Comparative Analysis of Physical Traits of Children with Fetal Alcohol Spectrum Disorders in South Africa and the United States and the Likelihood of FASD Births

Abstract

AbstractThe prevalence of fetal alcohol spectrum disorders (FASD) in recent years was 29% among children in the Western Cape Province of South Africa and 6.5% in four regions of the United States. Population-based studies in the general populations of these countries have greatly improved our understanding of the full continuum of FASD and provided large amounts of data on the physical and neurobehavioral traits of children with FASD. This chapter provides explicit detail of the physical growth and development and dysmorphology among children with FASD in both countries and compares their traits with those children who are developing typically in their respective communities. The findings in the two countries are then compared to one another for the diagnoses of fetal alcohol syndrome (FAS), partial fetal alcohol syndrome (PFAS), and alcohol-related neurodevelopment disorder (ARND). Over and above the cardinal features of FAS, many other minor anomalies that affect children with FASD in one country also affect children in the other. However, the pattern of effects is influenced not only by the level of prenatal alcohol exposure (PAE) but moderated in severity by distal maternal risk factors such as social and cultural environments and common racial and ethnic phenotypic characteristics. The data underscore the importance of assessing growth and dysmorphology in assigning all diagnoses in the FASD continuum, including ARND. Assessment of growth and dysmorphology in children with an FASD and comparison to typical development in the same population play an essential role in understanding and diagnosing the continuum of FASD.Key wordsGrowthDysmorphologyPhysical traitsSouth AfricaUnited StatesPopulation differences