July 31, 2013
 
Two recently published studies report prevalence data about fetal alcohol spectrum disorders (FASD) in South Africa and find that negative consequences of prenatal exposure to alcohol may be lessened if a child is provided with adequate nutrition and appropriate cognitive and behavioral stimulation in his or her first seven years of life.
 
Dr. Philip MayPhilip A. May, PhD, faculty member at the University of North Carolina’s Nutrition Research Institute (NRI) and research professor of nutrition at UNC’s Gillings School of Global Public Health, is lead author of both papers.
 
At the NRI, May is conducting a comprehensive study of South African mothers and their children who are affected by FASD. The work is funded through a $5.3 million grant from the National Institutes of Health’s National Institute on Alcohol Abuse and Alcoholism.
 
The study “Approaching the Prevalence of the Full Spectrum of Fetal Alcohol Spectrum Disorders in a South African Population-Based Study” appeared in the May issue of Alcoholism: Clinical and Experimental Research
 
“This is the first population-based study of the prevalence of FASD to diagnose a significant number of alcohol-related disabilities which are at the mild end of the continuum,” May said, of the study.
 
Employing newly refined diagnostic criteria, the researchers were able to better indicate the scope of the problem.
 
May and colleagues examined a cohort of South African children in first grade and found that diagnoses within the FASD spectrum continue to be among the highest reported in the world – between 13.6 percent and 20.9 percent of South African children born.
 
Diagnoses for Fetal Alcohol Syndrome (FAS), Partial Fetal Alcohol Syndrome (PFAS), Alcohol-Related Neurodevelopmental Disorders (ARND) and Alcohol-Related Birth Defects (ARBD) are included in the FASD continuum.
 
“There is evidence of advances in diagnosis of the milder effects of alcohol exposure in the prenatal period,” May said. “The rate of FASD is greater than we ever thought in human populations.”
 
In “Maternal Factors Predicting Cognitive and Behavioral Characteristics of Children with Fetal Alcohol Spectrum Disorders,” which appeared in the Journal of Developmental and Behavioral Pediatrics in June, May and colleagues found evidence that good health and nutrition of the pregnant mother  provides her child with an advantage for cognitive and behavioral development by age seven.
 
“In the first seven years of life,” May said, “environmental advantages of cognitive and behavioral stimulation and adequate nutrition can, in many cases, serve to minimize any negative consequences of prenatal alcohol exposure on the children’s social, behavioral and intellectual functioning.”
 
The NIAAA grant is funding a study for children as young as 12 months to improve their development with nutritional supplements and a regimen of cognitive and behavioral interventions.
 
“There is hope that a good postnatal environment in the early years of life can mitigate some, if not most, of the damage that occurs from alcohol exposure in the prenatal period,” May said.
 
Children with FASD exhibit symptoms that include poor coordination, speech and language delays, poor memory and hyperactivity.
 
“Improved understandings about the specific characteristics and patterns of FASD in these South African populations have broad implications for public health in most every human population,” May said.
 
Co-authors of the Alcoholism: Clinical and Experimental Research article are Jason Blankenship, J. Phillip Gossage, Wendy O. Kalberg and David Buckley, of the University of New Mexico’s Center on Alcoholism, Substance Abuse and Addictions; Anna-Susan Marais, Ronel Barnard, Marlene De Vries, Charles Parry and Soraya Seedat, of Stellenbosch University’s Department of Psychiatry (Tygerberg, South Africa); Luther K. Robinson, in dysmorphology and clinical genetics at the State University of New York at Buffalo; Colleen M. Adnams, of the University of Cape Town (South Africa) Department of Psychiatry; Melanie Manning, Stanford University’s Department of Pediatrics; Kenneth L. Jones, of The University of California-San Diego’s Division of Dysmorphology/Teratology; and H. Eugene Hoyme, of The University of South Dakota’s Sanford School of Medicine. May also is affiliated with the Center on Alcoholism, Substance Abuse and Addictions at The University of New Mexico-Albuquerque.
 
Co-authors of the Journal of Developmental and Behavioral Pediatrics article are Gossage, Kalberg, Marais, Robinson, Manning, Blankenship, Buckley, Hoyme, Adnams and Barbara Tabachnick, of California State University at Northridge’s Department of Psychology.


 
Gillings School of Global Public Health contact: David Pesci, director of communications, (919) 962-2600 or dpesci@unc.edu.
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