Guidelines and strategies for screening fetal alcohol spectrum disorder in Canada

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Jeremy N Matlow


Fetal Alcohol Spectrum Disorder, Screening, Guidelines, Strategies


Fetal alcohol spectrum disorder (FASD) is a multi-factorial complication that encompasses malformations, mental retardation, and neurobehavioural anomalies. Early diagnosis and treatment of FASD is necessary for prevention of secondary characteristics later in life, such as mental health problems, inappropriate sexual behaviour, and trouble with the law. Since a FASD diagnosis involves a collaborative effort of several professionals, which can be time-intensive and costly, early screening of high risk women and of potentially affected children can lead to more efficient utilization of diagnostic clinics. Many healthcare professionals are aware that FASD is a severe condition and therefore ask their female patients about alcohol consumption, however there is still a general lack of knowledge on how to gauge alcohol dependence in women of childbearing age and how to screen children born to these women. The purpose of this review is therefore to summarize guidelines and strategies available to Canadian healthcare professionals on screening for potential FASD throughout pregnancy, infancy, and childhood. Proper questioning during a consultation or administering an alcohol questionnaire can help screen for problematic alcohol patterns in women of childbearing age. Additionally, in utero alcohol exposure can be assessed via screening for physiological malformations at birth, quantifying alcohol metabolites in meconium, and administering behavioural tests to young children. By understanding the resources available to Canadian healthcare professionals, prevention or screening of FASD can lead to proper referrals, early diagnosis, and reduced socioeconomic burden.