Maternal Risk Factors for Fetal Alcohol Syndrome and Partial Fetal Alcohol Syndrome in South Africa: A Third Study

May, Philip A.; Gossage, J. Phillip; Marais, Anna Susan; Hendricks, Loretta S.; Snell, Cudore L.; Tabachnick, Barbara G.; Stellavato, Chandra; Buckley, David; Brooke, Lesley E.; Viljoen, Denis

doi:10.1111/j.1530-0277.2008.00634.x

Cited by 179 publications

(224 citation statements)

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“…In general, the factors associated with AEP risk in the present study are consistent with the maternal risk factors for FAS identified in previous studies in the Western and Northern Cape Provinces (May et al, 2005(May et al, , 2008Urban et al, 2008;Viljoen et al, 2002). However, parity was associated with lower risk of an AEP in this survey, but is usually associated with greater risk of having a child with an FASD.…”

Section: Discussionsupporting

confidence: 92%

“…Maternal risk factors for FAS have been investigated in the Western and Northern Cape provinces (May et al, 2005(May et al, , 2008Urban et al, 2008;Viljoen, Croxford, Gossage, Kodituwakku, & May, 2002). The risk factors identified by those studies include: (1) demographic characteristics (e.g., education, occupation/employment, income, marital status at index pregnancy); (2) alcohol consumption patterns (e.g., current drinking, age of onset of drinking); (3) tobacco use behaviours (e.g., tobacco use during pregnancy); (4) partners' and family members' characteristics (e.g., partner drinking, heavy drinking by family members); (5) alcohol consumption prior to and during each month of the past pregnancy; (6) reproductive health history (e.g., parity, gravidity, birth order of index child, stillbirth); (7) physical characteristics (e.g., height, weight and body mass index; BMI).…”

mentioning

confidence: 99%

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

Morojele

London

Olorunju

et al. 2010

Social Science & Medicine

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a b s t r a c tThe study sought to determine the prevalence and predictors of being at risk of an alcohol-exposed pregnancy (AEP) among women of child-bearing age in an urban and rural location in South Africa. We conducted a cross-sectional household survey of 1018 women aged 18-44 years in one urban (n ¼ 606) and one rural (n ¼ 412) site. The women were interviewed using a structured questionnaire. We defined the primary dependent variable, being at risk of having an AEP, as current alcohol use, not being pregnant, being fertile, and no effective use of contraceptives. The independent variables included demographic, substance use, health perceptions, psycho-social, and partner characteristics. The rural women (21.84%) were more likely than their urban counterparts (11.22%) to be at risk of an AEP. In multiple logistic regression analyses, significant predictors of being in the ''at risk'' group for the urban women were (a) being 'white' as opposed to 'black/African', and being 'coloured' as opposed to 'black/African'; and (b) current smoking. For the rural women, significant risk factors were (a) current smoking and (b) early onset of alcohol use. The significant protective factors were (a) education; (b) knowledge about Fetal Alcohol Syndrome; (c) parity. Use of stricter alcohol use criteria (i.e., three or more drinks and five or more drinks per sitting) in the definition of risk of an AEP yielded slightly different patterns of significant predictors. The results revealed high levels of risk of an alcohol-exposed pregnancy, especially amongst the rural women, and a need for location-specific prevention programmes. The high burden of AEP in South Africa calls for the establishment of national AEP prevention strategies and programmes as a matter of urgency.

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Section: Discussionsupporting

confidence: 92%

mentioning

confidence: 99%

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

Morojele

London

Olorunju

et al. 2010

Social Science & Medicine

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“…[42][43][44] Current alcohol consumption for the week preceding the interview was embedded into the nutrition questions 45 to aid accurate calibration of drinking quantity, frequency, and timing of alcohol use before and during the index pregnancies. 10,11,[23][24][25]33 Retrospective reports of alcohol use have been found to be superior to concurrent reports, but alcohol use has still been found to be frequently underreported in studies such as this. 33,[46][47][48] Maternal risk data were gathered for 153 women (Fig 2).…”

Section: Study Procedures: Screening In Tiers I and Iimentioning

confidence: 88%

“…Detailed maternal risk factor information for FASD in other populations has been reported elsewhere. 12,24,25,34,46 …”

Section: Study Procedures: Screening In Tiers I and Iimentioning

confidence: 99%

“…5,9 One approach used successfully to determine the minimal prevalence of FASD in communities in South Africa, [10][11][12][13][14] Italy, 15,16 and Croatia 17,18 uses active case ascertainment in schools. Providing targeted physical examinations and cognitive/ behavioral testing to primary school children [19][20][21][22] and interviewing their mothers [23][24][25] can be effective for studying FASD prevalence and characteristics.…”

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Prevalence and Characteristics of Fetal Alcohol Spectrum Disorders

et al. 2014

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WHAT'S KNOWN ON THIS SUBJECT: Most studies of fetal alcohol syndrome and fetal alcohol spectrum disorders (FASD) prevalence in the general population of the United States have been carried out using passive methods (surveillance or clinicbased studies), which underestimate rates of FASD. WHAT THIS STUDY ADDS:Using active case ascertainment methods among children in a representative middle class community, rates of fetal alcohol syndrome and total FASD are found to be substantially higher than most often cited estimates for the general US population. abstract OBJECTIVES: To determine the prevalence and characteristics of fetal alcohol spectrum disorders (FASD) among first grade students (6-to 7-year-olds) in a representative Midwestern US community. METHODS:From a consented sample of 70.5% of all first graders enrolled in public and private schools, an oversample of small children (#25th percentile on height, weight, and head circumference) and randomly selected control candidates were examined for physical growth, development, dysmorphology, cognition, and behavior. The children's mothers were interviewed for maternal risk. RESULTS:Total dysmorphology scores differentiate significantly fetal alcohol syndrome (FAS) and partial FAS (PFAS) from one another and from unexposed controls. Alcohol-related neurodevelopmental disorder (ARND) is not as clearly differentiated from controls. Children who had FASD performed, on average, significantly worse on 7 cognitive and behavioral tests and measures. The most predictive maternal risk variables in this community are late recognition of pregnancy, quantity of alcoholic drinks consumed 3 months before pregnancy, and quantity of drinking reported for the index child's father. From the final multidisciplinary case findings, 3 techniques were used to estimate prevalence. FAS in this community likely ranges from 6 to 9 per 1000 children (midpoint, 7.5), PFAS from 11 to 17 per 1000 children (midpoint, 14), and the total rate of FASD is estimated at 24 to 48 per 1000 children, or 2.4% to 4.8% (midpoint, 3.6%). (Continued on last page) CONCLUSIONS:

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Researching the Prevalence and Characteristics of FASD in International Settings

May

2010

Fetal Alcohol Spectrum Disorder

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Maternal Risk Factors for Fetal Alcohol Syndrome and Partial Fetal Alcohol Syndrome in South Africa: A Third Study

Cited by 179 publications

References 84 publications

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

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

Prevalence and Characteristics of Fetal Alcohol Spectrum Disorders

Researching the Prevalence and Characteristics of FASD in International Settings

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