Greetings from Denmark. Janni Niclasen, psychologist PhD Assistant professor Institute of Psychology University of Copenhagen Denmark

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1 Janni Niclasen, psychologist PhD Assistant professor Institute of Psychology University of Copenhagen Denmark

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3 Who drinks and how much: 5.5 million people in Denmark Well-fare state World happiness report Most people drink alcohol on a regular basis 7% of women and 3% of men are abstainers Average yearly intake: 12 litres of pure alcohol (age 16 and over) People with tertiary education drink more than those less educated App births per year Official guidelines: Are you pregnant avoid alcohol. Are you trying to become pregnant avoid alcohol just in case.

4 The Family centre of Denmark: an offer to those abusing alcohol/ drugs

5 FAS in Denmark: In Denmark the problem of FAS is not as big as it is in Canada Danes drink a lot but in the low-moderate range and many children exposed to low level drinking Many children probably born with FASD (no official prevalence rate) App. 75 children born with FAS (a total of births per year)

6 The Family centre of Denmark ( Familieambulatoriet ): The Family Centre was established in 1989 Based on Loretta Finnegan s work from the Thomas Jefferson University Hospital, Philadelphia Focus on obstetric care for vulnerable, pregnant women (dependent on prescribed/ illegal drugs, alcohol) Five centres one in each of the five regions in Denmark

7 The Family centre of Denmark ( Familieambulatoriet ): Target groups: Pregnant women with a high-risk use of alcohol and/ or legal/ illegal drugs Children aged 0-7 years exposed to alcohol and/ or drugs in pregnancy Long-term interventions: from pregnancy until the child starts school The same team follows the mother/ child throughout the intervention: 1 MD, 1 psychologist, 1 midwife and 1 social worker)

8 The Family centre of Denmark ( Familieambulatoriet ): Who can make use of the Family Clinic? Open visitation anyone can show up (early contact important) Most referred on the basis of questionnaire filled in at the midwife centre All pregnant women with present or previous (last two years) use of illegal substances Two or more binge episodes in pregnancy Three or more drinks/ week in pregnancy GP in early pregnancy Psychiatric wards Other centres (social centres, alcohol outpatient clinics etc.)

9 The Family centre of Denmark ( Familieambulatoriet ): A bit of statistics in relation to the work at the Family Centre: Preterm births (from 20% to 7%) Low birth weight (from 31% to 7%) Lack of oxygen during birth (from 20% to 5%) Treatment required withdrawal symptoms (from 85% to 60%) Almost all children born to alcohol/ drug-free homes Some children directly to foster care family from birth 92% of children followed by the Family Centre until school age 89% of the children develop normally remaining 11% mostly born with FAS or FASD and to unstable families Database at the Family Centre

10 Studies looking at prenatal exposure to low doses of alcohol 1. Excellent data in Denmark Several large-scale birth cohorts have been established Personal identification numbers Nationwide demographic and healthcare registries: Psychiatric Central Register (psychiatric diagnoses) Medical Birth Register (Health of newborns, antenatal care and delivery) Civil registration system (CPR numbers, vital status, immigration) National register of patients (Hospital procedures and diagnoses) IDA database (labour market, education, income, and unenployment) Registry of Medicinal Product Statistics (prescribed medication) 2. Low level drinking is what interests most people/ public debate Not OK to suggest that drinking one glass of wine is not OK Those doing the moderate drinking in Denmark are the well-educated

11 Interested in the clinical work at the Family Centre or research with cohort/ registries from Denmark please feel free to contact me: Thank you for your attention!!!! Janni Niclasen, psychologist, PhD Assistant professor Institute of Psychology University of Copenhagen Denmark