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Fetal Alcohol Spectrum Disorder (FASD)

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (30 April 2019) | Viewed by 58534

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Special Issue Editors

Dr. Svetlana Popova

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Guest Editor

Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, World Health Organization/Pan-American Health Organization Collaborating Centre in Addiction and Mental Health
Epidemiology Division, Office of Global Public Health Education & Training, Dalla Lana School of Public Health; and Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
Interests: epidemiology, co-morbidities, burden and economic cost, prevention and intervention strategies related to Fetal Alcohol Spectrum Disorder and maternal substance use

Dr. Larry Burd

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Guest Editor

North Dakota Fetal Alcohol Syndrome Center, Department of Pediatrics, University of North Dakota School of Medicine and Health Sciences, Pediatric Therapy Services, Altru Health System, Grand Forks, ND, USA
Interests: prenatal alcohol exposure, maternal substance use, mortality, mental disorders, comorbidity, Fetal Alcohol Spectrum Disorder, birth defects and developmental disabilities

Special Issue Information

Dear Colleagues,

The International Journal of Environmental Research and Public Health invites the submission of papers on biomedical, psychological, and sociological aspects related to Fetal Alcohol Spectrum Disorder (FASD), to be featured in this Special Issue to be published in April 2019. Accepted papers will be published online prior to their inclusion in this Special Issue in order to make the research available more quickly.

Original articles (including both quantitative and qualitative research), methodological pieces, reviews, and case reports will be considered for publication and submitted for peer review, if eligible.

Numerous studies in the past 40-50 years on both humans and animals have demonstrated that alcohol is a teratogen and can cause irreversible embryonic and fetal damage. The term “Fetal Alcohol Spectrum Disorder” is used to characterize the full range of damage caused by prenatal alcohol exposure, varying from mild to severe, and encompassing a broad array of physical defects and cognitive, behavioral, emotional, and adaptive functioning deficits. FASD is a prevalent (it exceeds 1% in 76 countries) alcohol-related developmental disability that require a large amount of support from various services including health, community, remedial education, and many others. Thus, FASD has a huge economic and societal impact in all countries.

The goal of this Special Issue is to publish papers that expand our current knowledge of prenatal alcohol and other substances’ exposure and FASD and make it accessible to the research community, educators, policy makers, and others interested in this area. We invite all FASD-related research submissions, and we especially encourage the submission of papers from authors in developing countries where there are less infrastructure and traditional support of research on prenatal substance use exposure and FASD.

For detailed information on the journal, please refer to https://0-www-mdpi-com.brum.beds.ac.uk/journal/ijerph.

The keywords listed below provide an outline of some of the possible areas of interest.

Dr. Svetlana Popova
Dr. Larry Burd
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

prevention
treatment
recent advances in screening and diagnosis
therapeutic and non-therapeutic interventions
comorbidities
mortality
epidemiology
economic cost
risk factors of maternal substance use and FASD
outcome trajectories (children, adults, and elderly people with FASD)
law enforcement
service delivery (i.e., health care, special education, etc.)
experience and perception (patients and carers living with FASD, and practitioners)
policy

Published Papers (12 papers)

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Editorial

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6 pages, 245 KiB

Open AccessEditorial

Fetal Alcohol Spectrum Disorders: Fixing Our Aim to Aim for the Fix

by Larry Burd and Svetlana Popova

Int. J. Environ. Res. Public Health 2019, 16(20), 3978; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16203978 - 18 Oct 2019

Cited by 18 | Viewed by 3939

Abstract

We, as editors of this special issue on Fetal Alcohol Spectrum Disorders (FASD), are proud to present eleven papers [...] Full article

(This article belongs to the Special Issue Fetal Alcohol Spectrum Disorder (FASD))

Research

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10 pages, 422 KiB

Open AccessArticle

The Prevalence of Fetal Alcohol Spectrum Disorders in An American Indian Community

by Annika C. Montag, Rhonda Romero, Toni Jensen, Amiyonette Goodblanket, Ami Admire, Conner Whitten, Daniel Calac, Natacha Akshoomoff, Maria Sanchez, MarLa Zacarias, Jennifer A. Zellner, Miguel del Campo, Kenneth Lyons Jones and Christina D. Chambers

Int. J. Environ. Res. Public Health 2019, 16(12), 2179; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16122179 - 20 Jun 2019

Cited by 12 | Viewed by 4019

Abstract

The prevalence of fetal alcohol spectrum disorders (FASD) differs among populations and is largely unknown among minority populations. Prevalence and characterization of FASD is necessary for prevention efforts and allocation of resources for treatment and support. However, prevalence data are lacking, including among many minority populations. The aim of this study was to obtain an FASD prevalence estimate in a Southern California American Indian community employing active case-ascertainment. In 2016, American Indian children aged 5–7 years and their caregivers were recruited in collaboration with Southern California Tribal Health Clinic. Children were assessed using physical examinations and neurobehavioral testing. Parent or guardian interviews assessed child behavior and prenatal exposures including alcohol. Of 488 children identified as eligible to participate, 119 families consented and 94 completed assessments to allow a classification for FASD. Participating children (n = 94) were an average of 6.61 ± 0.91 years old and half were female. Most interviews were conducted with biological mothers (85.1%). Less than one third (29.8%) of mothers reported consuming any alcohol in pregnancy and 19.1% met study criteria for risky alcohol exposure prior to pregnancy recognition. Overall 20 children met criteria for FASD, resulting in an estimated minimum prevalence of 41.0 per 1000 (4.1%). No cases of fetal alcohol syndrome (FAS) were identified; 14 (70.0%) met criteria for alcohol related neuro- developmental disorder (ARND). Minimum prevalence estimates found in this sample are consistent with those noted in the general population. Full article

(This article belongs to the Special Issue Fetal Alcohol Spectrum Disorder (FASD))

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13 pages, 302 KiB

Open AccessArticle

The Potential for Fetal Alcohol Spectrum Disorder Prevention of a Harmonized Approach to Data Collection about Alcohol Use in Pregnancy Cohort Studies

by Nancy Poole, Rose A. Schmidt, Alan Bocking, Julie Bergeron and Isabel Fortier

Int. J. Environ. Res. Public Health 2019, 16(11), 2019; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16112019 - 06 Jun 2019

Cited by 12 | Viewed by 4949

Abstract

Prenatal alcohol exposure is a leading cause of disability, and a major public health concern in Canada. There are well-documented barriers for women and for service providers related to asking about alcohol use in pregnancy. Confidential research is important for learning about alcohol use before, during and after pregnancy, in order to inform fetal alcohol spectrum disorder (FASD) prevention strategies. The Research Advancement through Cohort Cataloguing and Harmonization (ReACH) initiative provides a unique opportunity to leverage the integration of the Canadian pregnancy and birth cohort information regarding women’s drinking during pregnancy. In this paper, we identify: The data that can be collected using formal validated alcohol screening tools; the data currently collected through Canadian provincial/territorial perinatal surveillance efforts; and the data currently collected in the research context from 12 pregnancy cohorts in the ReACH Catalogue. We use these findings to make recommendations for data collection about women’s alcohol use by future pregnancy cohorts, related to the frequency and quantity of alcohol consumed, the number of drinks consumed on an occasion, any alcohol consumption before pregnancy, changes in use since pregnancy recognition, and the quit date. Leveraging the development of a Canadian standard to measure alcohol consumption is essential to facilitate harmonization and co-analysis of data across cohorts, to obtain more accurate data on women’s alcohol use and also to inform FASD prevention strategies. Full article

(This article belongs to the Special Issue Fetal Alcohol Spectrum Disorder (FASD))

13 pages, 277 KiB

Open AccessArticle

How Personal Perspectives Shape Health Professionals’ Perceptions of Fetal Alcohol Spectrum Disorder and Risk

by Kerryn Bagley and Dorothy Badry

Int. J. Environ. Res. Public Health 2019, 16(11), 1936; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16111936 - 31 May 2019

Cited by 13 | Viewed by 10690

Abstract

This article examines how health, allied health and social service professionals’ personal perspectives about alcohol and the risks associated with alcohol consumption become non-clinical factors that may influence their professional practice responses in relation to fetal alcohol spectrum disorder (FASD). It presents findings derived from a qualitative, interview-based study of professionals from a range of health, allied health and social service professions in New Zealand. The data derived from these interviews revealed four frames of reference that practitioners use when thinking about alcohol and risk: reflection on personal experience; experiences of friends, relatives and colleagues; social constructions of alcohol use and misuse; and comparisons to other types of drug use. The article concludes that these non-clinical factors are important considerations in professional decision making about FASD. Full article

(This article belongs to the Special Issue Fetal Alcohol Spectrum Disorder (FASD))

16 pages, 656 KiB

Open AccessArticle

Associated Factors of Drinking Prior to Recognising Pregnancy and Risky Drinking among New Zealand Women Aged 18 to 35 Years

by Sherly Parackal, Mathew Parackal and John Harraway

Int. J. Environ. Res. Public Health 2019, 16(10), 1822; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16101822 - 23 May 2019

Cited by 2 | Viewed by 2808

Abstract

Nearly half of all pregnant women in the Western world drink prior to recognising pregnancy. The current study aimed to investigate the factors associated with drinking prior to recognising pregnancy among pregnant women and factors associated with risky drinking among nonpregnant sexually active women. The study was a cross-sectional survey of a random sample of women aged 18 to 35 years (n = 1062) selected from the New Zealand electoral roll. Pregnant women (currently pregnant: n = 65; previously pregnant: n = 202) who were risky drinkers and who smoked in the year prior to pregnancy had five times the odds (p < 0.01) and women who planned their pregnancy (p = 0.05) and who used a community service card (p = 0.004) had less than half the odds to drink prior to recognising pregnancy than their respective counterparts. Among sexually active nonpregnant women who consumed alcohol, those who smoked in the year prior to the survey and those who drank for social reasons, for mood enhancement or coping reasons had higher odds of being risky drinkers (p < 0.05). Addressing risky drinking, especially in social settings, and smoking among women of peak childbearing age may mitigate the potential risk of drinking prior to recognising pregnancy. Full article

(This article belongs to the Special Issue Fetal Alcohol Spectrum Disorder (FASD))

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12 pages, 320 KiB

Open AccessArticle

Community Perceptions of Alcohol Exposed Pregnancy Prevention Program for American Indian and Alaska Native Teens

by Umit Shrestha, Jessica Hanson, Tess Weber and Karen Ingersoll

Int. J. Environ. Res. Public Health 2019, 16(10), 1795; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16101795 - 21 May 2019

Cited by 9 | Viewed by 3435

Abstract

A community needs assessment during a tribally-led Changing High-Risk Alcohol Use and Increasing Contraception Effectiveness Study (CHOICES) intervention highlighted the need to reduce the risk for alcohol exposed pregnancy (AEP) among American Indian and Alaska Native (AIAN) adolescent girls. The CHOICES for American Indian Teens (CHAT) Program aims to reduce the risk of AEP among AIAN teens in one Northern Plains tribal community. The CHAT team adopted an iterative process to modify the tribally-led CHOICES curriculum for AIAN teens. This paper describes the iterative process as well as the community perception towards AEP prevention among AIAN teens. The CHAT team conducted several levels of formative and qualitative research, including one-on-one interviews (n = 15) with community members, AIAN elders and school counsellors; and three focus groups with AIAN adolescent girls (n = 15). A qualitative data analysis identified several recommendations that centered on making the information regarding alcohol and birth control appealing to teens; ensuring the confidentiality of the participants; making the program culturally relevant; and including boys in the program. This study outlines various components prioritized by community members in creating a culturally-relevant and age-appropriate AEP prevention program and provides community perceptions of AEP prevention for the teens in this community Full article

(This article belongs to the Special Issue Fetal Alcohol Spectrum Disorder (FASD))

21 pages, 8977 KiB

Open AccessArticle

National Evaluation of Canadian Multi-Service FASD Prevention Programs: Interim Findings from the Co-Creating Evidence Study

by Deborah Rutman and Carol Hubberstey

Int. J. Environ. Res. Public Health 2019, 16(10), 1767; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16101767 - 18 May 2019

Cited by 11 | Viewed by 3912

Abstract

Since the 1990s, a number of multi-service prevention programs working with women who have substance use, mental health, or trauma and/or related social determinants of health issues have emerged in Canada. These programs use harm reduction approaches and provide outreach and “one-stop” health and social services on-site or through a network of services. While some of these programs have been evaluated, others have not, or their evaluations have not been published. This article presents interim qualitative findings of the Co-Creating Evidence project, a multi-year (2017–2020) national evaluation of holistic programs serving women at high risk of having an infant with prenatal alcohol exposure. The evaluation utilizes a mixed-methods design involving semi-structured interviews, questionnaires, focus groups, and client intake/outcome “snapshot” data. Findings demonstrated that the programs are reaching vulnerable pregnant/parenting women who face a host of complex circumstances including substance use, violence, child welfare involvement, and inadequate housing; moreover, it is typically the intersection of these issues that prompts women to engage with programs. Aligning with these results, key themes in what clients liked best about their program were: staff and their non-judgmental approach; peer support and sense of community; and having multiple services in one location, including help with mandated child protection. Full article

(This article belongs to the Special Issue Fetal Alcohol Spectrum Disorder (FASD))

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13 pages, 600 KiB

Open AccessArticle

Collaborative Action on Fetal Alcohol Spectrum Disorder Prevention: Principles for Enacting the Truth and Reconciliation Commission Call to Action #33

by Lindsay Wolfson, Nancy Poole, Melody Morton Ninomiya, Deborah Rutman, Sherry Letendre, Toni Winterhoff, Catherine Finney, Elizabeth Carlson, Michelle Prouty, Audrey McFarlane, Lia Ruttan, Lisa Murphy, Carmen Stewart, Lisa Lawley and Tammy Rowan

Int. J. Environ. Res. Public Health 2019, 16(9), 1589; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16091589 - 07 May 2019

Cited by 17 | Viewed by 6253

Abstract

The association between fetal alcohol spectrum disorder (FASD), residential schools and subsequent assimilatory policies in Canada is of such significance that it was included in the groundbreaking Truth and Reconciliation Commission of Canada’s Final Report through Call to Action #33, which focuses on collaboratively developing FASD prevention programs in Indigenous communities. A consensus statement with eight tenets for enacting Call to Action #33 was co-developed in May 2017 using a Two-Eyed Seeing approach during and after a meeting on Indigenous approaches to FASD prevention held in Canada. The consensus statement provides guidance for creating community-based, culture-led FASD prevention programs in Indigenous communities. The eight tenets reflect the diverse perspectives of Indigenous and non-Indigenous participants, are grounded in available research evidence, and align with Indigenous worldviews and wellness models. This paper uses the consensus statement and eight exemplary FASD prevention programs from Indigenous communities and organizations across Canada to highlight identity, culture, and relationships as central elements of FASD prevention in Indigenous communities. The consensus statement provides guidance for developing community- and culture-led FASD prevention programs and highlights the importance of Indigenous knowledge systems in developing and researching FASD prevention in, and with, Indigenous communities. Full article

(This article belongs to the Special Issue Fetal Alcohol Spectrum Disorder (FASD))

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10 pages, 610 KiB

Open AccessArticle

Perceptions of Fetal Alcohol Spectrum Disorder (FASD) at a Mental Health Outpatient Treatment Provider in Minnesota

by Jerrod Brown and Diane Harr

Int. J. Environ. Res. Public Health 2019, 16(1), 16; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16010016 - 21 Dec 2018

Cited by 12 | Viewed by 4045

Abstract

Resulting from prenatal exposure to alcohol, Fetal Alcohol Spectrum Disorder (FASD) is characterized by deficits in adaptive and cognitive functioning. This disorder is typically accompanied by co-occurring disorders and conditions (e.g., mood, anxiety, psychosis, and substance use disorders). This complicated presentation of diverse symptoms makes the process of screening, assessing, and diagnosing FASD very difficult, limiting the likelihood that clients receive the treatment and services that they need. Although mental health care providers have an opportunity to intervene on behalf of clients with FASD, professionals may not be very familiar or comfortable with this complicated and life-altering disorder. The present study explores the familiarity of 79 mental health outpatient treatment professionals’ personal knowledge and training about FASD. Findings suggest that the majority of respondents had received at least some FASD training, understood the basic symptoms of FASD, and were realistic about FASD’s impact on treatment. Full article

(This article belongs to the Special Issue Fetal Alcohol Spectrum Disorder (FASD))

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Review

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24 pages, 1627 KiB

Open AccessReview

The Distribution of Available Prevention and Management Interventions for Fetal Alcohol Spectrum Disorder (2007 to 2017): Implications for Collaborative Actions

by Babatope O. Adebiyi, Ferdinand C. Mukumbang and Charlene Erasmus

Int. J. Environ. Res. Public Health 2019, 16(12), 2244; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16122244 - 25 Jun 2019

Cited by 12 | Viewed by 6868

Abstract

The global prevalence of Fetal Alcohol Spectrum Disorder (FASD) remains high despite the various preventive and management interventions that have been designed and implemented to tackle the issue in various settings. The aim of the scoping review is to identify and classify prevention and management interventions of FASD reported globally across the life span and to map the concentration of these interventions across the globe. We searched some selected databases with predefined terms. Framework and narrative approaches were used to synthesize and report on the findings. Thirty-two prevention intervention studies and 41 management interventions studies were identified. All the interventions were reported to be effective or showed promising outcomes for the prevention and management of FASD, except four. Although Europe and Africa have a relatively higher prevalence of FASD, the lowest number of interventions to address FASD were identified in these regions. Most of the interventions for FASD were reported in North America with comparatively lower FASD prevalence. The uneven distribution of interventions designed for FASD vis-à-vis the burden of FASD in the different regions calls for a concerted effort for knowledge and intervention sharing to enhance the design of contextually sensitive preventive and management policy in the different regions. Full article

(This article belongs to the Special Issue Fetal Alcohol Spectrum Disorder (FASD))

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16 pages, 1814 KiB

Open AccessReview

Fetal Cerebral Artery Mitochondrion as Target of Prenatal Alcohol Exposure

by Anna N. Bukiya

Int. J. Environ. Res. Public Health 2019, 16(9), 1586; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16091586 - 07 May 2019

Cited by 11 | Viewed by 3573

Abstract

Prenatal alcohol exposure results in an array of developmental abnormalities known as fetal alcohol spectrum disorders (FASDs). Despite the high prevalence of FASDs, therapeutic interventions against accidental or intended exposure of developing fetuses to alcohol are limited. This review outlines current knowledge about mitochondria in cerebral blood vessels as a potential target for anti-FASDs intervention. First, it describes the multifaceted role of mitochondria in maintaining the cerebral artery diameter as shown in adult tissue. Second, current literature on alcohol-driven damage of mitochondrial morphology and function in several fetal tissues, including liver, heart, and brain is summarized. The functional consequences of alcohol exposure in these organs include morphological enlargement of mitochondria, increased oxidative stress, and alteration of cellular respiration. These studies point to a tissue-specific effect of alcohol on mitochondrial function and a particular vulnerability of fetal mitochondria to alcohol exposure when compared to adult counterparts. Third, recent work from our group describing persistent changes in fetal baboon cerebral artery proteome following three episodes of prenatal alcohol exposure is reviewed. In conclusion, the consequences of prenatal alcohol exposure on cerebral artery mitochondria constitute an open field of investigation and, eventually, a point of therapeutic intervention against FASDs. Full article

(This article belongs to the Special Issue Fetal Alcohol Spectrum Disorder (FASD))

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Other

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12 pages, 317 KiB

Open AccessCase Report

Partnering with the Health Professions to Promote Prevention of an Alcohol-Exposed Pregnancy: Lessons Learned from an Academic–Organizational Collaborative

by Leigh Tenkku Lepper, Diane King, Joy Doll, Sandra Gonzalez, Ann Mitchell and Joyce Hartje

Int. J. Environ. Res. Public Health 2019, 16(10), 1702; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16101702 - 15 May 2019

Cited by 1 | Viewed by 2769

Abstract

Background: Evidence-based strategies exist to train healthcare professionals to ask their patients and clients about alcohol use, and are successful. Implementation of these strategies utilizing a system-level approach has not been conducted nationwide. This case study reports on the success of academic partnerships with national health professional organizations to increase adoption of evidence-based strategies to prevent alcohol-exposed pregnancies. Methods: Authors reviewed and summarized multi-level strategies created as part of the developmental phase of this project in order to report successes and challenges. We applied the three principles of reflection, sense-making, and reciprocal learning, as identified in the practice change literature, to synthesize our experience. Results: There were five primary lessons learned as a result of this work: Development of technology-based training websites requires significant time to design, implement, and test; project ‘mission-drift’ is inevitable, but not necessarily unwelcome; time and effort is required to create and sustain functioning workgroups when there are different organizational cultures; and changing real-world practice is hard to do, yet changing the conversation on screening and brief intervention is possible. Conclusions: Use of multi-level strategies within an academic–professional organization model was successful in promoting awareness and education of healthcare professionals in the prevention of alcohol-exposed pregnancies. Full article

(This article belongs to the Special Issue Fetal Alcohol Spectrum Disorder (FASD))

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