1.1  Prevalence of
Fetal Alcohol Spectrum disorder

 

The
fetal alcohol spectrum disorder is a difficult condition to diagnose, especially
in undeveloped countries, where prevalence estimates of FASD are inexistent.
However, some estimations have been done. The global prevalence of FASD is estimated
as 7.7 per 1000 population, being the European Region the one with the highest
prevalence at 19.8 per 1000 population. The countries with the highest estimate
of FASD were South Africa with 111.1 per 1000 population, Croatia at 53.3 per
1000 population, Ireland at 47.5 at 1000 population, Italy at 45.0 per 1000
population, and Belarus at 36.6 per 1000 population (Lange et al., 2017).

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On
the other hand, the estimated prevalence in selected populations has shown to
be higher than the global prevalence. It was 15.6 to 24.6 times higher in
aboriginal populations; 5.2 to 67.7 times higher in children in care; 30.3 times
higher in correctional population; 23.7 times higher in low socio-economic
status; and 18.5 times higher in population in psychiatric care (Lange et al., 2017).

1.2  Consequences
of alcohol exposure during pregnancy

 

The
exposure to alcohol during pregnancy is very harmful for the fetus as has been
shown in numerous studies, even when the level is very low it can cause damage
and not only in the brain. Nowadays, it is not possible to determine a safe level
and period when drinking alcohol is not dangerous for the fetus (Sarman, 2018).

In
a study performed with early chick embryos with an exposure of 2% ethanol, it
was proven the relation between alcohol exposure and an increased incidence of
parietal bone defects and retarded growth of the rostrum. (Zhang et al., 2017)

 

1.3  Fetal alcohol
spectrum disorder diagnosis

 

Fetal
alcohol spectrum disorder (FASD) is the biggest nonheritable origin of intellectual
disorder and it is caused by intrauterine exposure to alcohol. Depending on the
kind of symptoms, different names are used to describe FASD: Fetal Alcohol Syndrome
(FAS) which is the most extreme part of the FASD; Alcohol-Related Neurodevelopmental
Disorder (ARND) which includes problems with learning and behavior and they
might have intellectual disabilities; and Alcohol-Related Birth Defects (ARBD).
Each category is differentiated by the presence or not of facial abnormalities,
problems in the growth, disfunctions in the central nervous system, and neurobehavioral
disabilities. (Centers for Disease Control and
Prevention, 2017)

A
multidisciplinary team is needed to assess and diagnose FASD and a neurological
assessment should be included. At the start of the diagnosis, the level of
prenatal exposure is assessed. This information must be taken from the mother
or another source like a medical record or a family member. In addition, the
exposure to other drugs is analyzed too as the women who consume alcohol during
their pregnancy have more chances to consume drugs. To concrete a diagnosis of
FAS, the presence of this characteristics is needed: abnormal facial features,
growth problems, central nervous system problems and neurobehavioral disabilities.
(Denny,
Coles, & Blitz, 2017)

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