A Multiple-Level, Comprehensive Approach to the Prevention of Fetal Alcohol Syndrome (FAS) and Other Alcohol-Related Birth Defects (ARBD)

Abstract

A comprehensive program for the prevention of fetal alcohol syndrome (FAS) and alcohol-related birth defects (ARBD) must consider multiple approaches and utilize knowledge from a variety of academic disciplines. Issues related to culture, society, behavior, belief systems, and medicine must all be considered for both etiology and solutions. A broad paradigm such as a public health model integrates various elements of approach. Because FAS and other levels of ARBD form a spectrum, from severe to negligible damage, a variety of drinking patterns with various characteristics and etiologies have to be addressed. This paper describes a multiple-level, comprehensive program with primary, secondary, and tertiary prevention components. Practical recommendations are proposed for addressing ARBD in a variety of arenas. While secondary and tertiary prevention hold promise for short-term reduction of FAS and ARBD prevalence, comprehensive prevention serves both short- and long-term effects. Multiple level prevention efforts are well served by clear and compelling vision and mission statements, and require careful evaluation.

"I drink": Mothers' alcohol consumption as both individualised and imposed occupation

“…Although FAS has internationally been reported in different racial groups 5 cases of FAS have predominantly been described among Native Americans, 6 Aboriginal populations in Australia 7 as well as indigenous populations of the Northern Cape and Western Cape Provinces of South Africa 8,9,10 . Alarmingly, the figures of a study done in a previously disadvantaged school in South Africa in the Western Cape and Northern Cape Provinces of South Africa revealed the highest prevalence in the world 2 .…”

Predictors of risk of alcohol-exposed pregnancies among women in an urban and a rural area of South Africa

“…The aims of the study were to determine, for each site separately: (a) the extent to which women of childbearing age are at risk of having an AEP and (b) the demographic, health, substance use, psycho-social, community, and partner predictors of risk for having an AEP among women of child-bearing age. This study was designed as part of the formative phase of an intervention programme designed to apply a public health approach to preventing AEP that would include universal, indicated and selective interventions (May, 1995).…”

Avaliação do Consumo de Bebida Alcoólica Durante a Gravidez

“…No entanto, a exposição é maior para o concepto porque o metabolismo e a eliminação são mais lentos; o líquido amniótico fica impregnado de álcool não-modificado e de acetaldeído, pois não possui a quantidade necessária de enzimas para sua biodegradação 3,4 . Os danos fetais são diferentes, conforme o período gestacional: no primeiro trimestre da gestação, o risco é de anomalias físicas e dismorfismo; no segundo, há risco de abortamento e, no terceiro, pode ocorrer diminuição do crescimento fetal, em especial o perímetro cefálico e o cérebro 5,6 . Em 1988, o Congresso Norte-americano aprovou a lei que obriga a colocação de aviso no rótulo de bebidas alcoólicas com a mensagem "mulheres grávidas não devem consumir álcool".…”