Media release

From: The University of Sydney

One child in every Australian classroom affected by fetal alcohol spectrum disorder, study finds

A new study led by the University of Sydney has found that up to one in 28 Australians – or roughly one child per classroom – may be living with fetal alcohol spectrum disorder (FASD), a potentially preventable condition caused by prenatal alcohol exposure.

Published in the Drug and Alcohol Review, it is the first Australian study to estimate FASD prevalence in the general population, using national-level modelling. Researchers combined data on alcohol use during pregnancy in Australia with the known risk of FASD to estimate a national prevalence rate of 3.64 percent, or nearly 4 per hundred.  The result was drawn from a meta-analysis of 78 studies spanning from 1975 to 2018.

FASD is the most common preventable cause of acquired brain injury, neurodevelopmental disability and birth defects in Australia. It carries lifelong impacts – including problems with learning, language, development and behaviour – and there are high rates of comorbidities such as attention deficit hyperactivity disorder (ADHD) and autism.

“Alcohol readily crosses the placenta and damage to the developing brain and organs can occur in the earliest stages of pregnancy, before many women even realise they are pregnant,” said senior author Professor Elizabeth Elliott, who has published numerous landmark studies on FASD while at the Sydney Medical School.

“Our advice is clear: in pregnancy, every moment matters and the best way to prevent FASD is to stop drinking the moment you start trying to conceive. This is not always easy and women who are alcohol dependent or have difficulty stopping drinking should seek medical advice.

“Many pregnancies resulting in a baby born with FASD are unplanned, so if you drink alcohol and are sexually active, we recommend that you use contraception.”

The report highlights the urgent need for increased awareness of the harms of prenatal alcohol exposure. Early diagnosis and early intervention are critical to improve life outcomes, particularly in vulnerable populations such as youth in detention, children in foster care, and some remote Indigenous communities, where prevalence rates of FASD are significantly higher.

The researchers also warned against outdated information and myths surrounding prenatal alcohol exposure, including the belief that early pregnancy is a “safe” window for alcohol consumption. The risk of harm to the unborn child depends on many factors including maternal age, genetics and body composition as well as the amount, timing and frequency of prenatal alcohol exposure. Hence, the clear recommendations set by the National Health and Medical Research Council are that women who are pregnant or planning a pregnancy should abstain from alcohol.

Sophie Harrington, the CEO for the National Organisation for Fetal Alcohol Spectrum Disorders (NOFASD) Australia and a biological mother of a teenager with FASD, said: “As the national voice for parents, caregivers and individuals with FASD, NOFASD have advocated the need for a national prevalence study for many years.

“This data is invaluable in raising awareness of FASD, its impacts on individuals and their families and the need for increased understanding and supports. It will further inform public health messaging and prevention strategies to raise awareness about the risks of alcohol consumption during pregnancy—information I wish had been available to me in the very early weeks before my pregnancy was confirmed."

Jessica Birch, an advocate and young adult living with FASD, said: “This paper shows that FASD is much more common that we previously thought in Australia. Health professionals must be aware of this condition because a diagnosis of FASD is the key that unlocks understanding, the gateway to support, and the first step toward healing and hope. That recognition can be transformative -- for individuals living with FASD and the families who stand by them.”

Key facts about FASD:

• FASD is a permanent, disabling, preventable condition caused by injury to the brain and other organs following prenatal alcohol exposure.
• It is associated with significant costs to healthcare, education, disability, justice, housing, and welfare systems.
• It impacts not only individuals and families, but entire communities.
• Australia’s National FASD Strategy (2018-28) identifies the critical need for data on prevalence to shape services and policy.

“Our finding is a wake-up call,” said Professor Elliott. “We need action across multiple sectors – health, education, justice – to ensure we prevent future cases and support people living with FASD.”

Alcohol’s other impacts on pregnancy and developing babies

Although the study did not examine other effects of alcohol during the early stages of pregnancy, previous research has found that alcohol exposure can lead to epigenetic changes in a developing fetus by switching on genes that may contribute to adverse health outcomes later in life.

Alcohol may result in adverse pregnancy outcomes, for example a US metanalysis of data of over 230,000 pregnant women found those exposed to alcohol during pregnancy had a greater risk of miscarriage compared to those who abstained.

In memory of Dr Tracey Tsang: a champion for children and FASD research

The study was led by Dr Tracey Tsang, a senior research fellow who dedicated her career to advancing research, advocacy, and care for children with FASD. Dr Tsang passed away shortly before the study’s publication, but leaves a lasting legacy in the field of paediatric health.

“On behalf of our research team, we honour Dr Tsang’s memory and dedication by striving to advance the understanding and prevention of FASD. We hope this paper serves as a lasting legacy of her tireless work and inspires continued action to support affected individuals, families, and communities,” said Professor Elliott.

Research

Tsang, T., Rosenblatt, D., Parta, I., Elliott, E., Estimating the Prevalence of Fetal Alcohol Spectrum Disorder in Australia (Drug and Alcohol Review, 2025)

Declaration:
Tracey W. Tsang was supported by the Australian Government Department of Health Fetal Alcohol Spectrum Disorder Australian Registry Grant. Elizabeth J. Elliott was supported by the National Health and Medical Research Council of Australia Investigator Grant, Leadership 3. The APSU was funded by the Australian Department of Health, Communicable Disease Epidemiology Surveillance Section.

NOFASD are the peak body supporting people and families living with FASD across Australia, and provide a free and confidential helpline 7 days a week 1800 860 613.