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Fetal alcohol syndrome: a prospective national surveillance study
  1. E J Elliott1,
  2. J Payne2,
  3. A Morris1,
  4. E Haan3,
  5. C Bower2
  1. 1
    Discipline of Paediatrics and Child Health, University of Sydney, The Children’s Hospital at Westmead and The Australian Paediatric Surveillance Unit, Westmead, NSW, Australia
  2. 2
    Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Subiaco, WA, Australia
  3. 3
    Women’s and Children’s Hospital, Adelaide, SA, Australia
  1. Professor Elizabeth Elliott, University of Sydney Discipline of Paediatrics and Child Health, c/o The Children’s Hospital at Westmead, Locked Bag 4001, Westmead 2145, NSW, Australia; elizabe2{at}


Objective: To describe the epidemiology of cases of fetal alcohol syndrome (FAS) seen by Australian paediatricians.

Methods: Active, national case-finding using the Australian Paediatric Surveillance Unit (APSU). Monthly reporting of incident cases aged <15 years by paediatricians between January 2001 and December 2004.

Results: Over 1150 paediatricians submitted reports each month to the APSU. Of 169 reported cases, 92 fulfilled the study criteria for FAS. There was a significant increase in the number of children reported each year from 2001 to 2004. Of 92 children, 53.3% were male, 35.7% were preterm (<37 weeks’ gestation) and 64.6% were of low birth weight (<2.5 kg). Most (94.4%) had high risk exposure to alcohol in utero and 78.3% were exposed to one or more additional drugs. The median age at diagnosis was 3.3 years (range: newborn to 11.9 years): 6.5% were diagnosed at birth and 63% by 5 years of age. Of the 92 cases, 56% had growth deficiency, 53.2% had microcephaly, 85.9% had evidence of central nervous system dysfunction, 24% had additional birth defects, 5.4% had sensorineural deafness and 4.3% had visual impairment. Of children with FAS, 65% were Indigenous, 51% had a sibling with FAS, and only 40.2% lived with a biological parent.

Conclusion: Our data are the only prospective national data available on FAS throughout the world. These findings highlight the severity, complexity and impact of FAS, the need for effective strategies for prevention, and the necessity for education to facilitate earlier diagnosis, referral and reporting of cases.

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  • Funding: This study was funded the Health Promotion Foundation of Western Australia (Healthway Project Grant 10563) and the National Health and Medical Research Council (NH&MRC) Program Grants 003209 and 353514, and NH&MRC Fellowships (CB: 172303 and 353625 and EE: 457084). The APSU is a Unit of the Division of Paediatrics and Child Health, Royal Australasian College of Physicians and is funded by the Department of Health and Ageing, Faculty of Medicine at the University of Sydney, and an NHMRC Enabling Grant (402784).

  • Competing interests: Supporting sources had no role in the study design, data collection, analysis and interpretation or writing of the article. The supporting sources did not control or influence the decision to submit the final manuscript for publication.

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