Fetal alcohol syndrome: a prospective national surveillance study

Abstract

Objective: To describe the epidemiology of cases of fetal alcohol syndrome (FAS) seen by Australian paediatricians. Method: Active, national case-finding using the Australian Paediatric Surveillance Unit. Monthly reporting of incident cases aged <15 years by paediatricians between January 2001 and December 2004. Results: Over 1150 paediatricians submitted reports each month to the APSU. Of 169 reported cases, 92 fulfilled the study criteria for FAS. There was a significant increase in the number of children reported each year from 2001 to 2004. Of 92 children, 53.3% were male, 35.7% were preterm (<37w gestation), and 64.6% were of low birth weight (<2.5kg). Most (94.4%) had ‘high risk’ exposure to alcohol in utero and 78.3% were exposed to one or more additional drugs. The median age at diagnosis was 3.3 years (range newborn to 11.9 years): 6.5% were diagnosed at birth and 63% by 5 years of age. Of the 92 cases, 56% had growth deficiency, 53.2% had microcephaly, 85.9% had evidence of central nervous system dysfunction; 24% had additional birth defects; 5.4% had sensorineural deafness and 4.3% had visual impairment. . Of children with FAS, 65% were Indigenous; 51% had a sibling with FAS; and only 40.2% lived with a biological parent. Conclusion: Our data are the only prospective national data available on FAS throughout the world. These findings highlight the severity, complexity and impact of FAS; the need for effective strategies for prevention; and the need for education to facilitate earlier diagnosis, referral and reporting of cases.