Childhood behavioral and developmental disorders : association with maternal alcohol consumption and use of health services in Cape Town, South Africa

[Background] Prenatal alcohol exposure can result in a range of permanent birth defects known as Fetal Alcohol Spectrum Disorders (FASD). Fetal Alcohol Syndrome (FAS), which detrimentally affects the neurodevelopmental, physical, and social capabilities of children, is the most severe diagnosis on this scale of disorders. Research suggests that FASD rates exceed FAS in various populations. South Africa’s Western Cape region has one of the highest rates of FAS in the world. [Hypothesis] In populations where the prevalence of full-blown FAS is already known to be high, such as the Western Cape, other, less severe childhood developmental and behavioural disorders may be due to prenatal alcohol exposure. Objectives The aim of this research was to determine the odds of maternal alcohol use in children with behavioural and/or developmental disorders (BDD) in comparison to children free from behavioural disorders. This project also examined the average utilisation of health services by children with BDD as an arm of a larger study on the economic burden of FAS in South Africa. [Methods] Opportunistic sampling was employed to select parents or caretakers of 110 children aged 4 to 12 for interviews at a tertiary children’s public hospital in Cape Town. Health service utilization and maternal alcohol consumption habits were compared between 55 cases, children with BDD and 55 controls, children free from such disorders. Univariate analyses and logistic regression methods were used to determine these associations. [Ethics] The University of Cape Town Research Ethics Committee approved this study. Dr. T. Blake, Senior Medical Superintendent of Red Cross War Memorial Children’s Hospital granted access to Red Cross Hospital. Before each study interview was conducted, informed consent, which emphasized confidentiality of responses and the right to refuse to answer a question or withdraw from the interview, was taken from the adult respondent. We also explained to participants that they would remain anonymous and that their answers would not affect their child’s treatment in the clinics. [Results] BDD were significantly associated with current maternal alcohol consumption, maternal binge drinking in the last six months, and maternal alcohol use six months before pregnancy, but not significantly with reported maternal gestational drinking. The median number of visits to a clinic in the last six months was significantly higher for cases than for controls. [Conclusions] Childhood BDD among our study participants were not attributed to prenatal alcohol exposure. Current maternal alcohol consumption has a significant impact on BDD in children, possibly serving as a proxy for unstable home environments. The competing environmental factors that influence childhood BDD warrants further research.

Grantor dc:publisher.institution

Department of Public Health and Family Medicine

Year dc:date.issued

2010

Author dc:creator

• Katwan, Elizabeth

Advisor dc:contributor.advisor

• London, Leslie

Language dc:language.iso

eng

Handle dc:identifier.uri

http://hdl.handle.net/11427/9038

OAI identifier oai:identifier

oai:open.uct.ac.za:11427/9038