Understanding Foetal Alcohol Spectrum Disorders (FASD) and maternal alcohol consumption during pregnancy

Abstract

Background: Fetal Alcohol Spectrum Disorders (FASD) refers to a spectrum of disorders caused by prenatal alcohol consumption. Alcohol consumption during pregnancy and its interference with the development of the fetus and child is complex and highly variable. However, little is known regarding which alcohol consumption patterns most strongly predict FASD. The current study aims to provide the required evidence to estimate the FASD prevalence and identify which alcohol consumption patterns are most in need of intervention. Methods: A systematic literature search on global FASD prevalence and related alcohol consumption was conducted in multiple databases up to August 2015, including PubMed, PsychINFO, PsychARTICLES, ERIC, CINAHL, EMBASE and MEDLINE. A query was generated and resulting hits were exported and screened by two independent screeners, after which results were extracted and (meta-) analyzed. Findings: Global FASD prevalence estimates from included studied ranged from 0 to 176.77 per 1,000 live births. Substantial heterogeneity prompted meta-regressions, revealing geography as important moderator, and suggested cautious interpretation. Furthermore, studies lacked information to indicate when drinking during pregnancy becomes harmful for the unborn child. Also, a substantial variation in alcohol consumption measures was found, ranging from ‘any consumption’ to fine-grained specification of intensity and frequency. While precluded meta-analysis, this variation did enable development of guidelines for measuring alcohol consumption. Discussion: FASD prevalence implies an urgent need for health promotion interventions addressing maternal alcohol consumption. To identify the most expedient target behaviors for such interventions, we propose guidelines for studies examining maternal alcohol consumption patterns in relation to FASD.