Elliott Elizabeth J
Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, NSW, Australia; The Sydney Children's Hospitals Network, NSW, Australia; National Health and Medical Research Council, Canberra, ACT, Australia; Australian Paediatric Surveillance Unit, Sydney, NSW, Australia
Public Health Res Pract. 2015 Mar 30;25(2):e2521516. doi: 10.17061/phrp2521516.
Fetal alcohol spectrum disorders (FASD) are increasingly recognised throughout Australia as important, but preventable, disorders that result in lifelong problems with health and learning, mental health, behaviour and substance misuse. The role of this article is to highlight current efforts, which are in their infancy, to recognise and prevent FASD in Australia. A federal parliamentary inquiry into FASD (2011), development of an Australian Government 'action plan' to prevent FASD (2013) and the announcement in June 2014 of government funding to progress the plan and appoint a National FASD Technical Network have focused attention on the need for FASD prevention in Australia. Other welcome developments include the formation of Parliamentarians for the Prevention of FASD (2011), revision of guidelines regarding alcohol use in pregnancy by the National Health and Medical Research Council (NHMRC; 2009) and provision of targeted funding for FASD research by the NHMRC (2013). Initiatives by Indigenous communities to restrict access to alcohol and diagnose and prevent FASD have had a significant impact in high-risk communities. The National Organisation for FASD has an important ongoing advocacy and educational remit. Nongovernment organisations such as the Foundation for Alcohol Research and Education have contributed to prevention by developing resources to assist health professionals to advise women about the harms of alcohol use in pregnancy; encouraging men to abstain from alcohol during the pregnancy; drafting a national plan; and advocating for pregnancy warning labels on alcohol. Internationally, in 2014, a charter on prevention of FASD was published in The Lancet Global Health, and the World Health Organization released guidelines for identification and management of substance use in pregnancy. Early recognition and support for individuals with FASD is crucial to prevent adverse secondary outcomes; however, primary prevention of alcohol use in pregnancy, and hence FASD, should be our future goal. The causal pathway to drinking in pregnancy is complex and requires a broad social ecological approach. Prevention will take time, must involve all government sectors and should incorporate primary, secondary and tertiary strategies to target both the broader community and populations at high risk of alcohol use during pregnancy.
胎儿酒精谱系障碍（FASD）在澳大利亚越来越被视为重要但可预防的疾病，这些疾病会导致终身的健康、学习、心理健康、行为及药物滥用问题。本文的作用是强调澳大利亚目前在识别和预防FASD方面所做的尚处于起步阶段的努力。联邦议会对FASD的调查（2011年）、澳大利亚政府制定预防FASD的“行动计划”（2013年）以及2014年6月宣布政府为推进该计划提供资金并任命一个全国FASD技术网络，都使人们将注意力集中在澳大利亚预防FASD的必要性上。其他值得欢迎的进展包括预防FASD议员组织的成立（2011年）、国家卫生与医学研究理事会（NHMRC；2009年）对孕期饮酒指南的修订以及NHMRC为FASD研究提供定向资金（2013年）。原住民社区限制酒精获取以及诊断和预防FASD的举措在高危社区产生了重大影响。全国FASD组织有着持续的重要宣传和教育职责。诸如酒精研究与教育基金会等非政府组织通过开发资源来协助卫生专业人员向女性宣传孕期饮酒的危害、鼓励男性在妻子孕期戒酒、起草国家计划以及倡导在酒精产品上标注孕期警示标签等方式为预防工作做出了贡献。在国际上，2014年，《柳叶刀全球健康》发表了一份预防FASD的宪章，世界卫生组织发布了孕期物质使用识别与管理指南。对FASD患者的早期识别和支持对于预防不良继发后果至关重要；然而，孕期饮酒从而预防FASD的一级预防才应是我们未来的目标。孕期饮酒的因果路径复杂，需要广泛的社会生态方法。预防工作需要时间，必须涉及所有政府部门，并且应纳入一级、二级和三级预防策略，以针对更广泛的社区以及孕期酒精使用高危人群。
