Estimating the Prevalence of Fetal Alcohol Spectrum Disorder in Australia

Fetal alcohol spectrum disorder (FASD) is caused by prenatal alcohol exposure (PAE) and characterised by severe neurodevelopmental impairment. Australian studies have reported PAE prevalence of between 14% and 78% of births. Estimating national FASD prevalence in the general population using gold-standard active case ascertainment is costly and time-consuming, and alternative approaches are required.

Using a published equation for the risk of FASD following PAE (estimated from an international meta-analysis) and a pooled estimate of PAE prevalence in Australia (from a meta-analysis of 78 studies reporting 16 large general population-based birth cohorts between 1975 and 2018), we estimated the population prevalence of FASD. Monte Carlo simulations were used to determine confidence intervals.

Estimated FASD prevalence in the general population was 3.64% (95% confidence interval 2.91%, 4.41%).

The estimated FASD prevalence in the general population of Australia was comparable to that in other high-income countries (e.g., USA, Canada). Although it is likely that certain vulnerable populations have significantly higher FASD prevalence, this estimate provides a baseline estimate for the general population to inform service development and strategies for prevention of FASD and guide future research.