AIM: To develop and trial a method for estimating the prevalence of fetal alcohol spectrum disorders (FASD) in Sweden.

METHODS: A school-based study with a full physical examination, including a dysmorphology assessment, neuropsychological testing, behavioural ratings, academic evaluation and maternal nutritional interview conducted as an add-on to the regular health check-up in 4th grade.

RESULTS: Out of 348 eligible children, 223 participated. In the 206 children with a dysmorphological evaluation, 9.2% (n = 19) met criteria for a fetal alcohol spectrum disorder, with alcohol-related neurodevelopmental disorder accounting for 4.9% (n = 10), fetal alcohol syndrome for 2.4% (n = 5) and partial fetal alcohol syndrome for 1.9% (n = 4). According to the conservative method using all eligible children as the denominator, the prevalence of FASD was 5.5% (95% confidence interval [CI] 3.3-8.4) and fetal alcohol syndrome 1.4% (95% CI 0.5-3.3).

CONCLUSION: The lowest prevalence estimate of FASD in Sweden is similar to that found in other European countries, and four orders of magnitude more common than the prevalence of the diagnosis in official hospital records. A screening procedure for large-scale studies may utilise both behavioural and anthropometric measures, including head circumference, depending on the objective.