Fetal Alcohol Spectrum Disorders in a Pacific Southwest City: Maternal and Child Characteristics

• Type of Material: Article
• Authors: Christina D. Chambers, University of California San Diego; Claire Coles, Emory University; Julie Kable, Emory University; Natacha Akshoomoff, University of California San Diego; Ronghui Xu, University of California San Diego; Jennifer A. Zellner, University of California San Diego; Gordon Honerkamp-Smith, University of California San Diego; Melanie A. Manning, Stanford University; Margaret P. Adam, University of Washington; Kenneth Lyons Jones, University of California San Diego
• Language: English
• Date: 2019-12-01
• Publisher: WILEY
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2019 by the Research Society on Alcoholism
• Final Published Version (URL): http://dx.doi.org/10.1111/acer.14213
• Title of Journal or Parent Work: ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH
• Volume: 43
• Issue: 12
• Start Page: 2578
• End Page: 2590
• Grant/Funding Information: This project was funded by the National Institutes of Health, the National Institute on Alcohol Abuse and Alcoholism, Grant UO1AA019879 as part of the Collaboration on Fetal Alcohol Spectrum Disorders Prevalence (CoFASP) consortium.
• Keywords: Substance Abuse; BINGE DRINKING; Life Sciences & Biomedicine; Fetal Alcohol Spectrum Disorders; Pregnant Women; Prenatal Alcohol Use; WOMEN; PREVALENCE; Prevalence; Science & Technology; UNITED-STATES

Abstract

Background: There are limited data on the characteristics of children with fetal alcohol spectrum disorders (FASD) and their mothers from the general population in the United States. Methods: During the 2012 and 2013 academic years, first-grade children in a large urban Pacific Southwest city were invited to participate in a study to estimate the prevalence of FASD. Children who screened positive on weight, height, or head circumference ≤25th centile or on parental report of developmental concerns were selected for evaluation, along with a random sample of those who screened negative. These children were examined for dysmorphology and neurobehavior and their mothers or collateral sources were interviewed. Children were classified as fetal alcohol syndrome (FAS), partial fetal alcohol syndrome (pFAS), alcohol-related neurodevelopmental disorder (ARND), or No FASD. Results: A total of 854 children were evaluated; 5 FAS, 44 pFAS, 44 ARND, and 761 No FASD. Children with FAS or pFAS were more likely to have dysmorphic features, and 32/49 (65.3%) of those met criteria for neurobehavioral impairment on cognitive measures with or without behavioral deficits. In contrast, 28/44 (63.6%) of children with ARND met criteria on behavioral measures alone. Mothers of FASD children were more likely to recognize pregnancy later, be unmarried, and report other substance use or psychiatric disorders, but did not differ on age, socioeconomic status, education, or parity. Mothers of FASD children reported more drinks/drinking day each trimester. The risk of FASD was elevated with increasing number of drinks/drinking day prior to pregnancy recognition, even at the level of 1 drink per day (adjusted odds ratio 3.802, 95% confidence interval 1.634, 8.374). Conclusions: Data from this general population sample in a large urban region in the United States demonstrate the variability of expression of FASD and point to risk and protective factors for mothers in this setting.