Diagnosis across the fetal alcohol spectrum disorders (FASD) continuum

Fetal Alcohol Spectrum Disorders (FASD) comprise a continuum of neurodevelopmental and physical disabilities resulting from the teratogenic effects of prenatal alcohol exposure. FASD is recognized as the leading cause of preventable developmental disabilities worldwide. Recent U.S. school-based studies estimate its prevalence at 11.3-50.0 per 1000 children (approximately 1-5 %), with rates in certain high-risk populations reaching up to 169 per 1000 (approximately 17 %). Although early diagnosis is associated with improved long-term outcomes, FASD remains frequently underrecognized or misdiagnosed. Multiple factors contribute to this gap, including a shortage of specialized multidisciplinary diagnostic teams and the absence of a universally accepted diagnostic framework. This narrative review examines recent advances in the clinical diagnosis of FASD and highlights areas for future research aimed at improving diagnostic precision. The evidence presented underscores a clear public health message: abstaining from alcohol consumption during pregnancy is the safest and most effective strategy to prevent FASD.