# Actions to prevent and identify fetal alcohol spectrum disorders to be implemented in general practice: a consensus

## TL;DR

This paper outlines 11 consensus-based actions for general practitioners to prevent and identify fetal alcohol spectrum disorders, with four key actions for immediate implementation.

## Contribution

The paper provides a consensus-driven framework for FASD prevention and identification in general practice, including actionable recommendations.

## Key findings

- 11 consensus actions were identified for FASD prevention and identification.
- Four actions are highlighted for rapid implementation, including pre-conceptional consultations and information distribution.
- Short training supports for general practitioners are recommended to improve FASD outcomes.

## Abstract

Fetal alcohol exposure is the most common preventable cause of non-genetic intellectual disability. Fetal Alcohol Syndrome (FAS) is characterized by intellectual disability and distinctive facial features and affects 0.1% of live births, representing approximately 800 cases per year in France. Fetal Alcohol Spectrum Disorder (FASD) are 10 times more common than FAS, with an estimated 8,000 cases per year, and are associated with behavioral and social maladjustment in both children and adults, as well as various malformations. General practitioners play a key role in preventing and identifying FASD through their involvement in pregnancy and child monitoring.

Qualitative study using the Delphi method. Items were developed from the literature and semi-structured interviews with field professionals and health institutions. A panel of multi-professional experts, mostly general practitioners, was recruited.

24 initial actions were submitted to the experts. At the end of the first round, six actions reached a consensus and six were reformulated for the second round. At the end of the second round, three actions reached a consensus, for a total of 11 consensus actions. Four of these actions seem particularly relevant for rapid implementation, namely systematic proposal of pre-conceptional consultations for women planning pregnancy, systematic identification of environmental factors during child monitoring, systematic distribution of information on fetal alcohol exposure during pre-conception or early pregnancy, and the publication of a leaflet for general practitioners on the identification of children with FAS or FASD and the contact details of relevant associations.

Prevention and identification of FASD can be improved through short and general training supports for general practitioners. Early screening of FASD is crucial for children, and should be maintained throughout their monitoring. This study could be used for communication and dissemination of information based on the consensus obtained.