TY - JOUR
T1 - Fetal Alcohol Spectrum Disorders in a Southeastern County of the United States
T2 - Child Characteristics and Maternal Risk Traits
AU - May, Philip A.
AU - Hasken, Julie M.
AU - Stegall, Julie M.
AU - Mastro, Heather A.
AU - Kalberg, Wendy O.
AU - Buckley, David
AU - Brooks, Marita
AU - Hedrick, Dixie M.
AU - Ortega, Marian A.
AU - Elliott, Amy J.
AU - Tabachnick, Barbara G.
AU - Abdul-Rahman, Omar
AU - Adam, Margaret P.
AU - Robinson, Luther K.
AU - Manning, Melanie A.
AU - Jewett, Tamison
AU - Hoyme, H. Eugene
N1 - Funding Information:
This project was funded by the National Institutes of Health (NIH), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), grant UO1 AA019894, as part of the Collaboration on Fetal Alcohol Spectrum Disorders Prevalence (CoFASP) consortium. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Marcia Scott, Ph.D., Kenneth Warren, Ph.D., Faye Calhoun, D.P.A., and the late T-K Li, M.D., of NIAAA provided intellectual guidance, encouragement, and support for prevalence studies of FASD for many years. Our deepest thanks are extended to the superintendent of schools, Boards of Education, administrators, principals, psychologists, and teachers of the school system in the study communities who have hosted and assisted in the research process over the years. Their professional support, guidance, and facilitation have been vital to the success of this study. We are also grateful for the advice and participation in the planning and implementation of the project by the CoFASP Advisory Committee members who were led by Marcia Scott, Ph.D., NIAAA Project Officer: Judith Arroyo, Ph.D., Michael Charness, M.D., William Dunty, Ph.D., Daniel Falk, Ph.D., Dale Herald, M.D., Ph.D., and Edward Riley, Ph.D. We dedicate this paper to our deceased colleague, Jason Blankenship, Ph.D., who invested much effort into this project before his untimely death in October 2013. Protocols and consent forms were approved by the University of New Mexico School of Medicine, HRRC #96-209, #06-199, and #10-342; and the University of North Carolina, #11-0717. Active consent for children to participate was obtained from parents/guardians. Maternal interviews required a separate consent form.
PY - 2020/4/1
Y1 - 2020/4/1
N2 - Objective: To detail the characteristic traits of children with fetal alcohol spectrum disorders (FASDs) and maternal risk factors in a southeastern U.S. County. Methods: Independent samples were drawn from 2 different cohorts of first-grade students. All consented children (49.8%) were measured for height, weight, and head circumference, and those ≤ 25th centile entered the study along with a random sample drawn from all enrolled students. Study children were examined for physical growth, dysmorphology, and neurobehavior, and their mothers were interviewed. Results: Total dysmorphology scores discriminated well the physical traits of children across the FASD continuum: fetal alcohol syndrome (FAS) = 15.8, partial FAS (PFAS) = 10.8, alcohol-related neurobehavioral disorder (ARND) = 5.2, and typically developing controls = 4.4. Additionally, a neurobehavioral battery distinguished children with each FASD diagnosis from controls. Behavioral problems qualified more children for FASD diagnoses than cognitive traits. Significant proximal maternal risk variables were as follows: reports of prepregnancy drinking, drinking in any trimester, and comorbid use of other drugs in lifetime and during pregnancy, especially alcohol and marijuana (14.9% among mothers of children with FASD vs. 0.4% for controls). Distal maternal risks included reports of other health problems (e.g., depression), living unmarried with a partner during pregnancy, and a lower level of spirituality. Controlling for other drug use during pregnancy, having a child diagnosed with a FASD was 17.5 times greater for women who reported usual consumption of 3 drinks per drinking day prior to pregnancy than for nondrinking mothers (p < 0.001, 95% CI = 5.1 to 59.9). There was no significant difference in the prevalence of FASD by race, Hispanic ethnicity, or socioeconomic status. The prevalence of FASD was not lower than 17.3 per 1,000, and weighted estimated prevalence was 49.0 per 1,000 or 4.9%. Conclusion: This site had the second lowest rate in the CoFASP study, yet children with FASD are prevalent.
AB - Objective: To detail the characteristic traits of children with fetal alcohol spectrum disorders (FASDs) and maternal risk factors in a southeastern U.S. County. Methods: Independent samples were drawn from 2 different cohorts of first-grade students. All consented children (49.8%) were measured for height, weight, and head circumference, and those ≤ 25th centile entered the study along with a random sample drawn from all enrolled students. Study children were examined for physical growth, dysmorphology, and neurobehavior, and their mothers were interviewed. Results: Total dysmorphology scores discriminated well the physical traits of children across the FASD continuum: fetal alcohol syndrome (FAS) = 15.8, partial FAS (PFAS) = 10.8, alcohol-related neurobehavioral disorder (ARND) = 5.2, and typically developing controls = 4.4. Additionally, a neurobehavioral battery distinguished children with each FASD diagnosis from controls. Behavioral problems qualified more children for FASD diagnoses than cognitive traits. Significant proximal maternal risk variables were as follows: reports of prepregnancy drinking, drinking in any trimester, and comorbid use of other drugs in lifetime and during pregnancy, especially alcohol and marijuana (14.9% among mothers of children with FASD vs. 0.4% for controls). Distal maternal risks included reports of other health problems (e.g., depression), living unmarried with a partner during pregnancy, and a lower level of spirituality. Controlling for other drug use during pregnancy, having a child diagnosed with a FASD was 17.5 times greater for women who reported usual consumption of 3 drinks per drinking day prior to pregnancy than for nondrinking mothers (p < 0.001, 95% CI = 5.1 to 59.9). There was no significant difference in the prevalence of FASD by race, Hispanic ethnicity, or socioeconomic status. The prevalence of FASD was not lower than 17.3 per 1,000, and weighted estimated prevalence was 49.0 per 1,000 or 4.9%. Conclusion: This site had the second lowest rate in the CoFASP study, yet children with FASD are prevalent.
KW - Alcohol Use and Abuse
KW - Children with FASD
KW - Fetal Alcohol Spectrum Disorders
KW - Maternal Risk Traits for FASD
KW - Prenatal Alcohol Use
KW - Prevalence
KW - Women
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U2 - 10.1111/acer.14313
DO - 10.1111/acer.14313
M3 - Article
C2 - 32293734
AN - SCOPUS:85083422624
VL - 44
SP - 939
EP - 959
JO - Alcoholism: Clinical and Experimental Research
JF - Alcoholism: Clinical and Experimental Research
SN - 0145-6008
IS - 4
ER -