RT Journal Article
SR Electronic
T1 Fetal alcohol spectrum disorders from childhood to adulthood: a Swedish population-based naturalistic cohort study of adoptees from Eastern Europe
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e032407
DO 10.1136/bmjopen-2019-032407
VO 9
IS 10
A1 Landgren, Valdemar
A1 Svensson, Leif
A1 Gyllencreutz, Emelie
A1 Aring, Eva
A1 Grönlund, Marita Andersson
A1 Landgren, Magnus
YR 2019
UL http://bmjopen.bmj.com/content/9/10/e032407.abstract
AB Background Fetal alcohol spectrum disorders (FASD) are a global health concern. To further understand FASD in adulthood is a major public health interest.Objective To describe the clinical characteristics of young adults with FASD adopted from orphanages to a socially more favourable and stable rearing environment as children.Design Prospective observational cohort studySetting Western SwedenParticipants A population-based cohort of 37 adoptees diagnosed with FASD in childhood.Outcome measures Assessment consisted of clinical evaluations of social, medical, psychiatric, neuropsychological, adaptive and ophthalmological status by a physician, ophthalmologist, orthoptist and psychologist.Results Out of 37 adoptees with FASD, 36 (15 females) were evaluated at a median age of 22 years (range 18–28) and a mean follow-up time of 15.5 years (range 13–17). Twenty (56%) were dependent on social support. Sexual victimisation was reported by nine (26%). In 21 individuals with fetal alcohol syndrome, growth restriction in height and head circumference of approximately −1.8 SD persisted into adulthood. Of 32 examined, 22 (69%) had gross motor coordination abnormalities. High blood pressure was measured in nine (28%). Ophthalmological abnormalities were found in 29 of 30 (97%). A median IQ of 86 in childhood had declined significantly to 71 by adulthood (mean difference: 15.5; 95% CI 9.5–21.4). Psychiatric disorders were diagnosed in 88%, most commonly attention deficit hyperactivity disorder (70%). Three or more disorders were diagnosed in 48%, and 21% had attempted suicide. The median Clinical Global Impression-Severity score was 6 = ‘severely ill’.Conclusion Major cognitive impairments, psychiatric morbidity, facial dysmorphology, growth restriction and ophthalmological abnormalities accompanies FASD in adulthood. Recognition of FASD in childhood warrants habilitation across the lifespan.