July 2025
Australian prevalence data on fetal alcohol spectrum disorder
By Melanie Hinze
New research estimates the prevalence of fetal alcohol spectrum disorder (FASD) in the general Australian population to be 3.64%, comparable with rates in other high-income countries such as the USA and Canada.
Writing in Drug and Alcohol Review, the study authors said this was the first estimate of FASD in the general Australian population using national level modelling. ‘[FASD] is a lifelong condition caused by prenatal alcohol exposure (PAE) … characterised by central nervous system injury and severe neurodevelopmental impairment, with or without birth defects and associated with numerous comorbidities and substantial economic costs,’ they wrote.
The study used an Australian meta-analysis of 78 studies, reporting 16 large general population-based birth cohorts between 1975 and 2018, along with a previously published equation for the risk of FASD to estimate the FASD prevalence in Australia.
The authors said it was likely that certain vulnerable populations had significantly higher FASD prevalence; however, this estimate provided a baseline for the general population to inform service development and strategies for the prevention of FASD and to guide future research.
‘It highlights the need for an increase in accessible, public, multidisciplinary diagnostic and support services, including early intervention, to improve health and wellbeing for individuals living with FASD and their families,’ the authors wrote.
Study coauthor, Professor Elizabeth Elliott, Distinguished Professor at The University of Sydney, and at The Children’s Hospital at Westmead, Sydney, told Medicine Today that GPs had a crucial role in the prevention and identification of FASD, noting FASD was not a rare disease in Australia, with at least one in two pregnancies being alcohol-exposed.
She recommended that GPs ask all pregnant women about their alcohol use and advise them to abstain, in line with NHMRC recommendations, noting that women who were alcohol dependent would require specialist care to do so safely. She also urged GPs to think about FASD as a potential diagnosis and ask about and carefully document prenatal alcohol exposure in any child with developmental delay, microcephaly, birth defects or facial dysmorphology.
‘Children at risk should be referred to a paediatrician and neurodevelopmental assessment commenced,’ she said. ‘This is important because early diagnosis and appropriate early treatment will improve long-term health and other outcomes.’
Australian Guidelines for the Assessment and Diagnosis of Fetal Alcohol Spectrum Disorder, available at https://child-health-research.centre.uq.edu.au/files/11771/Main-guidelines_full-version.pdf, were recently released to provide support for practitioners in undertaking assessment and diagnosis of FASD across the lifespan.