Epidemiology of FASD in a Province in Italy: Prevalence and Characteristics of Children in a Random Sample of Schools.
Background: Accurate estimates of the prevalence and characteristics of fetal alcohol syndrome (FAS) and fetal alcohol spectrum disorders (FASD) in a Western European population are lacking and are of particular interest in settings where the usual pattern of alcohol consumption is thought to be dai...
| Publicado en: | Alcoholism: Clinical & Experimental Research Vol. 30; no. 9; pp. 1562 - 1576 |
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| Autores principales: | , , , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Sep2006
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106018958&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106018958 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01456008 IQE jtl: Alcoholism: Clinical & Experimental Research issn: 01456008 maglogo: Y pubinfo: dt: Sep2006 vid: 30 iid: 9 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106018958 22028711 2009280881 10.1111/j.1530-0277.2006.00188.x NLM16930219 106018958 ppf: 1562 ppct: 14 formats: tig: atl: Epidemiology of FASD in a Province in Italy: Prevalence and Characteristics of Children in a Random Sample of Schools. aug: au: May PA Fiorentino D Phillip Gossage J Kalberg WO Eugene Hoyme H Robinson LK Coriale G Jones KL Del Campo M Tarani L Romeo M Kodituwakku PW Deiana L Buckley D Ceccanti M affil: University of New Mexico, Albuquerque, New Mexico. sug: subj: Fetal Alcohol Syndrome Epidemiology Abnormalities, Drug-Induced Epidemiology Alcohol Drinking Epidemiology Case Control Studies Child Child Development Cross Sectional Studies Data Analysis, Statistical Female Fetal Alcohol Syndrome Pathology Growth Physiology Intelligence Tests Italy Male Mothers Neuropsychological Tests Pregnancy Psychological Tests Retrospective Design Schools Smoking Epidemiology Socioeconomic Factors Human Child: 6-12 years Female Male ab: Background: Accurate estimates of the prevalence and characteristics of fetal alcohol syndrome (FAS) and fetal alcohol spectrum disorders (FASD) in a Western European population are lacking and are of particular interest in settings where the usual pattern of alcohol consumption is thought to be daily drinking with meals. To address these issues, an epidemiology study of FAS and other FASD was undertaken in Italian schools. Methods: Primary schools ( n=25) in 2 health districts of the Lazio region were randomly selected and recruited for the study. Five hundred forty-three children, 50% of those enrolled in first-grade classes, received parental permission to participate in a 2-tiered, active case ascertainment screening process. Detailed evaluation of children selected in a preliminary screening phase was carried out on those who were small for height, weight, and head circumference and/or referred by teachers for suspected learning and behavioral problems. Detailed evaluation was carried out on each child's: (1) physical growth and dysmorphology, (2) psychological development and behavior, and (3) prenatal exposure to alcohol and other risk factors for FASD via maternal interviews. A group of 67 randomly selected children without FASD from the same classes was utilized as a comparison group. Results: Using 2 denominators for prevalence estimation, a conservative one and a strict sample-based estimate, the prevalence of FAS in this province of Italy was 3.7 to 7.4 per 1,000 children. When cases of partial FAS (PFAS) and a case of alcohol-related neurodevelopmental deficits (ARND) were added to FAS cases, the rate of FASD was 20.3 to 40.5 per 1,000 and estimated at 35 per 1,000 overall or between 2.3 and 4.1% of all children. This exceeds previously published estimates of both FAS and FASD for the western world. Detailed data are presented that demonstrate the utility of the guidelines of the revised Institute of Medicine diagnostic criteria for FASD. Children with FASD are significantly more impaired/affected ( p<0.05) than randomly selected comparison children on all measures of growth deficiency, key facial features of FASD, overall dysmorphology scores, language comprehension, nonverbal IQ, and behavior. Maternal reports of current drinking were significantly higher for mothers of FASD children than comparison mothers, but reported rates of overall drinking during pregnancy were not significantly different. In contrast to expectations, daily drinking among mothers of the comparison group was not common. However, dysmorphology scores of the children were significantly correlated with drinking in the second and third trimesters, drinks per current drinking day, and current drinks per month. Finally, children with the physical features of FASD had lower IQs; nonverbal IQ was significantly correlated with head circumference and negatively correlated with overall dysmorphology score, smooth philtrum, and several other facial and physical anomalies characteristic of FAS. Conclusions: Using careful measures of ascertainment in a primary school setting, these results provide relatively high estimates of the prevalence of FASD and raise the question of whether FASD is more common in the western world than previously estimated. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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