Estimating the Prevalence of Fetal Alcohol Spectrum Disorder in Australia

Abstract

Introduction: Fetal alcohol spectrum disorder (FASD) is caused by prenatal alcohol exposure (PAE) and characterised by severe neurodevelopmental impairment. Australian studies have reported PAE prevalence of between 14% and 78% of births. Estimating national FASD prevalence in the general population using gold-standard active case ascertainment is costly and time-consuming, and alternative approaches are required. Methods: Using a published equation for the risk of FASD following PAE (estimated from an international meta-analysis) and a pooled estimate of PAE prevalence in Australia (from a meta-analysis of 78 studies reporting 16 large general population-based birth cohorts between 1975 and 2018), we estimated the population prevalence of FASD. Monte Carlo simulations were used to determine confidence intervals. Results: Estimated FASD prevalence in the general population was 3.64% (95% confidence interval 2.91%, 4.41%). Discussion and Conclusions: The estimated FASD prevalence in the general population of Australia was comparable to that in other high-income countries (e.g., USA, Canada). Although it is likely that certain vulnerable populations have significantly higher FASD prevalence, this estimate provides a baseline estimate for the general population to inform service development and strategies for prevention of FASD and guide future research.