Abstract
The incidence of fetal alcohol syndrome (FAS) in northeastern Manitoba was investigated by examining all 745 live births occurring in Thompson General Hospital in 1994. Birth records were screened with criteria designed to capture all potential FAS cases. Cases were then eliminated if follow-up records indicated the child was not developmentally delayed or no longer had the small head or body size identified at birth. Cases still meeting criteria were personally examined. Five cases of FAS were identified among the 46% of eligible children screened at age 2, roughly an incidence of 7.2/1,000. However, because only 46% of the high risk cases were personally examined, incidence could be as high as 14.8/1,000. Only 1/5 FAS cases had been identified prior to our investigation. The results indicate the incidence of FAS in northeastern Manitoba is very high and that much greater effort needs to be made in its prevention and early detection.
Résumé
L’incidence du syndrome d’alcoolisme foetal (SAF) dans le nord-est du Manitoba a été étudiée en examinant les 745 naissances vivantes de l’hôpital général de Thompson en 1994. Les naissances enregistrées ont été examinées avec des critères conçus pour détecter les cas potentiels de SAF. Ensuite, on a éliminé les cas enregistrés où l’enfant n’avait pas de retard dans son développement et ceux dont la taille du corps ou de la tête était anormalement petite à la naissance mais dont le problème s’est résorbé par la suite. Ensuite, les cas répondant encore à nos critères ont été examinés. Cinq cas de SAF ont été identifiés parmi les 46% des enfants éligibles examinés à l’âge de 2 ans, représentant une incidence de 7,2/1 000. Cependant, parce que seulement 46% ont été examinés, l’incidence réelle pourrait être de 14,8/1 000. Avant notre recherche, seulement 1/5 des cas de SAF avait été identifié. Donc, les résultats indiquent que l’incidence du SAF dans le nord-est du Manitoba est élevée et un effort important doit être fait pour le prévenir et le détecter hâtivement.
References
- 1.U.S. Department of Health and Human Services, National Institute on Alcohol Abuse and Alcoholism. Fetal Alcohol Syndrome. Alcohol Alert 1991;No. 13.
- 2.Michaelis EK, Michaelis ML. Cellular and molecular bases of alcohol’s teratogenic effects. Alcohol Health and Research World. 1994;18:17–21. [PMC free article] [PubMed] [Google Scholar]
- 3.May PA. Fetal alcohol effects among North American Indians. Evidence and implications for society. Alcohol Health and Research World. 1991;15:239–48. [Google Scholar]
- 4.Olegard R, Sabel KG, Aronsson M, et al. Effects on the child of alcohol abuse during pregnancy: Retrospective and prospective studies. Acta Paediatr Scand (Suppl) 1979;275:112–21. doi: 10.1111/j.1651-2227.1979.tb06170.x. [DOI] [PubMed] [Google Scholar]
- 5.Gibson GT, Baghurst PA, Colley DP. Maternal alcohol, tobacco, and cannabis consumption and the outcome of pregnancy. Aust N Z J Obstet Gynaecol. 1983;23:15–19. doi: 10.1111/j.1479-828X.1983.tb00151.x. [DOI] [PubMed] [Google Scholar]
- 6.Wright JT, Barrison IG, Lewis IG, et al. Alcohol consumption, pregnancy, and low birth weight. Lancet. 1983;3:663–65. doi: 10.1016/S0140-6736(83)91964-5. [DOI] [PubMed] [Google Scholar]
- 7.Chavez GF, Corder JF, Becerra JE. Leading major congenital malformations among minority groups in the United States. MMWR. 1988;37:17–24. [PubMed] [Google Scholar]
- 8.Wong N. British Columbia Surveillance Registry. 1983. [Google Scholar]
- 9.Abel EL, Sokol RJ. A revised conservative estimate of the incidence of FAS and its economic impact. Alcohol Clin Exp Res. 1991;15:514–24. doi: 10.1111/j.1530-0277.1991.tb00553.x. [DOI] [PubMed] [Google Scholar]
- 10.Habbick BF, Nanson JL, Snyder RE, et al. Foetal alcohol syndrome in Saskatchewan: Unchanged incidence in a 20-year period. Can J Public Health. 1996;87:204–7. [PubMed] [Google Scholar]
- 11.Robinson GC, Conry JL, Conry RF. Clinical profile and prevalence of fetal alcohol syndrome in an isolated community in British Columbia. Can Med Assoc J. 1987;137:203–7. [PMC free article] [PubMed] [Google Scholar]
- 12.Asante KO, Nelms-Matzke J. Report on the Survey of Children with Chronic Handicaps and Fetal Alcohol Syndrome in the Yukon and Northwest British Columbia. 1985. [Google Scholar]
- 13.Fetal alcohol syndrome plagues Manitoba reserve, report says. The Globe and Mail. 1997. [Google Scholar]
- 14.Sokol RJ, Miller SI, Reed G. Alcohol abuse during pregnancy: An epidemiologic study. Alcohol Clin Exp Res. 1980;4:135–45. doi: 10.1111/j.1530-0277.1980.tb05628.x. [DOI] [PubMed] [Google Scholar]
- 15.May P, Hymbaugh KJ, Aase JM, Samet JM. Epidemiology of fetal alcohol syndrome among American Indians of the southwest. Social Biology. 1983;30:374–87. doi: 10.1080/19485565.1983.9988551. [DOI] [PubMed] [Google Scholar]
- 16.Statistics Canada. Live Births and Live Births in Hospital, by Occurrence and Residence, for Counties, Census Divisions and Districts. 1993. [Google Scholar]
- 17.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. doi: 10.1002/(SICI)1096-9926(199711)56:5<317::AID-TERA5>3.0.CO;2-U. [DOI] [PubMed] [Google Scholar]
- 18.Burd L, Moffatt ME. Epidemiology of fetal alcohol syndrome in American Indians, Alaskan natives, and Canadian native people: A review of the literature. Public Health Rep. 1994;109:688–93. [PMC free article] [PubMed] [Google Scholar]
- 19.Williams RJ, Gloster SP. Knowledge of FAS among Natives in Northern Manitoba. J Studies on Alcohol (in press). [DOI] [PubMed]