Christina D Chambers1,2, Claire Coles3,4, Julie Kable3,4, Natacha Akshoomoff5, Ronghui Xu2,6, Jennifer A Zellner1, Gordon Honerkamp-Smith1, Melanie A Manning7, Margaret P Adam8, Kenneth Lyons Jones1. 1. Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, California. 2. Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, La Jolla, California. 3. Department of Psychiatry, School of Medicine, Emory University, Atlanta, Georgia. 4. Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia. 5. Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California San Diego, La Jolla, California. 6. Department of Mathematics, University of California San Diego, La Jolla, California. 7. Departments of Pathology and Pediatrics, Stanford University School of Medicine, Stanford, California. 8. Department of Pediatrics, School of Medicine, University of Washington, Seattle, Washington.
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.
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 FASDchildren 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 FASDchildren 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.
Authors: Sylvia Roozen; Gjalt-Jorn Y Peters; Gerjo Kok; David Townend; Jan Nijhuis; Leopold Curfs Journal: Alcohol Clin Exp Res Date: 2016-01 Impact factor: 3.455
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; Christina D Chambers; Wendy O Kalberg; Jennifer Zellner; Haruna Feldman; David Buckley; David Kopald; Julie M Hasken; Ronghui Xu; Gordon Honerkamp-Smith; Howard Taras; Melanie A Manning; Luther K Robinson; Margaret P Adam; Omar Abdul-Rahman; Keith Vaux; Tamison Jewett; Amy J Elliott; Julie A Kable; Natacha Akshoomoff; Daniel Falk; Judith A Arroyo; Dale Hereld; Edward P Riley; Michael E Charness; Claire D Coles; Kenneth R Warren; Kenneth Lyons Jones; H Eugene Hoyme Journal: JAMA Date: 2018-02-06 Impact factor: 56.272
Authors: Philip A May; Marlene M De Vries; Anna-Susan Marais; Wendy O Kalberg; David Buckley; Colleen M Adnams; Julie M Hasken; Barbara Tabachnick; Luther K Robinson; Melanie A Manning; Heidre Bezuidenhout; Margaret P Adam; Kenneth L Jones; Soraya Seedat; Charles D H Parry; H Eugene Hoyme Journal: Int J Environ Res Public Health Date: 2017-05-12 Impact factor: 3.390
Authors: Philip A May; Julie M Hasken; Stephen R Hooper; Dixie M Hedrick; Julia Jackson-Newsom; Chalise E Mullis; Elizabeth Dobyns; Wendy O Kalberg; David Buckley; Luther K Robinson; Omar Abdul-Rahman; Margaret P Adam; Melanie A Manning; Tamison Jewett; H Eugene Hoyme Journal: Drug Alcohol Depend Date: 2021-08-02 Impact factor: 4.852
Authors: Philip A May; Julie M Hasken; Melanie A Manning; Luther K Robinson; Omar Abdul-Rahman; Margaret P Adam; Tamison Jewett; Amy J Elliott; Wendy O Kalberg; David Buckley; H Eugene Hoyme Journal: Am J Med Genet A Date: 2022-03-31 Impact factor: 2.578
Authors: Krista D Sowell; Roberta R Holt; Janet Y Uriu-Adams; Christina D Chambers; Claire D Coles; Julie A Kable; Lyubov Yevtushok; Natalya Zymak-Zakutnya; Wladimir Wertelecki; Carl L Keen Journal: J Am Coll Nutr Date: 2020-04-02 Impact factor: 3.169
Authors: J A Kable; C D Coles; C L Keen; J Y Uriu-Adams; K L Jones; L Yevtushok; Y Kulikovsky; N Zymak-Zakutnya; Iryna Dubchak; D Akhmedzhanova; W Wertelecki; C D Chambers Journal: Alcohol Date: 2021-12-20 Impact factor: 2.405
Authors: Svetlana Popova; Shannon Lange; Valerie Temple; Vladimir Poznyak; Albert E Chudley; Larry Burd; Margaret Murray; Jürgen Rehm Journal: Int J Environ Res Public Health Date: 2020-10-30 Impact factor: 3.390