Philip A May1, Carol Keaster2, Rosemary Bozeman2, Joelene Goodover3, Jason Blankenship4, Wendy O Kalberg5, David Buckley6, Marita Brooks7, Julie Hasken8, J Phillip Gossage9, Luther K Robinson10, Melanie Manning11, H Eugene Hoyme12. 1. Nutrition Research Institute, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Kannapolis, NC 28081, USA; Center on Alcoholism, Substance Abuse, and Addictions (CASAA), The University of New Mexico, 2650 Yale SE, Albuquerque, NM 87106, USA; Sanford Research & Department of Pediatrics, Sanford School of Medicine, The University of South Dakota, Sioux Falls, SD 57104, USA. Electronic address: philip_may@unc.edu. 2. City\County Health Department, USA. 3. Rocky Mountain City Public Schools, USA. 4. Center on Alcoholism, Substance Abuse, and Addictions (CASAA), The University of New Mexico, 2650 Yale SE, Albuquerque, NM 87106, USA. 5. Center on Alcoholism, Substance Abuse, and Addictions (CASAA), The University of New Mexico, 2650 Yale SE, Albuquerque, NM 87106, USA. Electronic address: wkalberg@unm.edu. 6. Center on Alcoholism, Substance Abuse, and Addictions (CASAA), The University of New Mexico, 2650 Yale SE, Albuquerque, NM 87106, USA. Electronic address: dbuckely@unm.edu. 7. Center on Alcoholism, Substance Abuse, and Addictions (CASAA), The University of New Mexico, 2650 Yale SE, Albuquerque, NM 87106, USA. Electronic address: maritab@unm.edu. 8. Nutrition Research Institute, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Kannapolis, NC 28081, USA. Electronic address: julie_hasken@unc.edu. 9. Center on Alcoholism, Substance Abuse, and Addictions (CASAA), The University of New Mexico, 2650 Yale SE, Albuquerque, NM 87106, USA. Electronic address: jgossage@unm.edu. 10. Dysmorphology and Clinical Genetics, School of Medicine, State University of New York at Buffalo, Buffalo, NY 10138, USA. Electronic address: lrobinson@upa.chob.edu. 11. Department of Pathology, Stanford University School of Medicine, Stanford, CA 94109, USA; Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94109, USA. Electronic address: mmanning@stanford.edu. 12. Sanford Research & Department of Pediatrics, Sanford School of Medicine, The University of South Dakota, Sioux Falls, SD 57104, USA. Electronic address: Gene.Hoyme@sanfordhealth.org.
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.
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
Authors: Haruna Sawada Feldman; Kenneth Lyons Jones; Suzanne Lindsay; Donald Slymen; Hillary Klonoff-Cohen; Kelly Kao; Smriti Rao; Christina Chambers Journal: Am J Med Genet A Date: 2011-10-14 Impact factor: 2.802
Authors: Philip A May; Amy Baete; Jaymi Russo; Amy J Elliott; Jason Blankenship; Wendy O Kalberg; David Buckley; Marita Brooks; Julie Hasken; Omar Abdul-Rahman; Margaret P Adam; Luther K Robinson; Melanie Manning; H Eugene Hoyme Journal: Pediatrics Date: 2014-11 Impact factor: 7.124
Authors: Friedrich Martin Wurst; Erika Kelso; Wolfgang Weinmann; Fritz Pragst; Michel Yegles; Inger Sundström Poromaa Journal: Am J Obstet Gynecol Date: 2008-01-25 Impact factor: 8.661
Authors: Philip A May; Jason Blankenship; Anna-Susan Marais; J Phillip Gossage; Wendy O Kalberg; Belinda Joubert; Marise Cloete; Ronel Barnard; Marlene De Vries; Julie Hasken; Luther K Robinson; Colleen M Adnams; David Buckley; Melanie Manning; Charles D H Parry; H Eugene Hoyme; Barbara Tabachnick; Soraya Seedat Journal: Drug Alcohol Depend Date: 2013-08-08 Impact factor: 4.492
Authors: Betty A Poitra; Shirley Marion; Marilyn Dionne; Esther Wilkie; Paul Dauphinais; Marma Wilkie-Pepion; John T Martsolf; Marilyn G Klug; Larry Burd Journal: Neurotoxicol Teratol Date: 2003 Nov-Dec Impact factor: 3.763
Authors: Philip A May; Daniela Fiorentino; Giovanna Coriale; Wendy O Kalberg; H Eugene Hoyme; Alfredo S Aragón; David Buckley; Chandra Stellavato; J Phillip Gossage; Luther K Robinson; Kenneth Lyons Jones; Melanie Manning; Mauro Ceccanti Journal: Int J Environ Res Public Health Date: 2011-06-22 Impact factor: 3.390
Authors: Philip A May; Anna-Susan Marais; Marlene M de Vries; Wendy O Kalberg; David Buckley; Julie M Hasken; Colleen M Adnams; Ronel Barnard; Belinda Joubert; Marise Cloete; Barbara Tabachnick; Luther K Robinson; Melanie A Manning; Kenneth Lyons Jones; Heidre Bezuidenhout; Soraya Seedat; Charles D H Parry; H Eugene Hoyme Journal: Drug Alcohol Depend Date: 2016-10-06 Impact factor: 4.492
Authors: Lauren R Doyle; Claire D Coles; Julie A Kable; Philip A May; Elizabeth R Sowell; Kenneth L Jones; Edward P Riley; Sarah N Mattson Journal: Birth Defects Res Date: 2019-02-04 Impact factor: 2.344
Authors: Leila Glass; Eileen M Moore; Natacha Akshoomoff; Kenneth Lyons Jones; Edward P Riley; Sarah N Mattson Journal: Alcohol Clin Exp Res Date: 2017-03-24 Impact factor: 3.455
Authors: Patrick K Goh; Lauren R Doyle; Leila Glass; Kenneth L Jones; Edward P Riley; Claire D Coles; H Eugene Hoyme; Julie A Kable; Philip A May; Wendy O Kalberg; Elizabeth R Sowell; Jeffrey R Wozniak; Sarah N Mattson Journal: J Pediatr Date: 2016-07-29 Impact factor: 4.406
Authors: Oladiran I Olateju; Muhammad A Spocter; Nina Patzke; Amadi O Ihunwo; Paul R Manger Journal: Metab Brain Dis Date: 2017-11-21 Impact factor: 3.584
Authors: H Eugene Hoyme; Wendy O Kalberg; Amy J Elliott; Jason Blankenship; David Buckley; Anna-Susan Marais; Melanie A Manning; Luther K Robinson; Margaret P Adam; Omar Abdul-Rahman; Tamison Jewett; Claire D Coles; Christina Chambers; Kenneth L Jones; Colleen M Adnams; Prachi E Shah; Edward P Riley; Michael E Charness; Kenneth R Warren; Philip A May Journal: Pediatrics Date: 2016-07-27 Impact factor: 7.124
Authors: Philip A May; Marlene M de Vries; Anna-Susan Marais; Wendy O Kalberg; Colleen M Adnams; Julie M Hasken; Barbara Tabachnick; Luther K Robinson; Melanie A Manning; Kenneth Lyons Jones; Derek Hoyme; Soraya Seedat; Charles D H Parry; H Eugene Hoyme Journal: Drug Alcohol Depend Date: 2015-12-31 Impact factor: 4.492