Prevalence and Patterns of Prenatal Alcohol Exposure in Australian Cohort and Cross-Sectional Studies: A Systematic Review of Data Collection Approaches

Abstract

This study sought to determine data collection approaches in Australian cohort studies and explore the potential impact on reported prenatal alcohol exposure (PAE) prevalence and patterns. Inclusion criteria were that studies related to a general Australian antenatal population where PAE was assessed and reported. Studies were excluded if they were not peer reviewed, examined the prevalence of PAE in pregnancies complicated by alcohol-use disorders, or were published in a language other than English. A systematic search of five electronic databases (PubMed, Embase, CINAHL, Web of Science, and Scopus) was conducted. Risk of bias was assessed using the Effective Public Health Practice Project quality assessment tool. Results were synthesised using MetaXL. Data from 16 separate birth cohorts (n = 78 articles) were included. Included cohorts were either general cohorts that included alcohol as a variable or alcohol-focused cohorts that were designed with a primary focus on PAE. PAE prevalence was estimated as 48% (95% CI: 38 to 57%). When subgroup analysis was performed, estimates of PAE prevalence when self-administered surveys and interviews were used for data collection were 53% (95% CI: 41% to 64%) and 43% (95% CI: 28% to 59%), respectively. Use of trained assessors was an influencing factor of the prevalence estimates when data were collected via interview. Alcohol-focused studies reported higher prevalence of PAE, regardless of method of survey administration. Where interviewer training is not possible, self-administered questionnaires will likely provide the most reliable PAE estimates. No funding sources are relevant to mention. Review was registered with PROSPERO (CRD42020204853).

Australian psychologists' knowledge, confidence, and practices in fetal alcohol spectrum disorder diagnostic assessment

“…However, there is no current literature specifically examining Australian psychologists' practices and confidence in assessing PAE, despite addressing and reducing PAE being an important public health issue (Popova et al., 2017). Estimates of PAE prevalence in Australia vary, with a recent systematic review of large Australian cohort studies estimating PAE prevalence in Australia at 48% (Young et al., 2022), whereas data from the National Drug Strategy Household Survey indicates around 35% of women drink alcohol during pregnancy, with 49% of women drinking prior to pregnancy recognition and 25% of women drinking after pregnancy recognition (Australian Institute of Health and Welfare, 2020).…”

Effects of prenatal alcohol exposure on infant lung function, wheeze, and respiratory infections in Australian children

“…The global prevalence of PAE has been calculated at 9.8% (95% CI 8.9, 11.1), with regional variations from 0% in some Middle Eastern countries such as Oman, to 60.4% in Ireland (Popova et al., 2017). A recent meta‐analysis of PAE in Australian cohort studies reported an overall prevalence of 48% (Young et al., 2022). Importantly, 50–60% of women reported alcohol consumption before they become aware of their pregnancy, suggesting PAE is more common in very early pregnancy.…”

Neurobehavioral alterations induced by third‐trimester gestation‐equivalent ethanol exposure are inhibited by folate administration

“…The prevalence of prenatal ethanol (EtOH) exposure (PEE) varies across the globe. In North‐American countries, 10%–15% of pregnant women reported that they engaged in EtOH use (Popova et al., 2017), but a meta‐analysis that was conducted in Australian samples (Young et al., 2022) indicated a pooled prevalence estimate of 48% (any consumption during pregnancy). Fetal alcohol syndrome is the most severe outcome of PEE.…”