Evidence map›Paper›PMID 27736681›Full record

ArticleDrug and alcohol dependence2016

The continuum of fetal alcohol spectrum disorders in a community in South Africa: Prevalence and characteristics in a fifth sample.

Philip A May, Anna-Susan Marais, Marlene M de Vries, Wendy O Kalberg, David Buckley, Julie M Hasken, Colleen M Adnams, Ronel Barnard, Belinda Joubert, Marise Cloete and 8 more

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In one paragraph

Article in Drug and alcohol dependence, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Philip A MayThe University of North Carolina at Chapel Hill, Nutrition Research Institute, United States; Stellenbosch University, Faculty of Medicine and Health Sciences, South Africa; The University of New Mexico, Center on Alcoholism, Substance Abuse and Addictions, United States. Electronic address: philip_may@unc.edu.
Anna-Susan MaraisStellenbosch University, Faculty of Medicine and Health Sciences, South Africa.
Marlene M de VriesStellenbosch University, Faculty of Medicine and Health Sciences, South Africa.
Wendy O KalbergThe University of New Mexico, Center on Alcoholism, Substance Abuse and Addictions, United States.
David BuckleyThe University of New Mexico, Center on Alcoholism, Substance Abuse and Addictions, United States.
Julie M HaskenThe University of North Carolina at Chapel Hill, Nutrition Research Institute, United States.
Colleen M AdnamsUniversity of Cape Town, Department of Psychiatry and Mental Health, South Africa.
Ronel BarnardStellenbosch University, Faculty of Medicine and Health Sciences, South Africa.
Belinda JoubertStellenbosch University, Faculty of Medicine and Health Sciences, South Africa.
Marise CloeteStellenbosch University, Faculty of Medicine and Health Sciences, South Africa.
Barbara TabachnickCalifornia State University, Northridge, United States.
Luther K RobinsonState University of New York, Buffalo, Department of Pediatrics, United States.
Melanie A ManningStanford University School of Medicine, Departments of Pathology and Pediatrics, United States.
Kenneth Lyons JonesUniversity of California San Diego School of Medicine, Department of Pediatrics, United States.
Heidre BezuidenhoutStellenbosch University, Faculty of Medicine and Health Sciences, South Africa.
Soraya SeedatStellenbosch University, Faculty of Medicine and Health Sciences, South Africa.
Charles D H ParryStellenbosch University, Faculty of Medicine and Health Sciences, South Africa; South African Medical Research Council, South Africa.
H Eugene HoymeSanford Research, University of South Dakota Sanford School of Medicine, Department of Pediatrics, United States; The University of Arizona College of Medicine, Department of Pediatrics and the Center for Applied Genetics and Genomic Medicine, United States.

Funding

UNIV OF NORTH CAROLINA CLINICAL NUTRITION RESEARCH UNITP30DK056350 · NIDDK · UNIV OF NORTH CAROLINA CHAPEL HILL · PI SUSAN M. SMITH · 1999 to 2026
$31.6M
Trajectory of Fetal Alcohol Spectrum Disorders (FASD) Across the Lifespan: Continuing Prevention and Longitudinal EpidemiologyU01AA015134 · NIAAA · UNIV OF NORTH CAROLINA CHAPEL HILL · PI MAY, PHILIP ALAN · 2009 to 2018
$7.8M
Trajectory of Fetal Alcohol Spectrum Disorders (FASD) Across the Lifespan: Continuing Prevention and Longitudinal EpidemiologyR01AA015134 · NIAAA · UNIV OF NORTH CAROLINA CHAPEL HILL · PI MAY, PHILIP ALAN · 2006 to 2022
$4.5M
NIAAA NIH HHS R01 AA015134NIAAA NIH HHS U01 AA015134NIDDK NIH HHS P30 DK056350
6 · The paper itself

Abstract

backgroundThe prevalence and characteristics of the continuum of diagnoses within fetal alcohol spectrum disorders (FASD) were researched in a fifth sample in a South African community.

methodsAn active case ascertainment approach was employed among all first grade learners in this community (n=862). Following individual examination by clinical geneticists/dysmorphologists, cognitive/behavioral testing, and maternal interviews, final diagnoses were made in multidisciplinary case conferences.

resultsPhysical measurements, cardinal facial features of FAS, and total dysmorphology scores clearly differentiated diagnostic categories in a consistent, linear fashion, from severe to mild. Neurodevelopmental delays and behavioral problems were significantly worse for each of the FASD diagnostic categories, although not as consistently linear across diagnostic groups. Alcohol use was documented by direct report from the mother in 71% to 100% of cases in specific diagnostic groups. Significant distal maternal risk factors in this population are: advanced maternal age at pregnancy; low height, weight, and body mass index (BMI); small head circumference; low education; low income; and rural residence. Even when controlling for socioeconomic status, prenatal drinking correlates significantly with total dysmorphology score, head circumference, and five cognitive and behavioral measures. In this community, FAS occurs in 59-79 per 1,000 children, and total FASD in 170-233 per 1,000 children, or 17% to 23%.

conclusionsVery high rates of FASD continue in this community where entrenched practices of regular binge drinking co-exist with challenging conditions for childbearing and child development in a significant portion of the population.

Indexed as

AdolescentAdultAlcohol DrinkingAlcoholismBlack PeopleChild DevelopmentEducational StatusFemaleFetal Alcohol Spectrum DisordersHumansInfant, NewbornLinear ModelsMaleMaternal AgeMothersPregnancyAlcohol abuseBinge drinkingChildren with FASDFetal alcohol spectrum disorders (FASD)Maternal risk for FASDMicrocephalyPrenatal alcohol usePrevalenceSouth Africa

Identifiers

PMID27736681
PMCPMC5086258

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.