9741234, auteur/autrice sur A.FASD

Actual and predicted prevalence of alcohol consumption during pregnancy in the WHO African Region

Objective: To estimate the prevalence of alcohol consumption and binge drinking during pregnancy among the general population in the World Health Organization (WHO) African Region, by country.

Methods: First, a comprehensive systematic literature search was performed to identify all published and unpublished studies. Then, several meta-analyses, assuming a random-effects model, were conducted to estimate the prevalence of alcohol consumption and binge drinking during pregnancy among the general population for countries in the WHO African Region with two or more studies available. Lastly, for countries with less than two studies or no known data predictions were obtained using regression modelling.

Results: The estimated prevalence of alcohol consumption during pregnancy among the general population ranged from 2.2% (95% confidence interval [CI]: 1.6-2.8%; Equatorial Guinea) to 12.6% (95% CI: 9.9-15.4%; Cameroon) in Central Africa, 3.4% (95% CI: 2.6-4.3%; Seychelles) to 20.5% (95% CI: 16.4-24.7%; Uganda) in Eastern Africa, 5.7% (95% CI: 4.4-7.1%; Botswana) to 14.2% (95% CI: 11.1-17.3%; Namibia) in Southern Africa, 6.6% (95% CI: 5.0-8.3%; Mauritania) to 14.8% (95% CI: 11.6-17.9%; Sierra Leone) in Western Africa, and 4.3% (95% CI: 3.2-5.3%; Algeria) in Northern Africa.

Conclusions: The high prevalence of alcohol consumption and binge drinking during pregnancy in some African countries calls for educational campaigns, screening and targeted interventions for women of childbearing age.

Le syndrome d’alcoolisation fœtale à Antananarivo: incidence et profil

Introduction : Le syndrome d’alcoolisation fœtale (SAF) est la forme la plus complète et la plus sévère de l’Ensemble des
Troubles Causés par l’Alcoolisation Fœtale (ETCAF). Les objectifs de cette étude étaient de calculer l’incidence du SAF au Centre Hospitalier Universitaire de Gynécologie Obstétrique de Befelatanana (CHUGOB) et de décrire les profils sociodémographique et clinique de ce syndrome.
Méthodes : L’étude était descriptive et transversale sur 6 mois. Les cas étaient inclus de façon exhaustive s’ils présentaient
un retard de croissance (poids inférieur au 10ème percentile selon la courbe de N. Mamelle) et des éléments dysmorphiques
caractéristiques du SAF. La consommation d’alcool était recherchée au moyen d’un questionnaire alimentaire.
Résultats : Au total, 23 cas ont été inclus. Huit ont été classés SAF confirmés, 7 SAF suspects et 8 SAF douteux.
L’incidence du SAF confirmé était de 5,3 pour 1000 naissances vivantes. Toutes les mères qui ont déclaré avoir pris de
l’alcool sont de bas niveau de scolarisation et travaillaient dans les secteurs secondaires ou tertiaires. La majorité des mères
avait moins de 25 ans (75%). Dans la sous-population de SAF confirmé, l’hypotrophie était harmonieuse dans 37,5% des
cas, les signes de dysmorphie craniofaciale étaient présents chez 54,5% et les signes neurologiques chez 9,3%.
Conclusion : Une information du grand public sur le méfait de l’alcool pour le fœtus, une formation spécialisée des
personnels soignants et une prise de conscience des autorités compétentes sont nécessaires.
Mots-clés : Alcool, grossesse, syndrome d’alcoolisation fœtale

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Fetal alcohol spectrum disorders

Fetal Alcohol Spectrum Disorders

Abstract

Alcohol readily crosses the placenta and may disrupt fetal development. Harm from prenatal alcohol exposure (PAE) is determined by the dose, pattern, timing and duration of exposure, fetal and maternal genetics, maternal nutrition, concurrent substance use, and epigenetic responses. A safe dose of alcohol use during pregnancy has not been established. PAE can cause fetal alcohol spectrum disorders (FASD), which are characterized by neurodevelopmental impairment with or without facial dysmorphology, congenital anomalies and poor growth. FASD are a leading preventable cause of birth defects and developmental disability. The prevalence of FASD in 76 countries is >1% and is high in individuals living in out-of-home care or engaged in justice and mental health systems. The social and economic efects of FASD are profound, but the diagnosis is often missed or delayed and receives little public recognition. Future research should be informed by people living with FASD and be guided by cultural context, seek consensus on diagnostic criteria and evidence-based treatments, and describe the pathophysiology and lifelong efects of FASD. Imperatives include reducing stigma, equitable access to services, improved quality of life for people with FASD and FASD prevention in future generations.

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Author : Svetlana Popova, Michael E. Charness, Larry Burd, Andi Crawford, H. Eugene Hoyme, Raja A. S. Mukherjee, Edward P. Riley & Elizabeth J. Elliott