title: Fetal alcohol spectrum disorder in Israel: increased prevalence in an at-risk population.
abstract: BACKGROUND
  Maternal exposure to alcohol during pregnancy can lead to a wide range of clinical manifestations in their offspring, termed fetal alcohol spectrum disorder (FASD). In Israel, relatively few cases of FASD have been diagnosed and the prevalence has not been systematically evaluated.
  
  
  OBJECTIVE
  To determine the number of children with FASD or at risk for FASD in a select population of high risk patients seen at a clinic evaluating foster and adopted children.
  
  
  METHODS
  Israeli children under 2 years old who were candidates for domestic adoption or in foster care were prospectively evaluated for clinical manifestations of FASD and information was obtained regarding parental use of alcohol or other illicit drugs.
  
  
  RESULTS
  Of the 100 patients prospectively evaluated, 8 had mothers with a known history of alcohol consumption during pregnancy. Two of the children had fetal alcohol syndrome (FAS) without known maternal exposure to alcohol and two had partial FAS. Eleven other children were at risk for development of one of the diagnostic categories of FASD.
  
  
  CONCLUSIONS
  In a population of pre-adoption and foster children, 15% either had manifestations of FASD or were at risk for developing FASD. Although this is a select high risk population, the data from this study strongly suggest a greater prevalence of FASD than previously assumed. Under-diagnosis of FASD is detrimental to affected children who could benefit from interventions designed to meet the needs of FASD victims.
authors.affiliation: Medical Unit for Adoption and Foster Care, Department of Pediatrics, Hadassah University Medical Center, Mount Scopus Campus, Jerusalem, Israel. tene@hadassah.org.il
authors.forename: Ariel
authors.initials: A
authors.lastname: Tenenbaum
authors.forename: Pnina
authors.initials: P
authors.lastname: Hertz
authors.forename: Talia
authors.initials: T
authors.lastname: Dor
authors.forename: Yael
authors.initials: Y
authors.lastname: Castiel
authors.forename: Alon
authors.initials: A
authors.lastname: Sapir
authors.forename: Isaiah D
authors.initials: ID
authors.lastname: Wexler
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D002657:Child Development / Q000187:drug effects; D002675:Child, Preschool; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D047109:Fetal Development / Q000187:drug effects; D005581:Foster Home Care; D006801:Humans; D007223:Infant; D007557:Israel / Q000453:epidemiology; D008297:Male; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000523:psychology; D037841:Pregnant People / Q000523:psychology; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D015995:Prevalence; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology