title: Fetal alcohol spectrum disorders among children in a Brazilian orphanage.
abstract: BACKGROUND
  The objective was to investigate the frequency of fetal alcohol spectrum disorders (FASD) and ophthalmologic anomalies in orphanage children in Brazil.
  
  
  METHODS
  A prospective study was performed on 94 children living in an orphanage in Brazil. The children were examined by a multidisciplinary team consisting of specialists in pediatrics, neurology, psychology, neuropsychiatry, and ophthalmology.
  
  
  RESULTS
  The main reasons for living in the orphanage, in 61% of the children, were negligence, child abuse, and abandonment. Of all the children studied, 50% had mothers with known alcohol abuse and 47% had one or more diagnoses of neurodevelopmental/behavioral and/or cognitive deficits. General developmental delay was found in 18%, intellectual disability in 3%, cognitive impairment in 27%, attention-deficit/hyperactivity disorder in 14%, and autism in 3%. Altogether 17% had FASD, comprising three children with fetal alcohol syndrome (FAS), six with partial FAS, and seven with alcohol-related neurodevelopmental disorder. 16% had ophthalmological findings such as poor vision, strabismus, and dysmorphology of the optic nerves. Twenty-eight children (30%) were adopted from the orphanage; of these, six had FASD (two FAS, three partial FAS, one alcohol-related neurodevelopmental disorder), five had attention-deficit/hyperactivity disorder, and eight had developmental delay.
  
  
  CONCLUSIONS
  Nearly half of the children living in the orphanage had neurodevelopmental disorders and a considerable number showed signs of damage from prenatal alcohol exposure. A broader look at the problem of FASD in Brazil and other South American countries is desirable to document the burden of disease and provide data for targeting prevention efforts.
authors.affiliation: Institute of Neuroscience and Physiology, Department of Ophthalmology, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Strömland
authors.forename: Liana O
authors.initials: LO
authors.lastname: Ventura
authors.forename: Layla
authors.initials: L
authors.lastname: Mirzaei
authors.forename: Keyla
authors.initials: K
authors.lastname: Fontes de Oliveira
authors.forename: José
authors.initials: J
authors.lastname: Marcelino Bandim
authors.forename: Adriana
authors.initials: A
authors.lastname: Parente Ivo
authors.forename: Carlos
authors.initials: C
authors.lastname: Brandt
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology*; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D005124:Eye Abnormalities / Q000453:epidemiology*; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D008297:Male; D065886:Neurodevelopmental Disorders / Q000453:epidemiology*; D009901:Optic Nerve Diseases / Q000453:epidemiology*; D019372:Orphanages
keywords: adopted children; developmental delay; fetal alcohol spectrum disorders; fetal alcohol syndrome; ophthalmology; orphanage