Romeo Jose S, Huckle Taisia, Casswell Sally, Connor Jennie, Rehm Jurgen, McGinn Valerie
SHORE & Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand.
Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
Drug Alcohol Rev. 2023 May;42(4):859-867. doi: 10.1111/dar.13619. Epub 2023 Feb 21.
Foetal alcohol spectrum disorder (FASD) is 100% caused by alcohol. The lifelong disability caused by prenatal alcohol exposure cannot be reversed. Lack of reliable national prevalence estimates of FASD is common internationally and true of Aotearoa, New Zealand. This study modelled the national prevalence of FASD and differences by ethnicity.
FASD prevalence was estimated from self-reported data on any alcohol use during pregnancy for 2012/2013 and 2018/2019, combined with risk estimates for FASD from a meta-analysis of case-ascertainment or clinic-based studies in seven other countries. A sensitivity analysis using four more recent active case ascertainment studies was performed to account for the possibility of underestimation.
We estimated FASD prevalence in the general population to be 1.7% (95% confidence interval [CI] 1.0%; 2.7%) in the 2012/2013 year. For Māori, the prevalence was significantly higher than for Pasifika and Asian populations. In the 2018/2019 year, FASD prevalence was 1.3% (95% CI 0.9%; 1.9%). For Māori, the prevalence was significantly higher than for Pasifika and Asian populations. The sensitivity analysis estimated the prevalence of FASD in the 2018/2019 year to range between 1.1% and 3.9% and for Māori, from 1.7% to 6.3%.
This study used methodology from comparative risk assessments, using the best available national data. These findings are probably underestimates but indicate a disproportionate experience of FASD by Māori compared with some ethnicities. The findings support the need for policy and prevention initiatives to support alcohol-free pregnancies to reduce lifelong disability caused by prenatal alcohol exposure.
胎儿酒精谱系障碍（FASD）完全由酒精所致。产前酒精暴露导致的终身残疾无法逆转。国际上普遍缺乏关于FASD可靠的全国患病率估计，新西兰也不例外。本研究对FASD的全国患病率及不同种族间的差异进行了建模分析。
FASD患病率是根据2012/2013年和2018/2019年孕期饮酒情况的自我报告数据，结合对其他七个国家基于病例确诊或诊所研究的荟萃分析得出的FASD风险估计值进行估算的。为了应对可能存在的低估情况，还使用了四项最新的主动病例确诊研究进行敏感性分析。
我们估计2012/2013年普通人群中FASD患病率为1.7%（95%置信区间[CI]为1.0%；2.7%）。对于毛利人，患病率显著高于太平洋岛民和亚洲人群。2018/2019年，FASD患病率为1.3%（95%CI为0.9%；1.9%）。对于毛利人，患病率显著高于太平洋岛民和亚洲人群。敏感性分析估计2018/2019年FASD患病率在1.1%至3.9%之间，而毛利人的患病率在1.7%至6.3%之间。
本研究采用了比较风险评估方法，使用了可获取的最佳全国数据。这些结果可能是低估，但表明与某些种族相比，毛利人受FASD影响的情况更为严重。这些发现支持了制定政策和预防措施以促进孕期戒酒，从而减少产前酒精暴露导致的终身残疾的必要性。
