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Adapted Media Release  Published: 17 January 2017
Worldwide, an estimated 119,000 children are born with Fetal Alcohol Syndrome (FAS) each year, a new study from the Centre for Addiction and Mental Health (CAMH) shows.

The study, published in The Lancet Global Health, provides the first-ever estimates of the proportion of women who drink during pregnancy, as well as estimates of FAS by country, World Health Organization (WHO) region and worldwide.
Globally, nearly 10 per cent of women drink alcohol during pregnancy, with wide variations by country and WHO region. In some countries, more than 45 per cent of women consume alcohol during pregnancy. In Canada, which has clinical guidelines advising abstinence during pregnancy, an estimated 10 per cent of pregnant women still drink, which is close to the estimated world average…

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LANCET Article
 

Nancy L. Day1,*, Alexis Helsel2, Kristen Sonon2, Lidush Goldschmidt1
Article first published online: 26 FEB 2013  DOI: 10.1111/acer.12073  Copyright © 2013 by the Research Society on Alcoholism

Background
Prenatal alcohol exposure (PAE) affects central nervous system development, growth, and morphology at higher exposure levels. Little is known about the effects of PAE at lower exposure levels or in young adults. Research on children with higher levels of PAE has shown that PAE predicts behavior problems. The question remains whether these effects are permanent or ameliorated by maturation into adulthood.

Methods
These data are from a longitudinal study of PAE. Mothers were recruited from a prenatal clinic and interviewed during their fourth prenatal month, seventh month, and delivery. In the postpartum, mothers and offspring were seen at 8 and 18 months, and 3, 6, 10, 14, 16, and 22 years.

Results
At 22 years, PAE significantly predicted behavior as measured with the adult self-report. These findings were significant controlling for covariates. Exposure at each trimester predicted increased behavior problems on the Total Score, Internalizing, Externalizing, Attention, and Critical Items scales. Use across pregnancy predicted a higher rate of behavior problems compared to no use and use in the first trimester only.

Conclusions
… Thus, there is no safe level or safe time during pregnancy for women to drink. These data demonstrate that the effects of PAE, even at low to moderate levels, extend into young adulthood and are most likely permanent.

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2014 By Andrew M. Seaman

NEW YORK (Reuters Health) - Children who are diagnosed with fetal alcohol spectrum disorder are at higher risk of having impaired gross motor skills, according to a review of past studies.
Balance, coordination and ball skills were the areas where children exposed to alcohol in the womb had the most problems, researchers found.
“This is biologically plausible as alcohol is a teratogen which causes damage to the developing brain,” Barbara Lucas told Reuters Health in an email. “Areas of the brain that may be damaged include those which are important for motor control.”

The researchers found 14 studies to include in the analysis and were able to combine data from 10 of those studies.
Overall, the odds of a child having gross motor skill impairment tripled when the child had a FASD diagnosis or was exposed to a moderate to heavy amount of alcohol while in the womb.

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Over 400 conditions co-occur with Foetal Alcohol Spectrum Disorders (FASD), study finds
January 5, 2016

Researchers at the Centre for Addiction and Mental Health (CAMH) have identified 428 distinct disease conditions that co-occur in people with Foetal Alcohol Spectrum Disorders (FASD), in the most comprehensive review of its kind.

The results were published today in The Lancet.
"We've systematically identified numerous disease conditions co-occurring with FASD, which underscores the fact that it isn't safe to drink any amount or type of alcohol at any stage of pregnancy, despite the conflicting messages the public may hear," says Dr. Lana Popova, Senior Scientist in Social and Epidemiological Research at CAMH, and lead author on the paper. "Alcohol can affect any organ or system in the developing fetus."
FASD is a broad term describing the range of disabilities that can occur in individuals as a result of alcohol exposure before birth. The severity and symptoms vary, based on how much and when alcohol was consumed, as well as other factors in the mother's life such as stress levels, nutrition and environmental influences. The effects are also influenced by genetic factors and the body's ability to break down alcohol, in both the mother and foetus.
Different Canadian surveys suggest that between six and 14 per cent of women drink during pregnancy.

The 428 co-occurring conditions were identified from 127 studies included in The Lancet review. These disease conditions, coded in the International Classification of Disease (ICD-10), affected nearly every system of the body, including the central nervous system (brain), vision, hearing, cardiac, circulation, digestion, and musculoskeletal and respiratory systems, among others.
While some of these disorders are known to be caused by alcohol exposure - such as developmental and cognitive problems, and certain facial anomalies - for others, the association with FASD does not necessarily represent a cause-and-effect link.

Problems range from communications disorders to hearing loss
However, many disorders occurred more often among those with FASD than the general population. Based on 33 studies representing 1,728 individuals with Foetal Alcohol Syndrome (FAS), the most severe form of FASD, the researchers were able to conduct a series of meta-analyses to establish the frequency with which 183 disease conditions occurred.
More than 90 per cent of those with FAS had co-occurring problems with conduct. About eight in 10 had communications disorders, related to either understanding or expressing language. Seven in 10 had developmental/cognitive disorders, and more than half had problems with attention and hyperactivity.

Because most studies were from the U.S., the frequency of certain co-occurring conditions was compared with the general U.S. population. Among people with FAS, the frequency of hearing loss was estimated to be up to 129 times higher than the general U.S. population, and blindness and low vision were 31 and 71 times higher, respectively.
"Some of these other co-occurring problems may lead people to seek professional help," says Rd. Popova. "The issue is that the underlying cause of the problem, alcohol exposure before birth, may be overlooked by the clinician and not addressed."

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