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Fetal Alcohol Spectrum Disorders

Fetal Alcohol Syndrome Center UND Medical School Room 5506 501 N Columbia Road Stop 9037 Grand Forks, ND 58202-9037 phone: (701) 777-3683 fax: (701) 777-4474 laburd@medicine.nodak.edu. Fetal Alcohol Spectrum Disorders. Dr. Larry Burd. Causes of Mental Retardation in the U.S.

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Fetal Alcohol Spectrum Disorders

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  1. Fetal Alcohol Syndrome CenterUND Medical School Room 5506501 N Columbia Road Stop 9037Grand Forks, ND 58202-9037 phone: (701) 777-3683fax: (701) 777-4474 laburd@medicine.nodak.edu Fetal Alcohol Spectrum Disorders Dr. Larry Burd

  2. Causes of Mental Retardationin the U.S. • Prenatal Alcohol Syndrome • Downs Syndrome • Fragile X Syndrome

  3. FASD in the United States • Born each year FAS 8,280 ARND 33,123 Total 41,403

  4. Cost of FASD in the United States • Daily cost $17,252,758 • Annual cost $778,661,230 • Special Education and Juvenile Justice $148,935,528 • Five year cost $31.4 billion

  5. FASD RATES IN NORTH DAKOTA Location Population FASD Rates ____________________________________________________________ North Dakota Live Births 1.1% 1980-2003 Site 1 Prenatal care 1/17 = 6% Child tracking 1984-1996 Site 2 Kindergarten students FAS = 1/98 students 1992-2005 FASD = 17.6 – 22 per 1,000 children North Dakota Statewide EPSDT 28/2,809 = 1% One year 2001

  6. THE MOMS

  7. THE CHILDREN

  8. The United States had 1,656,166women using alcohol during pregnancy in 2006 • How many are identified? • Heavy uses who drink all 40 weeks of pregnancy = 82,808.

  9. FASD Recurrence in the United States • Annual birth cohort: 4,140,419 • New FASD cases: 41,403 • Recurrent cases: 10,351 • 2,691 will recur in families with multiple affected children. • Start Prevention Here

  10. Severity Effect on Subsequent Births

  11. FASD – Familial and Generational X X SIDS FAS - Red PFAS - Yellow ARND - Green

  12. Exposure Assessment

  13. When was your last drink?

  14. Four State Consortium Prenatal Alcohol Exposure Minnesota Montana North Dakota South Dakota 11,000 women 28%

  15. Fetal Alcohol Screening Small head circumference Low nasal bridge Epicanthic folds Short palpebral fissures obscure the canthus (the inner corner of the eye) a normal feature in certain species of the Mongolian race Short nose Short midface Indistinct philtrum (an underdeveloped groove in the center of the upper lip between the nose and lip edge) Thin reddish upper lip

  16. Prenatal Exposure ofAdverse Outcomes High Exposure Low Fetal Stillbirth Infant FASD-ARND Death Mortality

  17. FASD: Does a diagnosis make a difference?

  18. FASD Diagnosis Related Risks • Cardiac defects > 30 fold • ADHD > 25 fold • Foster care placement > 50 fold • Substance abuse risk > 20 fold • Mental illness > 15 fold • Corrections placement > 10 fold

  19. FASD: Diagnosis Specific Management Issues • Mortality rate increased 3-7 fold • Substance abuse treatment for mother • Evaluate all siblings • Increased risk of substance abuse • Recurrence rate in younger siblings 75% • Long term planning • Prevention of secondary disabilities

  20. Can your program prevent one case of FASD this year? In the United States on this date next year, there will be 41,403 more people with FASD

  21. FASD Data • PowerPoint: FASD in US

  22. State Specific Data • All found at www.online-clinic.com • Cost and Prevalence Calculator (also on CD) • Exposure Model (also on CD) • PowerPoint

  23. Four State Consortium FASD Data • Issue Brief • Are Multi-State Efforts Effective? • Chart Abstraction of Individuals Evaluated for Fetal Alcohol Syndrome • Screening for Alcohol Use During Pregnancy

  24. Epidemiologic Tools for FASD • Burd L. et al. (2006). The Royal Society for the Promotion of Health • Prenatal Care • Community Based Assessment of Services for Children and Adults With Fetal Alcohol Spectrum Disorders

  25. Screening for FAS • Poitra B. et al. (2003). Neurotoxicology and Teratology

  26. Tobacco Prevention

  27. Prenatal Screening for FAS

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