Educating healthcare teams

Preventing prenatal alcohol exposure

Improving outcomes for individuals with FASD

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About Fetal Alcohol Spectrum Disorders

The SAFEST Choice Learning Collaborative was created in order to address and prevent Prenatal alcohol exposure (PAE) and Fetal Alcohol Spectrum Disorders (FASD). PAE is notably the most common preventable cause of intellectual and developmental disabilities in the US1. Alcohol is a teratogen and exposure to alcohol in utero can result in a range of developmental and physical challenges across a spectrum of disorders (Fetal Alcohol Spectrum Disorders-FASD).

FASD is an umbrella term and the impact of PAE exists across a spectrum of Fetal Alcohol Spectrum Disorders (FASD). These include Fetal Alcohol Syndrome (FAS) and partial FAS (pFAS), Alcohol-Related Birth Defects (ARBD), Alcohol-Related Neurodevelopmental Disorder (ARND), and Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE)2. Each varies in characteristics and occurrence. FASDs impact as much as 5% of school aged children3. Diagnosis criteria vary for each of the FASD4.

Alcohol at any stage in a pregnancy can have negative impacts as alcohol readily crosses the placenta5. Therefore, this is a considerable issue as alcohol use among pregnant people occurs commonly. One challenge in gaining precise data and information is shame and stigma surrounding drinking during pregnancy6. As nearly half of pregnancies are unplanned it is important to have a discussion about alcohol use before pregnancy4.

Therefore SAFEST Choice aims to reduce the incidence of prenatal alcohol exposure (PAE) and improve outcomes in children with a suspected or diagnosed fetal alcohol spectrum disorder (FASD). Pregnant patients will benefit from the screening and counseling on alcohol use. For pediatric patients, early identification can change the trajectory of their lives. These children are already in your practices.

Alcohol use and pregnancy: 13.5% report alcohol use in previous 30 days; 5.2% report binge drinking in previous 30 days; 2 percentage point increase in both categories as compared with the 2015-2017 period

In the CDC's most recent MMWR for pregnant adults there was a 2 percentage point increase in both reported alcohol use and binge drinking.

Sources

  1. Popova S, Dozet D, Burd L. Fetal alcohol spectrum disorder: can we change the future? Alcohol Clin Exp Res. 2020;44(4):815-819. https://doi.org/10.1111/acer.14317
  2. Centers for Disease Control and Prevention. Basics about FASDs. https://www.cdc.gov/ncbddd/fasd/facts.html. Accessed May 10, 2018.
  3. Popova S, Dozet D, Burd L. Fetal alcohol spectrum disorder: can we change the future? Alcohol Clin Exp Res. 2020;44(4):815-819. https://doi.org/10.1111/acer.14317
  4. Proof Alliance. Diagnostic Terms: Fetal Alcohol Spectrum Disorders (FASD). https://www.proofalliance.org/resource/diagnostic-terms-fetal-alcohol-spectrum-disorders-fasd. 2021.
  5. Center for Disease Control and Prevention. Alcohol Use in Pregnancy. https://www.cdc.gov/ncbddd/fasd/alcoholuse.html. Accessed May 10, 2018.
  6. Tan C, Denny C, Cheal N, Sniezek J, Kanny D. Alcohol Use and Binge Drinking Among Women of Childbearing Age — United States, 2011-2013. Morb Mortal Wkly Rep. 2015;64(37):1042-1046. https://www.jstor.org/stable/24856791
  7. Finer LB, Zolna MR. Declines in unintended pregnancy in the United States, 2008-2011. N Engl J Med. 2016;374(9):843-52. https://www.nejm.org/doi/full/10.1056/nejmsa1506575