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Fetal Alcohol Syndrome Center UND Medical School Room 5506 501 N Columbia Road Stop 9037 Grand Forks, ND 58202-9037 phone: (701) 777-3683 fax: (701) 777-4474 laburd@medicine.nodak.edu. Fetal Alcohol Spectrum Disorders. Dr. Larry Burd. Causes of Mental Retardation in the U.S.
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Fetal Alcohol Syndrome CenterUND Medical School Room 5506501 N Columbia Road Stop 9037Grand Forks, ND 58202-9037 phone: (701) 777-3683fax: (701) 777-4474 laburd@medicine.nodak.edu Fetal Alcohol Spectrum Disorders Dr. Larry Burd
Causes of Mental Retardationin the U.S. • Prenatal Alcohol Syndrome • Downs Syndrome • Fragile X Syndrome
FASD in the United States • Born each year FAS 8,280 ARND 33,123 Total 41,403
Cost of FASD in the United States • Daily cost $17,252,758 • Annual cost $778,661,230 • Special Education and Juvenile Justice $148,935,528 • Five year cost $31.4 billion
FASD RATES IN NORTH DAKOTA Location Population FASD Rates ____________________________________________________________ North Dakota Live Births 1.1% 1980-2003 Site 1 Prenatal care 1/17 = 6% Child tracking 1984-1996 Site 2 Kindergarten students FAS = 1/98 students 1992-2005 FASD = 17.6 – 22 per 1,000 children North Dakota Statewide EPSDT 28/2,809 = 1% One year 2001
The United States had 1,656,166women using alcohol during pregnancy in 2006 • How many are identified? • Heavy uses who drink all 40 weeks of pregnancy = 82,808.
FASD Recurrence in the United States • Annual birth cohort: 4,140,419 • New FASD cases: 41,403 • Recurrent cases: 10,351 • 2,691 will recur in families with multiple affected children. • Start Prevention Here
FASD – Familial and Generational X X SIDS FAS - Red PFAS - Yellow ARND - Green
Four State Consortium Prenatal Alcohol Exposure Minnesota Montana North Dakota South Dakota 11,000 women 28%
Fetal Alcohol Screening Small head circumference Low nasal bridge Epicanthic folds Short palpebral fissures obscure the canthus (the inner corner of the eye) a normal feature in certain species of the Mongolian race Short nose Short midface Indistinct philtrum (an underdeveloped groove in the center of the upper lip between the nose and lip edge) Thin reddish upper lip
Prenatal Exposure ofAdverse Outcomes High Exposure Low Fetal Stillbirth Infant FASD-ARND Death Mortality
FASD Diagnosis Related Risks • Cardiac defects > 30 fold • ADHD > 25 fold • Foster care placement > 50 fold • Substance abuse risk > 20 fold • Mental illness > 15 fold • Corrections placement > 10 fold
FASD: Diagnosis Specific Management Issues • Mortality rate increased 3-7 fold • Substance abuse treatment for mother • Evaluate all siblings • Increased risk of substance abuse • Recurrence rate in younger siblings 75% • Long term planning • Prevention of secondary disabilities
Can your program prevent one case of FASD this year? In the United States on this date next year, there will be 41,403 more people with FASD
FASD Data • PowerPoint: FASD in US
State Specific Data • All found at www.online-clinic.com • Cost and Prevalence Calculator (also on CD) • Exposure Model (also on CD) • PowerPoint
Four State Consortium FASD Data • Issue Brief • Are Multi-State Efforts Effective? • Chart Abstraction of Individuals Evaluated for Fetal Alcohol Syndrome • Screening for Alcohol Use During Pregnancy
Epidemiologic Tools for FASD • Burd L. et al. (2006). The Royal Society for the Promotion of Health • Prenatal Care • Community Based Assessment of Services for Children and Adults With Fetal Alcohol Spectrum Disorders
Screening for FAS • Poitra B. et al. (2003). Neurotoxicology and Teratology