parents. Five years later, Ken Jones and David Smith published a paper in the Lancet on the association between alcohol abuse and morphological signs, and provided diagnostic criteria for this condition.
What is the economic cost of FASD?
Even with the assumption that only 1% of the Canadian population have FASD – about 355 000 people – the annual cost was estimated at 1.8 billion Canadian Dollars (US$ 1.35 billion) per year in Canada.
Based on available Canadian data, this study estimates that youths with FASD are 19 times more likely to be incarcerated than youths without FASD in a given year.
The coordinator of the FAS Community Resource Center states that the actual lifetime costs for one particular child with FAS is almost five million dollars:
$1,496,000 for medical costs, $530,000 for psychiatric care, $354,000 for foster care, $12,000 for orthodontia, $6,000 for respite care, $240,000 for special education, $624,000 for supported employment, $360,000 for SSI, and $1,376,000 for residential placement.
The annual total societal cost of FAS was estimated at €76,000 per child (0–17 years) and €110,000 per adult (18–74 years), corresponding to €1.6 billion per year in the Swedish population using a prevalence of FAS of 0.2 %.
The 428 co-occurring conditions were identified from 127 studies included in The Lancet review. These disease conditions, coded in the International Classification of Disease (ICD-10), affected nearly every system of the body, including the central nervous system (brain), vision, hearing, cardiac, circulation, digestion, and musculoskeletal and respiratory systems, among others.
Based on scientific data:
450 FASD child a year.
Alcohol policy tools and prevention
Best prevention is effective alcohol policy.
- Raising alcohol taxes
- Limiting alcohol availability
- Banning alcohol advertising
A question of forced treatment.
Most FASD groups and doctors oppose it.
- availability of necessary interventions and treatments.
Lawyers argued her mother had poisoned her foetus but appeal judges ruled she had not committed a criminal offence.
It had been argued the woman ignored warnings and drank a "grossly excessive" amount of alcohol while pregnant.
She consumed eight cans of strong lager and half a bottle of vodka a day, the court heard.
"Essential ingredient" for a crime to be committed "is the infliction of grievous bodily harm on a
- grievous bodily harm on a foetus will not suffice".
- Among doctors, medical professionals
- Among wider public
- About men´s role