Fetal alcohol spectrum disorder and health professionals' awareness of the syndrome: A comparison of practitioners' knowledge in two french regions.

Abstract

Background: Fetal alcohol spectrum disorder (FASD) is the leading cause of non-genetic intellectual disabilities. Many healthcare professionals in France have benefited from initial and continuing training programs on this public health theme. The objective of our study is to describe and compare knowledge of FASD among health professionals in two different french regions with a health prevention and information system (Indian Ocean (IO)) or without (Nouvelle-Aquitaine (NA)).

Methods and settings: A free and anonymous electronic survey related to perinatality, childhood and adolescence was sent by email or social networks to various health professionals in the IO and NA regions. Responses were analyzed by comparing the function and affiliation of healthcare professionals to each region.

Results: We obtained 193 replies from the IO and 265 replies from NA. On the one hand, 79 % of healthcare professionals reported receiving training on FASD, and most of them were aware that there is no threshold of maternal alcohol intake without risk to the fetus. It appears that 91 % of them are aware of the cognitive-behavioral disorders associated with the diagnosis of FASD. On the other hand, barely 19 % were aware that maternal age is a risk factor, and only 39 % had knowledge of the three cardinal signs of FAS dysmorphia. Only 30 % described a neurological anomaly related to the diagnosis. Regarding alcohol-related neurodevelopmental disorders, 30 % wrongly believed that growth retardation and facial dysmorphia were necessary for diagnosis. Data analysis reveals more variability in inter-professional knowledge in the region without a platform. While there is no direct significant difference between regions regarding knowledge of the FASD, among the NA respondents, only 32 % reported that paternal alcohol consumption was a risk factor, whereas 51 % of the IO respondents were already aware of it.

Conclusion: This study points out the heterogeneity of healthcare professionals' knowledge of FASD within each region. It highlights the challenge of informing, training and orienting mothers and their children in an appropriate manner. The establishment of diagnostic platforms seems essential to provide early, optimised and adapted care in response to this particular public health problem.