Duimstra C, Johnson D, Kutsch C, Wang B, Zentner M, Kellerman S, Welty T
Public Health Service's Aberdeen Area Indian Health Service Eidemiology Program, Rapid City, SD 57702-8197.
Public Health Rep. 1993 Mar-Apr;108(2):225-9.
A pilot fetal alcohol syndrome (FAS) surveillance was carried out in four American Indian communities in the Northern Plains by the Aberdeen Area Indian Health Service to determine the incidence of FAS and to evaluate the feasibility of establishing continuing surveillance for FAS. Baseline data on the incidence of FAS would be used by the Indian Health Service to develop and evaluate preventive interventions, including treatment programs for pregnant women who drink alcohol. Four of the 1,022 children included in the project were found to have FAS, a rate of 3.9 per 1,000 live births. The rate is believed to underestimate the true rate of FAS because some low birth weight children were not screened, parents or guardians were reluctant to bring children suspected of FAS for evaluation, clinicians were hesitant to diagnose possible alcohol-damaged children for fear of labeling the child, and some children with FAS died before the diagnosis of FAS could be confirmed. If the rate of FAS is similar for the 39 percent of the infants not screened and for the 25 percent of suspected infants who were not evaluated, a rate of 8.5 cases of FAS per 1,000 live births may be postulated. The authors recommend routine screening of prenatal patients for substance abuse and establishing a tracking system for low birth weight infants suspected to have FAS or other alcohol-related developmental disorders, in an effort to establish more accurate FAS rates. Such a surveillance system would identify women at risk of having alcohol-affected infants so that appropriate treatment and counseling could be provided, possibly reducing the severity of adverse effects of alcohol on their fetuses.
美国阿伯丁地区印第安人健康服务机构在大平原北部的四个美国印第安社区开展了一项胎儿酒精综合征（FAS）的试点监测，以确定FAS的发病率，并评估建立FAS持续监测的可行性。印第安人健康服务机构将利用FAS发病率的基线数据来制定和评估预防干预措施，包括为饮酒的孕妇制定治疗方案。该项目纳入的1022名儿童中有4名被发现患有FAS，发病率为每1000例活产中有3.9例。据信该发病率低估了FAS的真实发病率，原因如下：一些低体重儿童未接受筛查；父母或监护人不愿带疑似患有FAS的儿童去评估；临床医生因担心给儿童贴上标签而不愿诊断可能受酒精损害的儿童；一些患有FAS的儿童在FAS诊断得到确认之前就已死亡。如果未接受筛查的39%婴儿以及未接受评估的25%疑似婴儿的FAS发病率与已统计的发病率相似，那么可以推测FAS的发病率为每1000例活产中有8.5例。作者建议对产前患者进行药物滥用的常规筛查，并为疑似患有FAS或其他与酒精相关发育障碍的低体重婴儿建立跟踪系统，以便确定更准确的FAS发病率。这样的监测系统将识别出有生出受酒精影响婴儿风险的女性，从而能够提供适当的治疗和咨询，可能会减轻酒精对其胎儿的不良影响的严重程度。
