Extract from the Cochrane Library page:

Indigenous peoples of Australia, Canada, USA, and New Zealand experience disproportionately high rates of suicide. Prevention strategies look for a holistic view of mental, physical, cultural, and spiritual health and have an early-Fetal alcohol spectrum disorders (FASDs), attributed to brain injury from prenatal alcohol exposure, are characterised by birth defects and developmental and behavioural problems, resulting in lifelong impairment and disability. FASDs occur throughout society, with high prevalence in disadvantaged Indigenous communities with widespread, risky alcohol use, including in Australia, Canada, and New Zealand.[1–4] Importantly, FASDs is preventable, and health professionals have a vital role in supporting women to avoid alcohol when planning pregnancy or when pregnant.

Few Cochrane Reviews are of direct relevance to preventing or managing FASDs, but the following findings can be highlighted:

  • Psychological/educational interventions may encourage abstinence.[5]
  • No randomised controlled trials were available for the reviews that assessed whether psychosocial interventions[6] or pharmacological interventions[7] benefit pregnant women with alcohol dependency.
  • Although home visits (before and after birth) increase service engagement and contraception use, there is no proven benefit for maternal or infant health outcomes.[8]
  • ‘Social support’ for disadvantaged women decreased pregnancy complication and caesarean rates but did not impact birth weight,[9] and attendance at specialised clinics did not reduced prematurity rates.[10]

Although FASDs are prevalent[1] and extremely costly to society[2], there remains a paucity of good-quality primary or secondary research evidence to guide prevention and optimal management.