Replication of High Fetal Alcohol Spectrum Disorders Prevalence Rates, Child Characteristics, and Maternal Risk Factors in a Second Sample of Rural Communities in South Africa.
Replication of High Fetal Alcohol Spectrum Disorders Prevalence Rates, Child Characteristics, and Maternal Risk Factors in a Second Sample of Rural Communities in South Africa.
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DOI：
10.3390/ijerph14050522
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发表时间：
2017-05-12
影响因子：
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通讯作者：
Hoyme HE
中科院分区：
文献类型：
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作者：
May PA;De Vries MM;Marais AS;Kalberg WO;Buckley D;Adnams CM;Hasken JM;Tabachnick B;Robinson LK;Manning MA;Bezuidenhout H;Adam MP;Jones KL;Seedat S;Parry CDH;Hoyme HE
背景资料：在南非三个农村社区的第二个样本中研究了胎儿酒精综合征（FAS）和胎儿酒精谱系障碍（FASD）的患病率和特征，以评估变化。方法：对身高、体重和/或头围≤第25百分位数的儿童和随机选择的儿童进行主动病例确定。最后的诊断是基于畸形，神经行为评分，和产妇风险访谈。结果如下：基本面部特征，头围，总畸形评分区分特定的FASD诊断类别在某种程度上线性的方式，但所有FASD性状显着差于随机选择的对照组。FASD儿童的神经发育迟缓明显比对照组严重。酗酒被明确记录为FASD的近端母亲风险因素，显著的远端风险因素包括：低体重、教育和收入;高妊娠率、产次和指数儿童出生时的年龄。在这些社区，FAS比率仍然极高，每1 000名儿童中有89至129人。在这些社区，每1 000名儿童中有196-276名患有严重的家庭性自闭症，占儿童总数的20-28%。结论：在这些普通人群中，FASD的发病率非常高，这些人群经常大量饮酒，通常是以狂欢的方式，与低社会经济条件共同发生。
Background: Prevalence and characteristics of fetal alcohol syndrome (FAS) and total fetal alcohol spectrum disorders (FASD) were studied in a second sample of three South African rural communities to assess change. Methods: Active case ascertainment focused on children with height, weight and/or head circumference ≤25th centile and randomly-selected children. Final diagnoses were based on dysmorphology, neurobehavioral scores, and maternal risk interviews. Results: Cardinal facial features, head circumference, and total dysmorphology scores differentiated specific FASD diagnostic categories in a somewhat linear fashion but all FASD traits were significantly worse than those of randomly-selected controls. Neurodevelopmental delays were significantly worse for children with FASD than controls. Binge alcohol use was clearly documented as the proximal maternal risk factor for FASD, and significant distal risk factors were: low body mass, education, and income; high gravidity, parity, and age at birth of the index child. FAS rates continue to extremely high in these communities at 89–129 per 1000 children. Total FASD affect 196–276 per 1000 or 20–28% of the children in these communities. Conclusions: Very high rates of FASD persist in these general populations where regular, heavy drinking, often in a binge fashion, co-occurs with low socioeconomic conditions.