Module 1: Historic Perspectives on Alcohol and Pregnancy
Current Knowledge
Increased information about the nature of prenatal alcohol exposure has led to an expansion in the terms used to describe its effects. Experts realized that some individuals had conditions besides FAS. A group of representatives from U.S. and Canadian agencies and experts from the field recently adopted the term "fetal alcohol spectrum disorders" (FASD).
FASD is an umbrella term describing the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. These effects may include physical, mental, behavioral, and learning disabilities with possible lifelong implications. The term FASD is not intended for use as a clinical diagnosis.
The prevalence of FASD in the United States is estimated to be at least 10 per 1,000, or 1 percent of all live births.14 The total number of children born each year with an FASD is about 40,000. FAS, the most well-known condition, is estimated to occur in 0.5 to 2 per 1,000 live births.14 However, the prevalence varies, depending on the population surveyed and the methodology used.
One study showed a rate of 5.6 per 1,000 live births among American Indians and Alaska Natives.15 In other countries, the rates may be even higher. One community in South Africa has a rate of 48 per 1,000 live births.16
Prevalence is difficult to determine for several reasons:
- Lack of standard diagnostic criteria
- Limited medical training on FASD
- Stigma that keeps families from identifying children with an FASD
- Lack of a national FASD registry, although most States have birth defects registries and some include FAS
- Lack of standard research methodology
Efforts are being made to improve surveillance. Several States are involved in CDC's Fetal Alcohol Syndrome Surveillance Network. The State of Alaska has a surveillance project, and the Washington State FAS Diagnosis and Prevention Network conducts surveillance.
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