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European Child & Adolescent Psychiatry

, Volume 23, Issue 10, pp 877–889 | Cite as

Identifying maternal risk factors associated with Fetal Alcohol Spectrum Disorders: a systematic review

  • Larissa Horta Esper
  • Erikson Felipe Furtado
Review

Abstract

To identify the demographic, psychological, and social maternal risk factors associated with the development of Fetal Alcohol Spectrum Disorders (FASD). A bibliographic search was conducted in PubMed, SciELO, Lilacs, Web of Knowledge, and PsycINFO. The Newcastle–Ottawa Quality Assessment Scale (NOS) was used to evaluate the quality of the studies with case–control design. Articles were selected based on their relevance and presentation of data related to statistical comparisons of at least one or more demographic, psychological, or social maternal risk factors for FASD. 738 references were identified, of which 15 met the criteria to be included in the present review. Mothers of FASD children tend to: be older at the time of birth of the affected child, present lower educational level, have other family relatives with alcohol abuse, have other children with FASD, present a pattern of little prenatal care and a distinguishing pattern of alcohol consumption (alcohol use before and during pregnancy, failure to reduce alcohol use during pregnancy, and frequent episodes of binge drinking). Application of the NOS scale of methodological quality indicated that 8 studies (53 %) met the criterion for selection, 4 (27 %) were suitable for the criterion for comparability and only 4 studies were suitable for the exposition criterion. Mothers of FASD children have a distinctive pattern of drinking and accumulate several social risk factors. Maternal age at birth of the child seems to accentuate the risk. There are, however, few controlled studies that are adequate according to the NOS requirements for methodological quality. Fewer are based on the verification of a theoretical model. Clinicians should be aware of the relevance of preventive assessment of FASD risk mothers.

Keywords

Fetal alcohol spectrum disorders Fetal alcohol syndrome Alcohol drinking Maternal risk factors Systematic review Research quality assessment 

Notes

Acknowledgments

CAPES Foundation (Brazilian Coordination for the Improvement of Higher Education Personnel, Ministry of Education) provided a PhD grant for Larissa Horta Esper. The authors greatly acknowledge Prof. Hendree E. Jones, University of North Carolina at Chapel Hill, for her contribution with many suggestions for the improvement of the manuscript.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

References

  1. 1.
    Memo L, Gnoato E, Caminiti S, Pichini S, Tarani L (2013) Fetal Alcohol Spectrum Disorders and fetal alcohol syndrome: the state of the art and new diagnostic tools. Early Hum Dev. 89(Suppl 1):S40–S43PubMedCrossRefGoogle Scholar
  2. 2.
    Landgraf MN, Nothacker M, Heinen F (2013) Diagnosis of fetal alcohol syndrome (FAS): german guideline version 2013. Eur J Paediatr Neurol. 17(5):437–446PubMedCrossRefGoogle Scholar
  3. 3.
    May PA, Brooke L, Gossage JP, Croxford J, Adnams C, Jones KL et al (2000) Epidemiology of fetal alcohol syndrome in a South African community in the Western Cape Province. Am J Public Health 90(12):1905–1912PubMedCrossRefPubMedCentralGoogle Scholar
  4. 4.
    May PA, Fiorentino D, Phillip Gossage J, Kalberg WO, Eugene Hoyme H, Robinson LK et al (2006) Epidemiology of FASD in a province in Italy: prevalence and characteristics of children in a random sample of schools. Alcohol Clin Exp Res 30:1562–1575 (United States)PubMedCrossRefGoogle Scholar
  5. 5.
    May PA, Gossage JP (2001) Estimating the prevalence of fetal alcohol syndrome. A summary. Alcohol Res Health. 25(3):159–167PubMedGoogle Scholar
  6. 6.
    May PA, May PA, Gossage JP, Kalberg WO, Robinson LK, Buckley D, Manning M, Hoyme HE (2009) The prevalence and epidemiologic characteristics of FASD from various research methods with an emphasis on in-school studies. Dev Disabil Res Rev 15(3):176–192PubMedCrossRefGoogle Scholar
  7. 7.
    May PA, Gossage JP, Marais AS, Hendricks LS, Snell CL, Tabachnick BG et al (2008) Maternal risk factors for fetal alcohol syndrome and partial fetal alcohol syndrome in South Africa: a third study. Alcohol Clin Exp Res 32:738–753 (England)PubMedCrossRefGoogle Scholar
  8. 8.
    Mesquita MDA, Segre CADM (2009) Freqüência dos efeitos do álcool no feto e padrão de consumo de bebidas alcoólicas pelas gestantes de maternidade pública da cidade de são paulo. Revista Brasileira de Crescimento e Desenvolvimento Humano, pp 63–77Google Scholar
  9. 9.
    Lange S, Shield K, Rehm J, Popova S (2013) Prevalence of Fetal Alcohol Spectrum Disorders in child care settings: a meta-analysis. Pediatrics 132(4):980–995CrossRefGoogle Scholar
  10. 10.
    Jones KL, Smith DW, Ulleland CN, Streissguth AP (1973) Pattern of malformation in offspring of chronic alcoholic mothers. Lancet 301:1267–1271CrossRefGoogle Scholar
  11. 11.
    Abel EL, Hannigan JH (1995) Maternal risk factors in fetal alcohol syndrome: provocative and permissive influences. Neurotoxicol Teratol 17:445–462 (United States)PubMedCrossRefGoogle Scholar
  12. 12.
    Wells GA, Shea B, O’Connell D et al (2000) The Newcastle–Ottawa scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. Ottawa Hospital Research Institute. Available at: http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm
  13. 13.
    Lundh A, Gotzsche PC (2008) Recommendations by Cochrane Review Groups for assessment of the risk of bias in studies. BMC Med Res Methodol 8:22 (England)PubMedCrossRefPubMedCentralGoogle Scholar
  14. 14.
    Stratton KR, Howe CJ, Battaglia FC (1996) Fetal alcohol syndrome: diagnosis, epidemiology, prevention, and treatment. National Academy Press, Washington, DCGoogle Scholar
  15. 15.
    Sokol RL, Clarren SK (1989) Guidelines for use of terminology describing the impact of prenatal alcohol on the offspring. Alcoholism 13:597–598PubMedCrossRefGoogle Scholar
  16. 16.
    Astley SJ, Clarren SK (2000) Diagnosing the full spectrum of fetal alcohol-exposed individuals: introducing the 4-digit diagnostic code. Alcohol Alcohol 35(4):400–410PubMedCrossRefGoogle Scholar
  17. 17.
    Pierog S, Chandavasu O, Wexler I (1979) The fetal alcohol syndrome: some maternal characteristics. Int J Gynaecol Obstet 16(5):412–415PubMedGoogle Scholar
  18. 18.
    Astley SJ, Bailey D, Talbot C, Clarren SK (2000) Fetal alcohol syndrome (FAS) primary prevention through fas diagnosis: II. A comprehensive profile of 80 birth mothers of children with FAS. Alcohol Alcohol 35(5):509–519PubMedCrossRefGoogle Scholar
  19. 19.
    Miller LA, Shaikh T, Stanton C, Montgomery A, Rickard R, Keefer S et al (1995) Surveillance for fetal alcohol syndrome in Colorado. Public Health Rep 110(6):690–697PubMedPubMedCentralGoogle Scholar
  20. 20.
    Bagheri MM, Burd L, Martsolf JT, Klug MG (1998) Fetal alcohol syndrome: maternal and neonatal characteristics. J Perinat Med 26(4):263–269PubMedCrossRefGoogle Scholar
  21. 21.
    Kvigne VL, Leonardson GR, Borzelleca J, Brock E, Neff-Smith M, Welty TK (2003) Characteristics of mothers who have children with fetal alcohol syndrome or some characteristics of fetal alcohol syndrome. J Am Board Fam Pract 16:296–303 (United States)PubMedCrossRefGoogle Scholar
  22. 22.
    Coyne KL, de Costa CM, Heazlewood RJ, Newman HC (2008) Pregnancy characteristics of women giving birth to children with fetal alcohol syndrome in Far North Queensland. Aust N Z J Obstet Gynaecol 48:240–247 (Australia)PubMedCrossRefGoogle Scholar
  23. 23.
    Viljoen D, Croxford J, Gossage JP, Kodituwakku PW, May PA (2002) Characteristics of mothers of children with fetal alcohol syndrome in the Western Cape Province of South Africa: a case control study. J Stud Alcohol 63(1):6–17PubMedGoogle Scholar
  24. 24.
    May PA, Gossage JP, White-Country M, Goodhart K, Decoteau S, Trujillo PM et al (2004) Alcohol consumption and other maternal risk factors for fetal alcohol syndrome among three distinct samples of women before, during, and after pregnancy: the risk is relative. Am J Med Genet C Semin Med Genet. 127C(1):10–20PubMedCrossRefGoogle Scholar
  25. 25.
    May PA, Gossage JP, Brooke LE, Snell CL, Marais AS, Hendricks LS et al (2005) Maternal risk factors for fetal alcohol syndrome in the Western cape province of South Africa: a population-based study. Am J Public Health 95:1190–1199 (United States)PubMedCrossRefPubMedCentralGoogle Scholar
  26. 26.
    May PA, Tabachnick BG, Gossage JP, Kalberg WO, Marais AS, Robinson LK et al (2011) Maternal risk factors predicting child physical characteristics and dysmorphology in fetal alcohol syndrome and partial fetal alcohol syndrome. Drug Alcohol Depend 119:18–27PubMedCrossRefPubMedCentralGoogle Scholar
  27. 27.
    Urban M, Chersich MF, Fourie LA, Chetty C, Olivier L, Viljoen D (2008) Fetal alcohol syndrome among grade 1 schoolchildren in Northern Cape Province: prevalence and risk factors. S Afr Med J 98(11):877–882PubMedGoogle Scholar
  28. 28.
    Cannon MJ, Dominique Y, O’Leary LA, Sniezek JE, Floyd RL (2012) Characteristics and behaviors of mothers who have a child with fetal alcohol syndrome. Neurotoxicol Teratol 34:90–95PubMedCrossRefGoogle Scholar
  29. 29.
    London L (2000) Alcohol consumption amongst South African farm workers: a challenge for post-apartheid health sector transformation. Drug Alcohol Depend 59:199–206PubMedCrossRefGoogle Scholar
  30. 30.
    Hoyme HE, May PA, Kalberg WO, Kodituwakku P, Gossage JP, Trujillo PM, Buckley DG, Miller JH, Aragon AS, Khaole N, Viljoen DL, Jones KL, Robinson LK (2005) A practical clinical approach to diagnosis of Fetal Alcohol Spectrum Disorders: clarification of the 1996 institute of medicine criteria. Pediatrics 115:39–47PubMedCrossRefGoogle Scholar
  31. 31.
    British medical association board of science (2007) Fetal Alcohol Spectrum Disorders: a Guide for Healthcare Professionals. British Medical Association, LondonGoogle Scholar
  32. 32.
    Jolly M, Sebire N, Harris J, Robinson S, Regan L (2000) The risks associated with pregnancy in women aged 35 years or older. Hum Reprod 15(11):2433–2437PubMedCrossRefGoogle Scholar
  33. 33.
    Chudley AE, Conry J, Cook JL, Loock C, Rosales T, LeBlanc N et al (2005) Fetal alcohol spectrum disorder: Canadian guidelines for diagnosis. CMAJ 172(5 Suppl):S1–S21PubMedCrossRefPubMedCentralGoogle Scholar
  34. 34.
    Pinheiro SN, Laprega MR, Furtado EF (2005) Psychiatric morbidity and alcohol use by pregnant women in a public obstetric service. Rev Saude Publica 39:593–598 (Brazil)PubMedCrossRefGoogle Scholar
  35. 35.
    Lewis PT, Shipman VC, May PA (2010) socioeconomic status, psychological distress, and other maternal risk factors for FASD among American Indians of the Northern Plains. Am Indian Alsk Nativ Res 17(2):1–21CrossRefGoogle Scholar
  36. 36.
    Simpson TL, Miller WR (2002) Concomitance between childhood sexual and physical abuse and substance use problems. A review. Clin Psychol Rev. 22(1):27–77PubMedCrossRefGoogle Scholar
  37. 37.
    May PA et al (2013) Maternal alcohol consumption producing Fetal Alcohol Spectrum Disorders (FASD): quantity, frequency, and timing of drinking. Drug Alcohol Depend 133(2):502–512PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Larissa Horta Esper
    • 1
  • Erikson Felipe Furtado
    • 1
    • 2
  1. 1.PAI-PAD Program for Assessment, Intervention and Prevention of Alcohol and Drugs in the Community, Faculty of Medicine of Ribeirao PretoUniversity of Sao PauloSao PauloBrazil
  2. 2.Section of Child and Adolescent Psychiatry, Department of Neurosciences and Behavior, Faculty of Medicine of Ribeirao PretoUniversity of Sao PauloSao PauloBrazil

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