Fetal Alcohol Spectrum Disorders

Alcohol contributes substantially to the global burden of disease. Alcohol consumption is not only associated with an individual’s health in general, but also with all types of injuries. More than half of all homicides and traffic-related deaths in South Africa are associated with alcohol. This Chapter elaborates on one of the hidden effects of alcohol, i.e. the adverse effects (harm/injury) of maternal drinking on the unborn child that may result in a spectrum of disorders referred to as Fetal Alcohol Spectrum Disorders (FASD). FASD is claimed to be the most frequent cause of preventable mental handicap in the world and is devastating in its lifelong effects on the affected person. South Africa, with the highest measured FASD prevalence rate in the world in some high risk communities, has no integrated national strategy or policy to deal with the phenomenon at present, and no ongoing surveillance is taking place in the country. Important achievements in the field of identifying, assessing prevalence and prevention of FASD have been reached through the work and involvement of the Foundation for Alcohol Related Research, constituted in 1997 as a non-profit organisation. Since then, important projects by a range of national and international organisations and universities are being conducted to explore strategies to reduce the harmful alcohol use by pregnant women and women in general. keywords: pre-natal alcohol abuse, Fetal Alcohol Syndrome (FAS), FASD, FASD surveillance, FASD prevention INTRODUCTION Alcohol contributes substantially to the global burden of disease (4% of total mortality and 4-5% of disability-adjusted life years), and thus is one of the largest avoidable health risk factors (Rehm, Mathers, Popova, Thavorncharoepsap, Teerawattanano & Patra, 2009). There is a clear association between alcohol consumption and the health of individuals. There is also a clear association between alcohol and all types of injuries (Krug, Dahlberg, Mercy, Zwi & Luzano, 2002; Rehm et al., 2004). In South Africa 58% of homicide deaths and 57% of road traffic crash deaths are associated with alcohol use (Matzopoulos, 2005). Despite the fact that many South Africans do not drink alcohol, alcohol abuse results in a considerable health burden in South Africa (Schneider et al., 2007). Household surveys