Worldwide cost of drinking alcohol during pregnancy could be far higher than expected

About 750 delegates from 27 countries will be in Vancouver to attend a four-day international conference on FASD hosted by the University of British Columbia

By Erin Ellis, Vancouver SunFebruary 27, 2013 3:37 PM

The true number of children exposed to alcohol before birth is so poorly understood that the World Health Organization has launched an international study to count them.

Photograph by: AFP , AFP/Getty Images

The true number of children exposed to alcohol before birth is so poorly understood that the World Health Organization has launched an international study to count them.

An oft-cited statistic that about one in 100 people in Canada have some type of Fetal Alcohol Spectrum Disorder (FASD) — ranging from mild learning disabilities to impulsive behaviour to full-blown Fetal Alcohol Syndrome — may be outdated, says Dr. Svetlana Popova, a senior scientist with the Centre for Addiction and Mental Health in Toronto.

She is in Vancouver until Saturday, along with about 750 delegates from 27 countries, for a four-day international conference on FASD hosted by the University of British Columbia.

“We still don’t know how many people around the world exist with this condition. … We expect that the prevalence in Eastern Europe to be higher than in Canada.”

The first countries to take part in the WHO study will be Canada, Ukraine, Poland, Belarus and Moldova, a former Soviet republic wedged between Romania and Ukraine that has the highest level of per-capita alcohol consumption in the world.

While the work continues in Eastern Europe and Canada, it will expand to Africa, Asia and Latin America.

Researchers will ultimately look at elementary school-aged children in more than 10 countries, first identifying those with learning disabilities, behavioural problems and below-average size who will proceed to the next stage of more detailed diagnostic testing to identify FASD. Mothers will later be asked about nutrition, stress, tobacco and alcohol use. In Canada, about 8,000 children in the Greater Toronto Area will take part in the screening this fall. The Canadian portion of the study is funded by the federal government.

North America has been the centre of research on Fetal Alcohol Syndrome since the condition was first named by doctors at the University of Washington in Seattle in 1973.

That’s despite the well-known high levels of alcohol consumption in other parts of the world.

A study published in 2008 — which said it was the first European study of its kind — found 45 per cent of 353 newborns tested in Barcelona, Spain, showed evidence that their mothers drank more than occasionally.

“It’s very sad that in some countries of Eastern Europe, for example, some doctors are still not aware of the harmful effects of alcohol during pregnancy. ‘Drink one glass of red wine per day and it’s good for your blood,’ they say to pregnant women. That is complete nonsense. It’s a very harmful message,” Popova emphasized in a telephone interview before the conference. “There is no amount of alcohol that has been proven to be safe during pregnancy. There is no safe time to drink during a pregnancy, and there is no safe type of alcohol.”

That message is getting through to most Canadian women who know they are pregnant, according to a wide-ranging questionnaire administered to 60,000 new mothers in Manitoba between 2007 and 2011, said Dr. Ana Hanlon-Dearman, a developmental pediatrician at Children’s Hospital in Winnipeg, who is also in Vancouver to speak at the conference.

Alcohol consumption among pregnant women fell from 16 per cent in 2007 to 14 per cent four years later, she said. While that is still high, 78 per cent of “high-risk” drinkers — those who had more than five drinks in a sitting — stopped drinking during the pregnancy.

“A higher percentage of teen mums stop drinking when they find out they’re pregnant. So they’re a high-risk group because we know they drink the most, but they are also a very responsive group,” Hanlon-Dearman said.

While no one can predict what the level of damage will be, she said, quitting drinking will prevent further harm.

Hanlon-Dearman said women most likely to drink throughout their pregnancy came from a variety of ethnic groups, but had typically not finished high school, had financial problems and were in an abusive relationship.

Speaker Gerald Thomas of the Canadian Centre on Substance Use based in Summerland, examined data from Stats Can to conclude that women between the ages of 25 and 34 had the greatest increase in heavy drinking of any age group, male or female, between 2003 and 2010. And 45 per cent of younger women — 18 to 24 — reported moderate to heavy drinking at least once a month.

While there is no data to show a corresponding increase in FASD in Canada, Thomas says it is clear that women of child-bearing age are consuming more alcohol than ever.

“This is a part of the shift in culture around the emancipation of women. It’s part of a large social movement. And also that the alcohol industry has recognized women as a growing market.”

Previous Canadian research suggests that at least 10 per cent of children in government care have FASD, along with about one-quarter of youths who are held in custody for psychiatric assessments. The estimated cost to Canadian society is hundreds of millions of dollars per year spent on medical care, social services, special education and lost productivity. The cost of imprisonment, which is far more common among people with FASD than the general population, is not included in the estimate.

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