Abstract
Background: Most studies of Fetal Alcohol Spectrum Disorder (FASD) have focused on children with the disorder. Much less attention has been given to morbidity and mortality among other family members.
Objective: To determine if a diagnosis of FASD in a child is a risk marker for premature mortality of the mother, we utilized a systematic review of studies documenting deaths of the mothers in order to estimate their mortality proportion. Methods: A search of Pubmed, Google Scholar, Scopus, Cochrane Library, and the reference list of articles published up to July of 2015 was utilized to identify studies reporting on the death of mothers of children with FASD. We included human studies from any country and in any language translated to English. We excluded studies that did not specifically report on FASD diagnosed in the children. The meta-analysis utilized the weighted mortality proportion from each study. Results: The initial search identified 1,897 studies and 26 were eligible for full text review of which 13 met the study inclusion criteria. For the eight studies that did not include controls the mean of the weighted mortality proportions was 17.04% (95% CI 11.04 to 23.04). For the five studies with controls the mean mortality proportion was 4.97% (95% CI 2.25 to 7.70). The combined mortality proportion for all 13 studies was 11.25%. A cause of death was reported for 47 (35%) of the women (alcohol related causes 31.9%, cirrhosis of the liver 19.1%, cancer 8.5%, and homicide 8.5%). The mean time from the birth of the child with FASD to death of the mother was 8.17 years with a range from 44 days to 24 years. Conclusions: The odds of premature mortality in mothers of people diagnosed with FASD were increased nearly five fold over the expected rate. Thus, a diagnosis of FASD in a child should be considered an important mortality risk marker for these mothers. The mortality risk associated with a diagnosis of FASD in a child may exceed many of the current risk markers used by health care professionals caring for these women. Increased attention to both prenatal alcohol exposure and a history of FASD in their children may identify women in need of close follow up. We estimate that worldwide, about 37,800 birth mothers of children with FASD die prematurely every year.Keywords: Fetal alcohol spectrum disorder, mortality, mothers, maternal, women, systematic review.
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