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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 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


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Causes of Mental Retardationin the U.S.

  • Prenatal Alcohol Syndrome

  • Downs Syndrome

  • Fragile X Syndrome


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FASD in the United States

  • Born each year

    FAS 8,280

    ARND 33,123

    Total 41,403


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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


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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




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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.


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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



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FASD – Familial and Generational

X

X

SIDS

FAS - Red

PFAS - Yellow

ARND - Green




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Four State Consortium Prenatal Alcohol Exposure

Minnesota

Montana

North Dakota

South Dakota

11,000 women 28%


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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


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Prenatal Exposure ofAdverse Outcomes

High

Exposure

Low

Fetal Stillbirth Infant FASD-ARND

Death Mortality



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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


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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


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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


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FASD Data

  • PowerPoint: FASD in US


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State Specific Data

  • All found at www.online-clinic.com

    • Cost and Prevalence Calculator (also on CD)

    • Exposure Model (also on CD)

    • PowerPoint


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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


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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


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Screening for FAS

  • Poitra B. et al. (2003). Neurotoxicology and Teratology