Associations Found Between Prenatal Alcohol Use and Many Co-Occurring Medical Conditions

Alcohol exposure is known to cause a spectrum of harms to the developing fetus. Researchers conducted a meta-analysis of 127 studies examining the prevalence of co-occurring medical conditions in individuals with fetal alcohol spectrum disorders (FASD). Co-occurring conditions were coded according to the International Classification of Diseases, tenth revision (ICD-10). Pooled prevalence data for each condition was compared with the US population.

• Data abstraction identified 428 conditions—excluding diagnostic criteria for fetal alcohol syndrome (FAS). Eighteen conditions had a pooled prevalence of > 50% in individuals with FASD.
• For many conditions, pooled prevalence in individuals with FAS was substantially higher than the general population. For example, individuals with FAS had a prevalence of visual impairment 31 times higher and blindness 71 times higher than the US population.

Comments:

The current naming convention that uses fetal alcohol spectrum disorders as an umbrella term to include fetal alcohol syndrome, partial fetal alcohol syndrome, and alcohol-related neurodevelopmental disorder underscores the variability of clinical presentation. This review suggests that the impact of alcohol on the fetus may be even greater than generally recognized. The findings are perhaps not surprising; unlike most psychoactive substances, which have their effect through a specific neuronal receptor, alcohol is known to have many sites of action both intra and extra-cellular throughout the body.

Sharon Levy, MD, MPH

Reference:

Popova S, Lange S, Shield K, et al. Comorbidity of fetal alcohol spectrum disorder: a systematic review and meta-analysis. Lancet. 2016;387(10022):978–987.