INCIDENCE AND PREVALENCE OF FETAL ALCOHOL SPECTRUM DISORDER BY SEX AND AGE GROUP IN ALBERTA, CANADA

Main Article Content

Nguyen Xuan Thanh
Egon Jonsson
Amy Salmon
Meghan Sebastianski

Keywords

FASD, incidence, prevalence, Alberta

Abstract

Objectives


To estimate incidence and prevalence of FASD by sex and age in Alberta, Canada.


Methods


We included all patients recorded in the Alberta provincial health databases of inpatients, outpatients, and practitioner claims from 2003 to 2012. The number of people with FASD were calculated from available data on FAS (ICD - 9 code 760.71; ICD - 10 codes Q86.0 and P04.3) and estimated prevalence of FASD among individuals diagnosed with 21 FASD - related conditions (identified by a literature review) for which there are ICD codes, such as learning disability, mental retardation, and nervous system defects (Table 1). Fractions of FASD - related diagnoses that can be attributed to alcohol use during pregnancy were estimated by a systematic review. The incidence was measured as the number of new cases per 1000 births. The prevalence was measured as the number of cases per 1000 population in 2012.


Results


Annually, 739 to 1884 people were born with FASD in Alberta establishing an incidence of 14.2 to 43.8 per 1000 births, depending on the length of follow – up. There were about 46,000 people living with FASD in Alberta 2012, including 6,000 FAS cases and 40,000 FASD - related cases. The prevalence of FASD was 11.7 (range 8.2 to 15.1) per 1000 population. The incidence and prevalence varied greatly by sex and age group. Generally, male and younger outnumbered female and older.


Conclusion


This study suggests new incidence and prevalence of FASD, which are higher than what has been commonly used (1%), and its variations among sex and age groups.

Abstract 1163 | PDF Downloads 707

References

1. Stratton KR, Howe CJ, Battaglia FC. Fetal alcohol syndrome diagnosis, epidemiology, prevention, and treatment. Washington DC: Institute of Medicine, National Academy Press, 1996.larren SK, Salmon A. Prevention of fetal alcohol spectrum disorder: proposal for a comprehensive approach. Expert Rev Obstet Gynecol 2010;5: 23 – 30
2. Clarren SK, Salmon A. Prevention of fetal alcohol spectrum disorder: proposal for a comprehensive approach. Expert Rev Obstet Gynecol 2010; 5: 23 – 30
3. Streissguth AP, Bookstein FL, Barr HM, et al. Risk factors for adverse life outcomes in fetal alcohol syndrome and fetal alcohol effects. Journal of Developmental and Behavioral Pediatrics 2004;25(4):228 - 38.
4. Rasmussen C, Andrew G, Zwaigenbaum L, Tough S. Neurobehavioural outcomes of children with FASD: a Canadian perspective. Paediatr Child Health 2008;13: 185 – 91.
5. Thanh NX, Jonsson E, Dennett L, Jacobs P. Costs of FASD. In: Riley EP, Clarren S, Weinberg J, and Jonsson E (Eds). Fetal Alcohol Spectrum Disorder – Management and Policy Perspectives of FA SD. Wiley - Blackwell 2011; 4 5 - 69.
6. Abel EL, Sokol RJ. Incidence of fetal alcohol syndrome and economic impact of FAS - related anomalies. Drug Alcohol Depend. 1987; 19(1):51 - 70.
7. Sampson PD, Streissguth AP, Bookstein FL, et al. Incidence of fetal alcohol syndrome and prevalence of alcohol-related neurodevelopmental disorder. Teratology 1997;56:317 - 26.
8. Centers for Disease Control and Prevention. Fetal Alcohol Spectrum Disorders (FASDs). Data & Statistics. Available: www.cdc.gov/ncbddd/fasd/data.html (accessed June 25, 2013).
9. May PA, Gossage JP, Kalberg WO, et al. Prevalence and epidemiologic characteristics of FASD from various research methods with an emphasis on recent in-school studies. Developmental Disability Research Reviews 2009;15:176 - 92.
10. Healthy Child Manitoba. Developing a National Prevalence Plan for FASD in Canada. March 2012. Available: www.canfasd.ca/wp - content/uploads/2013/02/FASD_Prevalence_Pos ition_Paper_ final_March2012.pdf (accessed June 25, 2013).
11. Public Health Agency of Canada. Fetal Alcohol Spectrum Disorder (FASD): A Framework for Action. Available: www.phac - aspc.gc.ca/publicat/fasd - fw - etcaf - ca/framework - eng.php (accessed November 21, 2012).
12. Alberta FASD Cross - Ministry Committee. FASD - 10 Year Strategic Plan 2008. Available: www.fasd - cmc.alberta.ca/uploads/1004/fasd10yrpl anfinal8 6321.pdf (accessed November 21, 2012).
13. Human Services, Alberta Government (2012). Alberta recognizes International Fetal Alcohol Spectrum Disorder Awareness Day. Information Bulletin.
14. Chudley AE, Conry J, Cook JL, Loock C, Rosales T, LeBlanc N. (20 05). Fetal alcohol spectrum disorder: Canadian guidelines for diagnosis. CMAJ 2005;172: S1 - 21.
15. Alberta Health. Overview of Administrative Health Databases. Available: www.health.alberta.ca/documents/Research - Health - Databases.pdf (accessed September 12, 201 2).
16. Stratton K, Howe CJ, Battaglia FC. Fetal alcohol syndrome: diagnosis, epidemiology, prevention, and treatment. Washington, DC: National Academy Press; 1996.
17. British Columbia Vital Statistics Agency. Health Status Registry Report 2005. Congenital Anomalies, Genetic Defects, and Selected Disabilities. Includes British Columbia Birth Data to Year 2002. Available: www.vs.gov.bc.ca/stats/ (accessed Nov. 2, 2012).
18. Klug MG, Burd L. Fetal alcohol syndrome prevention: annual and cumulative cost savings. Neurotoxicology and Teratology 2003;25:763 – 765.
19. Harwood HJ and Napolitano DM. Economic implications of the fetal alcohol syndrome. Alcohol Health and Research World. Fall 1985.
20. Thanh NX, Jonsson E. Costs of fetal alcohol spectrum disorder in Alberta, Canada. Canadian Journal of Clinical Pharmacology 2009 16(1):e80 - e90.
21. Penny Webb and Chris Bain. Essential Epidemiology: An Introduction for Students and Health Professionals. Second Edition. Cambridge University Press 2010. Appendix 6 - The Mantel - Haenszel method for calculating pooled odds ratios pp. 413 - 415.
22. World Health Organization. Metrics: Population Attributable Fraction (PAF). Available: www.who.int/healthinfo/global_burden_disease/ metrics_paf/en/index.html (accessed June 25, 2013)
23. Statistics Canada. Births, estimates, by province and territory. Available: www.statcan.gc.ca/tables - tableaux/sum - som/l01/cst01/demo04a - eng.htm (Accessed June 25, 2013).
24. Service Alberta. Death information. Available: www.servicealberta.gov.ab.ca/657.cfm (accessed June 25 2013).
25. Alberta Health Care Insurance Plan. Available: www.health.alberta.ca/health - care - insurance - plan.html (accessed June 25, 2013).
26. Government of Alberta. Interactive Health Data Application (IHDA). Available: www.ahw.gov.ab.ca/IHDA_Retrieval/ (accessed June 25 , 2013)
27. May PA, Fiorentino D, Gossage JP, et al. The epidemiology of FASD in a province in Italy: prevalence and characteristics of children in a random sample of school. Alcoholism, Clinical and Experimental Research 2006;30:1562 - 75.
28. Alberta Treasury Boar d and Finance. Alberta economy indicators at a glance. May 31, 2013. Available: www.finance.alberta.ca/aboutalberta/at - a - glance/2013/2013 - 0503 - alberta - economy - indicators.pdf (accessed June 28, 2013.)