Statewide surveillance of Fetal Alcohol Syndrome using retrospective chart abstractions

Background: Fetal Alcohol Syndrome (FAS) is the most damaging outcome of alcohol consumption during pregnancy. Ascertaining rates of FAS have involved several techniques, including retrospective record reviews, clinic-based studies, and active case ascertainments. Using these methods, rates of FAS vary in the United States, with many surveillance studies focusing primarily on specific populations. The purpose of this study was to conduct a statewide surveillance of FAS in North Dakota (ND) and South Dakota (SD). Methods: Chart abstractions from specialty diagnostic clinics and hospitals located across both states incorporated data with an International Classification of Diseases, version 9, (ICD-9) code of 760.71 from the birth years of 1995-2006. Results: Based on nearly 1,000 medical chart abstractions, the FAS prevalence rate (per 1,000 live births) were higher in both states (ND=0.8/1,000; SD=0.9/1,000) when compared to multi-state averages (0.67/1,000) using a comparable methodology. The average age of the biological mother was 26.1 and the average gestational age of the child was 36.9. Nearly 43% of children diagnosed were American Indian, a large proportion when considering that 6-9% of the states' populations are American Indian. Discussion: This adds to previous literature on FAS by determining statewide FAS rates rather than focusing on a particular racial group. Of interest is the higher prevalence of FAS in ND and SD and that a large proportion of children diagnosed were American Indian. Based on these results, more direct and community-based prevention efforts in these two states are necessary.