Monitoring Fetal Alcohol Spectrum Disorder during the neonatal period in France

• Published in: European journal of public health Vol. 29; no. Supplement_4
• Main Authors: Laporal, S, Demiguel, V, Cogordan, C, Barry, Y, Guseva-Canu, I, Goulet, V, Germanaud, D, Regnault, N
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01-11-2019; Oxford Publishing Limited (England)
• Subjects: Alcohol use; Births; Diagnosis; Disorders; Fetal alcohol syndrome; Frequency stability; Health care industry; National health insurance; Neonates; Newborn babies; Pregnancy; Prenatal experience; Public health; Reunion; Subgroups; Teratogenicity; France
• ISSN: 1101-1262; 1464-360X
• DOI: 10.1093/eurpub/ckz185.439

Abstract
Background
Alcohol is a known teratogenic and foetotoxic agent. At birth, only the complete foetal alcohol syndrome (FAS) and at most a suspicion for some incomplete syndromic forms can be diagnosed. Yet, other Consequences of prenatal Alcohol Exposure (CAE) can also be observed and recorded in the neonatal period. Our goal was to describe the frequency of diagnosis codes for FAS and CAE at the national and regional level.
Methods
Between 2006 and 2013, we identified the ICM-10 codes Q860 (FAS) and P043 (CAE) in the hospital records for stays occurring in the 28 first days of life in the French national health insurance database (SNDS). Our “potential Foetal Alcohol Spectrum Disorders group” (pFASD), included the FAS and CAE subgroups. The pFASD prevalence was estimated per 1000 live births at the national and regional levels overall and then comparing: 2006-2009 and 2010-2013.
Results
From 2006 to 2013, 3207 neonates were diagnosed with pFASD during the neonatal period, i.e. 0.48 cases per 1,000 live births, including 0.07‰ of FAS. Between 2006-2009 and 2010-2013, pFASD remained stable (p = 0.6). At the regional level, the proportion of pFASD was the most frequent in one of the overseas territories (La Reunion Island, 1.22‰ births) and in the north-eastern part of mainland France (0.90 ‰ births to 1.02 ‰).
Conclusions
This study is the first to produce a national estimate of the frequency of neonatal diagnosis of FAS. It shows a stability of the frequency of pFASD cases recorded over the 2006-2013 period which is certainly underestimated but gives a first minimal estimate of the burden of alcohol use during pregnancy in France.
Key messages
Alcohol use during pregnancy remains a public health issue in France.
Estimating the prevalence of FAS is of undeniable priority given the public health implications of these disorders that hinder the development of children exposed, and their avoidable nature.