title: Prevalence of alcohol consumption during pregnancy and Fetal Alcohol Spectrum Disorders among the general and Aboriginal populations in Canada and the United States.
abstract: Prenatal alcohol exposure may cause a number of health complications for the mother and developing fetus, including Fetal Alcohol Spectrum Disorders (FASD). This study aimed to estimate the pooled prevalence of i) alcohol use (any amount) and binge drinking (4 or more standard drinks on a single occasion) during pregnancy, and ii) Fetal Alcohol Syndrome (FAS) and FASD among the general and Aboriginal populations in Canada and the United States, based on the available literature. Comprehensive systematic literature searches and meta-analyses, assuming a random-effects model, were conducted. It was revealed that about 10% and 15% of pregnant women in the general population consume alcohol in Canada and the United States, respectively, and that about 3% of women engage in binge drinking during pregnancy in both countries. However, the prevalence of alcohol use during pregnancy in the Aboriginal populations of the United States and Canada were found to be approximately 3-4 times higher, respectively, compared to the general population. Even more alarmingly, it was estimated that approximately one in five women in the Aboriginal populations in both countries engage in binge drinking during pregnancy. Further, among the general population of Canada, the pooled prevalence was estimated to be about 1 per 1000 for FAS and 5 per 1000 for FASD. However, compared to the general population, the prevalence of FAS and FASD among the Aboriginal population in Canada was estimated to be 38 times and 16 times higher, respectively. With respect to the United States, the pooled prevalence of FAS and FASD was estimated to be about 2 per 1000 and 15 per 1,000, respectively, among the general population, and 4 per 1000 and 10 per 1,000, respectively, among the Aboriginal population. The FAS and FASD pooled prevalence estimates presented here should be used with caution due to the limited number of existing studies and their methodological limitations. Based on the results of the current study, it is evident that there is an urgent need for implementing more effective national prevention and surveillance strategies to monitor and lower the prevalence of alcohol consumption during pregnancy and FASD.
authors.affiliation: Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON, Canada, M5S 2S1; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, Canada, M5T 3M7; Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W., Toronto, ON, Canada, M5S 1V4; Institute of Medical Science, University of Toronto, Faculty of Medicine, Medical Sciences Building, 1 King's College Circle, Toronto, ON, Canada, M5S 1A8. Electronic address: lana.popova@camh.ca.
authors.forename: Svetlana
authors.initials: S
authors.lastname: Popova
authors.affiliation: Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON, Canada, M5S 2S1; Institute of Medical Science, University of Toronto, Faculty of Medicine, Medical Sciences Building, 1 King's College Circle, Toronto, ON, Canada, M5S 1A8.
authors.forename: Shannon
authors.initials: S
authors.lastname: Lange
authors.affiliation: Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON, Canada, M5S 2S1; Epidemiological Research Unit, Klinische Psychologie and Psychotherapie, Technische Universität Dresden, Chemnitzer Str. 46., 01187, Dresden, Germany.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Probst
authors.affiliation: Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON, Canada, M5S 2S1.
authors.forename: Nino
authors.initials: N
authors.lastname: Parunashvili
authors.affiliation: Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON, Canada, M5S 2S1; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, Canada, M5T 3M7; Institute of Medical Science, University of Toronto, Faculty of Medicine, Medical Sciences Building, 1 King's College Circle, Toronto, ON, Canada, M5S 1A8; Epidemiological Research Unit, Klinische Psychologie and Psychotherapie, Technische Universität Dresden, Chemnitzer Str. 46., 01187, Dresden, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Rehm
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology / Q000473:pathology*; D000438:Alcohols / Q000633:toxicity*; D002170:Canada; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D006801:Humans; D009035:Mothers; D011247:Pregnancy; D015995:Prevalence; D014481:United States
chemical_list: D000438:Alcohols
keywords: Fetal alcohol spectrum disorders; Fetal alcohol syndrome; North America; Prenatal alcohol exposure; Prevalence