Fetal Alcohol Spectrum Disorder Prevalence Studies in School Settings: A Global Systematic Review of Methods, Measures, Strengths and Limitations

IF 2.9 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review Pub Date : 2026-09-10 DOI:10.1111/dar.70233

Robyn McCarthy, Joshua Pink, Leana Olivier, David Gilbert, Raja Mukherjee, Penny A. Cook

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引用次数: 0

Abstract

Issues

Fetal alcohol spectrum disorder (FASD) is a prevalent yet widely underdiagnosed neurodevelopmental condition resulting from prenatal alcohol exposure (PAE). FASD has profound lifelong implications for affected individuals, their caregivers and society. Active case ascertainment is the gold standard for estimating FASD prevalence, but methodological variability limits comparability across studies. This review aims to systematically evaluate the methodologies and reporting practices of school-based FASD prevalence studies, with the goal of identifying best practices and informing standardised approaches to enhance the validity, reproducibility and policy relevance of future research.

Approach

A systematic review was conducted to examine the methods, measures, strengths and limitations of school-based FASD prevalence studies. Five databases were searched using key terms associated with FASD prevalence in school settings. Identified studies were screened and data were extracted and analysed.

Key Findings

The 29 included studies revealed variability in case definitions, diagnostic frameworks, tools and measures. Most studies employed active case ascertainment designs. Non-participation rates and details on community engagement or co-creation activities were often underreported. PAE assessment predominantly relied on maternal self-report.

Implications

Despite a shared goal of identifying FASD, methodological variability across studies may limit the comparability of outcomes. A lack of robust prevalence data impedes adequate funding for prevention, diagnosis and support services.

Conclusion

Establishing a universally accepted case definition and diagnostic guidelines for FASD is essential. Reporting of community engagement and involvement of individuals with lived experience should become standard practice and the development of objective measures for PAE identification is increasingly necessary.

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胎儿酒精谱系障碍在学校环境中的患病率研究：方法、措施、优势和局限性的全球系统综述。

胎儿酒精谱系障碍（FASD）是由产前酒精暴露（PAE）引起的一种普遍但广泛未被诊断的神经发育疾病。FASD对受影响的个人、他们的照顾者和社会具有深远的终身影响。主动病例确定是估计FASD患病率的金标准，但方法的可变性限制了研究之间的可比性。本综述旨在系统地评估以学校为基础的FASD患病率研究的方法和报告实践，目的是确定最佳实践并为标准化方法提供信息，以提高未来研究的有效性、可重复性和政策相关性。方法：系统回顾了以学校为基础的FASD患病率研究的方法、措施、优势和局限性。使用与学校环境中FASD患病率相关的关键术语搜索了五个数据库。筛选确定的研究，提取数据并进行分析。主要发现：纳入的29项研究揭示了病例定义、诊断框架、工具和措施的差异。大多数研究采用主动病例确定设计。不参与率和社区参与或共同创造活动的细节往往被低估。PAE评估主要依赖于产妇自我报告。结论：尽管确定FASD是一个共同的目标，但研究方法的可变性可能会限制结果的可比性。缺乏可靠的流行数据阻碍了为预防、诊断和支助服务提供充足资金。结论：建立一个普遍接受的FASD病例定义和诊断指南是必要的。报告社区参与情况和有实际经验的个人参与情况应成为标准做法，并且越来越有必要制定确定PAE的客观措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Drug and alcohol review SUBSTANCE ABUSE-

CiteScore

4.80

自引率

10.50%

发文量

151

期刊介绍： Drug and Alcohol Review is an international meeting ground for the views, expertise and experience of all those involved in studying alcohol, tobacco and drug problems. Contributors to the Journal examine and report on alcohol and drug use from a wide range of clinical, biomedical, epidemiological, psychological and sociological perspectives. Drug and Alcohol Review particularly encourages the submission of papers which have a harm reduction perspective. However, all philosophies will find a place in the Journal: the principal criterion for publication of papers is their quality.