{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T21:50:08Z","timestamp":1791669008833,"version":"4.3.4"},"reference-count":69,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["UO1 AA15134"],"award-info":[{"award-number":["UO1 AA15134"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alcoholism Clin &amp;amp; Exp Res"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This study is the ninth cross\u2010sectional community study of fetal alcohol spectrum disorders (FASD) conducted by the multidisciplinary Fetal Alcohol Syndrome Epidemiology Research team in the Western Cape Province of South Africa. It is the third comprehensive study of FASD in a rural, agricultural region of South Africa.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Population\u2010based, active case ascertainment methods were employed among a school\u2010based cohort to assess child physical and neurobehavioral traits, and maternal risk factor interviews were conducted to identify all children with FASD to determine its prevalence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Consent was obtained for 76.7% of 1158 children attending first grade in the region's public schools. Case\u2013control results are presented for 95 with fetal alcohol syndrome (FAS), 64 with partial fetal alcohol syndrome (PFAS), 77 with alcohol\u2010related neurodevelopmental disorder (ARND), 2 with alcohol\u2010related birth defects (ARBD), and 213 randomly\u2010selected controls. Four techniques estimating FASD prevalence from in\u2010person examinations and testing yielded a range of total FASD prevalence of 206\u2013366 per 1000. The final weighted, estimated prevalence of FAS was 104.5 per 1000, PFAS was 77.7 per 1000, ARND was 125.2 per 1000, and total FASD prevalence was 310 per 1000 (95% CI\u00a0=\u00a0283.4\u2013336.7). Expressed as a percentage, 31% had FASD. Although the rate of total FASD remained steady over 9\u2009years, the proportion of children within the FASD group has changed significantly: FAS trended down and ARND trended up. A detailed evaluation is presented of the specific child physical and neurobehavioral traits integral to assessing the full continuum of FASD. The diagnosis of a child with FASD was significantly associated with maternal proximal risk factors such as: co\u2010morbid prenatal use of alcohol and tobacco (OR\u00a0=\u00a019.1); maternal drinking of two (OR\u00a0=\u00a05.9), three (OR\u00a0=\u00a05.9), four (OR\u00a0=\u00a038.3), or more alcoholic drinks per drinking day; and drinking in the first trimester (OR\u00a0=\u00a08.4), first and second trimesters (OR\u00a0=\u00a017.7), or throughout pregnancy (OR\u00a0=\u00a018.6). Distal maternal risk factors included the following: slight or small physical status (height, weight, and head circumference), lower BMI, less formal education, late recognition of pregnancy, and higher gravidity, parity, and older age during the index pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The prevalence of FASD remained a significant problem in this region, but the severity of physical traits and anomalies within the continuum of FASD is trending downwards.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.14922","type":"journal-article","created":{"date-parts":[[2022,8,16]],"date-time":"2022-08-16T06:31:37Z","timestamp":1660631497000},"page":"1819-1836","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["The prevalence of fetal alcohol spectrum disorders in rural communities in South Africa: A third regional sample of child characteristics and maternal risk factors"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1939-8701","authenticated-orcid":false,"given":"Philip A.","family":"May","sequence":"first","affiliation":[{"name":"Nutrition Research Institute The University of North Carolina at Chapel Hill  Kannapolis North Carolina USA"},{"name":"Faculty of Medicine and Health Sciences Stellenbosch University  Tygerberg South Africa"},{"name":"Center on Alcoholism, Substance Abuse and Addictions The University of New Mexico  Albuquerque New Mexico USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlene M.","family":"de Vries","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences Stellenbosch University  Tygerberg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna\u2010Susan","family":"Marais","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences Stellenbosch University  Tygerberg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy O.","family":"Kalberg","sequence":"additional","affiliation":[{"name":"Center on Alcoholism, Substance Abuse and Addictions The University of New Mexico  Albuquerque New Mexico USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Buckley","sequence":"additional","affiliation":[{"name":"Center on Alcoholism, Substance Abuse and Addictions The University of New Mexico  Albuquerque New Mexico USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie M.","family":"Hasken","sequence":"additional","affiliation":[{"name":"Nutrition Research Institute The University of North Carolina at Chapel Hill  Kannapolis North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Abdul\u2010Rahman","sequence":"additional","affiliation":[{"name":"Department of Genetic Medicine Munroe\u2010Meyer Institute, University of Nebraska Medical Center  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luther K.","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics State University of New York  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie A.","family":"Manning","sequence":"additional","affiliation":[{"name":"Department of Pathology and Pediatrics Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soraya","family":"Seedat","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences Stellenbosch University  Tygerberg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles D. 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