In the Western Cape of South Africa, Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Spectrum Disorders (FASD) continue to be a significant public health problem, with rates of FAS of over 70/1000, the highest reported rates in the world. Unfortunately, the diagnosis of FASD is usually only made once a child has begun school or even later, thus a missing a critical developmental window for intervention. The PASS Research Network is a collaborative project that aims to delineate the roles of prenatal alcohol exposure in SIDS and unexplained stillbirth and has completed a pilot study in Cape Town, South Africa. Consequently, this study has collected a vast amount of information on alcohol exposure and neurobehavioral and physiological data in the prenatal and early infancy periods, and represents one of the few prospective collections of this data. We propose to create an infrastructure that allows us to follow the children enrolled in this pilot study through age 2. This would afford us the opportunity to compare vast amount of information collected and relate this information to neurobehavioral and physiological changes that manifest during the toddler years, helping us to determine early markers for FASD. It would also us to assess feasibility for follow up of the much larger cohort that will be enrolled into the PASS study in Phase II. Accordingly, the additional aims of this study include identifying areas at the Cape Town site that would limit feasibility of follow up studies, developing strategies to rectify these limitations, and building local capacity in neurodevelopmental assessment, research skills and data management. Despite numerous efforts at intervention, use of alcohol in pregnant women the Western Cape remains high. By identifying early markers of FASD, this project aims to contribute to earlier diagnosis and thus intervention during critical developmental phases. ? ? ?
