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Fetal alcohol spectrum disorders from childhood to adulthood: A Swedish population-based naturalistic cohort study of adoptees from Eastern Europe

Journal article
Authors Valdemar Landgren
L. Svensson
Emelie Gyllencreutz
Eva Aring
Marita Andersson Grönlund
Magnus Landgren
Published in BMJ Open
Volume 9
Issue 10
ISSN 2044-6055
Publication year 2019
Published at Institute of Neuroscience and Physiology
Gillberg Neuropsychiatry Centre
Language en
Keywords adoption, attention deficit disorder with hyperactivity, fetal alcohol syndrome, mental retardation, motor skills disorders
Subject categories Psychiatry, Neurosciences


Background Fetal alcohol spectrum disorders (FASD) are a global health concern. To further understand FASD in adulthood is a major public health interest. Objective To describe the clinical characteristics of young adults with FASD adopted from orphanages to a socially more favourable and stable rearing environment as children. Design Prospective observational cohort study Setting Western Sweden Participants A population-based cohort of 37 adoptees diagnosed with FASD in childhood. Outcome measures Assessment consisted of clinical evaluations of social, medical, psychiatric, neuropsychological, adaptive and ophthalmological status by a physician, ophthalmologist, orthoptist and psychologist. Results Out of 37 adoptees with FASD, 36 (15 females) were evaluated at a median age of 22 years (range 18-28) and a mean follow-up time of 15.5 years (range 13-17). Twenty (56%) were dependent on social support. Sexual victimisation was reported by nine (26%). In 21 individuals with fetal alcohol syndrome, growth restriction in height and head circumference of approximately -1.8 SD persisted into adulthood. Of 32 examined, 22 (69%) had gross motor coordination abnormalities. High blood pressure was measured in nine (28%). Ophthalmological abnormalities were found in 29 of 30 (97%). A median IQ of 86 in childhood had declined significantly to 71 by adulthood (mean difference: 15.5; 95% CI 9.5-21.4). Psychiatric disorders were diagnosed in 88%, most commonly attention deficit hyperactivity disorder (70%). Three or more disorders were diagnosed in 48%, and 21% had attempted suicide. The median Clinical Global Impression-Severity score was 6 = severely ill'. Conclusion Major cognitive impairments, psychiatric morbidity, facial dysmorphology, growth restriction and ophthalmological abnormalities accompanies FASD in adulthood. Recognition of FASD in childhood warrants habilitation across the lifespan. © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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