PloS one
Estimated incidence and number of new cases with prenatal alcohol exposure and fetal alcohol spectrum disorders in Finland 1990-2025
By Jolma M, Koivu-Jolma M, Gissler M and 2 others.
Abstract
Background
Fetal alcohol spectrum disorders (FASD) arising from prenatal alcohol exposure (PAE) are the leading preventable cause of neurobehavioral disorders. Early pregnancy is particularly vulnerable to ethanol toxicity, yet alcohol use often continues until pregnancy recognition. In Finland, national incidence estimates of PAE and FASD remain limited.
Objective
To estimate the incidence of any PAE and heavy PAE in Finland between 1990 and 2025, and to model the annual number of children with FASD born in Finland.
Methods
We developed a mathematical modelling framework integrating studies on alcohol use during pregnancy in Finland, biomarker-based estimates of heavy PAE, national population statistics, and international active case ascertainment studies on FASD prevalence. Incidence of any PAE was estimated from self-reported alcohol use, including pre-recognition exposure. Heavy PAE was estimated by combining binge-drinking prevalence, delayed pregnancy recognition, biomarker data and anonymous self-reports. FASD incidence was modelled using two approaches: 1) an international multiplier linking FASD prevalence to heavy episodic drinking prevalence among women (Model M), and 2) a conventional epidemiological ratio between any PAE and FASD (Model L).