Friday, July 24, 2009

Foetal alcohol syndrome - questions

Yesterday a group submitted to the parliamentary health select committee about FASD, foetal alcohol syndrome disorder. The first thing that caught my eye in the report about their submission was their targeting of Glen Innes and East Tamaki for education action. That tells us a lot. They have chosen areas where they know drinking during pregnancy is a problem. Suburbs that feature a high welfare population and high teenage birth rate.

The second thing I noticed was their costing to New Zealand of FASD as "more than $1 billion each year."

By coincidence yesterday I was reading this report;

4.4.1 Fetal Alcohol Syndrome

This study uses recent estimates that 2.0 per 1,000 live births have FAS and that it cost an estimated $1.9 billion in 1992 to treat infants, children, and surviving adults for FAS and its sequelae. Synopsis

FAS is estimated to occur in 2.0 per 1,000 live births in the United States each year (Bloss 1995, personal communication). It is estimated that during 1992, the cost of treating FAS-affected infants, children, and adults was $1,944 million. Most of the cost associated with FAS treatment is incurred while developmentally disabled persons are either institutionalized or receiving intensive home-based services during their adult years. This estimate does not include other effects that result from fetal alcohol exposure that has not been diagnosed as FAS.

So in NZ it is estimated that over 1 percent of babies are born with FAS yet the US estimates the incidence at 2 per 1,000 births or 0.2 percent. These figures are wildly divergent. Which results in correspondingly divergent costings.

Yet I can believe that 1 percent (and much more) of mothers drank considerable amounts of alcohol during pregnancy. The US is probably employing a much higher diagnostic threshold ie they are documenting the most severe cases.

Getting back to where the problem is concentrated as indicated by where the group is focussing their efforts, "teenage girls and their families" in the poorest areas of Auckland. Around 4,500 females were granted a sickness benefit for pregnancy related reasons in 2008. Two thirds transfer to a DPB. 80 percent were aged 18-24 (an unknown number were younger). I wonder how much of their sickness benefit was spent on alcohol?

If society really wants to promote responsible parenting, pre- and post-birth, is putting up cash incentives to anyone with reproductive equipment the best idea we can come up with?


Luke H said...

Hi Lindsay,

According to Stats NZ, in the June 2007 year there were 61,610 live births registered in New Zealand. If there were 640 FAS babies, that's about 1% (not 10% as in your post). Still 5 times more than the US figures.

If our rate was similar to the US stats, there would be 123 babies with FAS born every year. So the children born in one year would cost about $200 million over their lives, not $1 billion.

Also, the cost surely depends on just how disabled the kids are. Most of the kids will be mildly disabled and not cost so much?

These people are campaigning for fund for FAS help, so of course they are going to have a broad definition of FAS which can include as many babies as possible.

Lindsay said...

64,159 births in year to March 2009 so they are definitely working on 1 percent.

Lindsay said...

Can't even get my comments in the right order today. The first should have said, thank you Luke. That was a bad error on my part.

Shane Pleasance said...

Perhaps we could ask the Invercargill Licensing Trust to stump up for treatment payments here in Invercargill? Not entirely tongue in cheek. Maybe sell the wonderful velodrome?

Mark.V. said...

It is assumed that drinking alcohol during pregnancy causes FAS, there is however some debate about this is in fact the case.

Women who drink during pregnancy are likely to drink prior to pregnancy. Given that women have a life time supply of eggs I wonder what effect drinking prior to pregnancy will have on those eggs.

The point being is FAS caused by the fetus short term exposure to alcohol, or by the the long term exposure of the woman's eggs to alcohol?

Comrade MOT said...

It is great of you to bring up this issue. It is a big issue that is widely ignored. As well as having cases where FAS can be clearly diagnosed, due to the children having significant dsorders, the are many cases of alohol use by pregnant mothers, that my not cause a severe diagnosable syndromes but still cause harm to the child (Foetal Alcohol effects). Having any FAS cases is an absolute disgrace and needs to be adressed. Preferably it should be a criminal offence for mothers to cause FAS.