Prevalence and characteristics of fetal alcohol syndrome and partial fetal alcohol syndrome in a Rocky Mountain Region City

Drug Alcohol Depend. 2015 Oct 1:155:118-27. doi: 10.1016/j.drugalcdep.2015.08.006. Epub 2015 Aug 14.

Abstract

Background: The prevalence and characteristics of fetal alcohol syndrome (FAS) and partial FAS (PFAS) in the United States (US) are not well known.

Methods: This active case ascertainment study in a Rocky Mountain Region City assessed the prevalence and traits of children with FAS and PFAS and linked them to maternal risk factors. Diagnoses made by expert clinical dysmorphologists in multidisciplinary case conferences utilized all components of the study: dysmorphology and physical growth, neurobehavior, and maternal risk interviews.

Results: Direct parental (active) consent was obtained for 1278 children. Averages for key physical diagnostic traits and several other minor anomalies were significantly different among FAS, PFAS, and randomly-selected, normal controls. Cognitive tests and behavioral checklists discriminated the diagnostic groups from controls on 12 of 14 instruments. Mothers of children with FAS and PFAS were significantly lower in educational attainment, shorter, later in pregnancy recognition, and suffered more depression, and used marijuana and methamphetamine during their pregnancy. Most pre-pregnancy and pregnancy drinking measures were worse for mothers of FAS and PFAS. Excluding a significant difference in simply admitting drinking during the index pregnancy (FAS and PFAS=75% vs. 39.4% for controls), most quantitative intergroup differences merely approached significance. This community's prevalence of FAS is 2.9-7.5 per 1000, PFAS is 7.9-17.7 per 1000, and combined prevalence is 10.9-25.2 per 1000 or 1.1-2.5%.

Conclusions: Comprehensive, active case ascertainment methods produced rates of FAS and PFAS higher than predicted by long-standing, popular estimates.

Keywords: Alcohol use and abuse; Children with FAS and PFAS; Fetal alcohol spectrum disorders; Maternal risk factors; Prenatal alcohol use; Prevalence; United States.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Alcohol Drinking / epidemiology
  • Case-Control Studies
  • Child
  • Child Development / drug effects*
  • Female
  • Fetal Alcohol Spectrum Disorders / diagnosis*
  • Fetal Alcohol Spectrum Disorders / epidemiology*
  • Humans
  • Male
  • Mothers / statistics & numerical data
  • Pregnancy
  • Prevalence
  • Risk Factors
  • United States / epidemiology