Prevalence and Traits of FASD in the US Population: Evidence from Schools

描述(由申请人提供)： 背景/项目摘要：对美国主流人群来说，对胎儿酒精谱系障碍(FASD)的患病率和人群特征进行准确的评估是迫切需要的，也是早就应该进行的。FASD在美国普通人群和我们的学校中的真实范围、性质和影响目前尚不清楚和/或未知，尽管最近的一项估计显示FASD的患病率为2%至5%。通过在三个人群的一年级班级中进行筛查、测试和高度结构化的跨学科、LOM推荐的诊断程序，我们建议：1)通过两种不同的病例对照和随机抽样方法，评估FASD在美国三个特定一年级人群中的两个队列中的患病率；2)确定a)身体生长和形态以及b)神经发育特征的确切特征；3)应用阵列比较基因组杂交(ACGH)技术，在嵌套研究中评估可能影响严重FASD(FASD或PFAS)面部变形的任何主要遗传因素(如基因缺失综合征)；4)确定不同水平FASD的美国主流女性中特定的孕产妇风险因素；以及5)与FASD流行率协作(CoFASP)的数据分析协调部分(DACC)协调所有数据内容、收集、格式和程序，并将收集的所有数据提供给这一NIAAA资助的倡议的DACC。研究将在以下地点进行：密歇根州大瀑布；南达科他州苏福尔斯；以及北卡罗来纳州ABC县[化名]。在大瀑布进行了三项试点研究，据估计，那里一年级儿童中FASD的比例为1%至2.5%，这一比例大大高于美国目前的估计。目前，我们处于真正独特的地位。随着我们的流行病学方法和程序的成熟，未来美国人口研究的创新方向是明确的。我们经验丰富的临床研究人员团队具有凝聚力、跨学科和专家精神，在美国和其他国家的类似研究中拥有12年的经验。这是这项以人群为基础的关于FASD在美国主流人群中的流行率和特征的研究的合适时机，在美国主流人群中，FASD可能是一个相当大的、但被低估的公共卫生问题。 公共卫生相关性：胎儿酒精谱系障碍(FASD)在美国主流人群中的患病率和特征尚不清楚；最近的估计认为，FASD可能影响2%至5%的儿童。对3个有代表性的美国人群的一年级儿童(及其母亲)进行的关于FASD的创新、活跃的病例确定研究将对主流人群中FASD的规模、特征和特定背景病因进行准确测量。更好地了解FASD对公众健康和临床的影响将为更好地诊断、干预和预防提供指导。

DESCRIPTION (provided by applicant): Background/Project Summary: Accurate assessments of the prevalence and population-based characteristics of fetal alcohol spectrum disorders (FASD) are sorely needed and long overdue for the U.S. mainstream population. The true extent, nature, and impact of FASD in the general population of the U.S., and in our schools, are currently unclear and/or unknown, although a recent estimate has placed the prevalence of FASD at 2 to 5%. Through screening, testing, and highly-structured interdisciplinary, lOM-recommended diagnostic procedures in 1st grade classes of three populations, we propose to: 1) assess the prevalence of FASD in two cohorts each within three specific 1st grade populations in the U.S. via two different applications of case control and random sampling methods; 2) define the exact characteristics of a) physical growth and morphology and b) neurodevelopmental characteristics U.S. children with and without FASD; 3) apply array comparative genomic hybridization (aCGH) techniques, in a nested study, to assess any major genetic factors (e.g. gene deletion syndromes) that may affect facial dysmorphia in cases of severe FASD (FAS or PFAS); 4) define specific maternal risk factors among mainstream American women for various levels of FASD; and 5) coordinate all data content, collection, formatting, and procedures with the Data Analysis Coordination Component (DACC) of the Collaboration of FASD Prevalence (CoFASP), and provide all data collected to the DACC of this NIAAA-funded initiative. Research will take place in: Great Falls, MT; Sioux Falls, SD; and ABC County, NC [pseudonym]. Three pilot studies have been carried out in Great Falls, and FASD has been estimated there at 1 to 2.5% of 1st grade children, a rate substantially higher than current estimates for the U.S. We are in a truly unique position at this time. As our epidemiologic methods and procedures have matured, the directions for innovation within future studies of U.S. populations are clear. Our experienced team of clinical researchers is cohesive, interdisciplinary, and expert, with 12 years experience in similar studies in the U.S. and foreign countries. This is an opportune time for this population-based study of the prevalence and characteristics of FASD in mainstream U.S. populations where FASD may be a substantially large, but underreported, public health problem. PUBLIC HEALTH RELEVANCE: The prevalence and characteristics of fetal alcohol spectrum disorders (FASD) in the mainstream U.S. population are not known; recent estimates hold that FASD may affect 2 to 5% of all children. Innovative, active case ascertainment research on FASD in 1st grade children (and their mothers) of 3 representative U.S. populations will produce accurate measures of the magnitude, characteristics, and specific contextual etiology of FASD in mainstream populations. A better understanding of the public health and clinical impact of FASD in the general population will guide the way to better diagnosis, intervention, and prevention.