Pratique clinique Clinical Pratice F etal alcohol spectrum disorder (FASD) is the most common preventable cause of mental dis- ability in the western world with an estimated inci- dence in North America of 9.1 per 1000 live births. 1,2 Fetal alcohol spectrum disorder refers to a group of conditions that can include abnormalities in facial features, growth deficiency, and central nervous system dysfunction in children whose mothers consumed alcohol during pregnancy. Children with all these characteristics are described as having fetal alcohol syndrome. In Canada, estimated life- time costs for one person with FASD for additional education, disability payments, and health care are $844 066. 3 Studies of alcohol-consumption trends in pregnant women and women of childbearing age and a recent Canadian survey of the attitudes and approaches of health care providers to FASD high- light opportunities for prevention. 4-7 Prevention through preconception counseling Women can negatively affect the development of their fetuses before they even realize they are preg- nant by consuming alcohol after conception. hus, women of childbearing age should be made aware of the risks of alcohol consumption during pregnancy Suzanne C. Tough, PHD Margaret Clarke, MD Sterling Clarren, MD Preventing fetal alcohol spectrum disorders Preconception counseling and diagnosis help ABSTRACT QUESTION By the time women find out they are pregnant and see a family physician, they might have already consumed alcohol during the pregnancy and affected the development of their fetuses. How can family physicians better prevent exposure to alcohol during pregnancy? ANSWER Women of childbearing age should be counseled about the risks associated with alcohol consumption during pregnancy before they become pregnant. Diagnosing children who have fetal alcohol spectrum disorders can help identify birth mothers who are at risk of other alcohol-exposed pregnancies and who need support to change their behaviour. RÉSUMÉ QUESTION Avant que les femmes apprennent qu’elles sont enceintes et qu’elles voient leur médecin de famille, elles peuvent avoir déjà consommé de l’alcool durant leur grossesse et affecté le développement de leur fœtus. Comment les médecins de famille peuvent-ils mieux prévenir l’exposition à l’alcool durant la grossesse? RÉPONSE Les femmes en âge de procréer devraient recevoir des conseils sur les risques associés à la consommation d’alcool durant la grossesse avant qu’elles deviennent enceintes. Le diagnostic d’enfants souffrant de troubles reliés à l’alcoolisme fœtal peut aider à identifier les mères naturelles qui sont à risque de vivre d’autres grossesses où le fœtus sera exposé à l’alcool et qui ont besoin de soutien pour modifier leur comportement. Motherisk Update FOR PRESCRIBING INFORMATION SEE PAGE 1285 ➛ VOL 5: SEPTEMBER • SEPTEMBRE 2005 d Canadian Family Physician • Le Médecin de famille canadien 1199