Philip A May1, Julie M Hasken2, Stephen R Hooper3, Dixie M Hedrick2, Julia Jackson-Newsom4, Chalise E Mullis4, Elizabeth Dobyns4, Wendy O Kalberg5, David Buckley5, Luther K Robinson6, Omar Abdul-Rahman7, Margaret P Adam8, Melanie A Manning9, Tamison Jewett10, H Eugene Hoyme11. 1. Nutrition Research Institute, The University of North Carolina at Chapel Hill, Kannapolis, NC, United States; Center on Alcoholism, Substance Abuse and Addictions, The University of New Mexico, Albuquerque, NM, United States. Electronic address: Philip_may@unc.edu. 2. Nutrition Research Institute, The University of North Carolina at Chapel Hill, Kannapolis, NC, United States. 3. Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States. 4. Office of the Vice Chancellor for Research, The University of North Carolina at Greensboro, Greensboro, NC, United States. 5. Center on Alcoholism, Substance Abuse and Addictions, The University of New Mexico, Albuquerque, NM, United States. 6. Department of Pediatrics, State University of New York, Buffalo, NY, United States. 7. Department of Genetic Medicine, Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE, United States. 8. Division of Genetic Medicine, Department of Pediatrics, University of Washington, Seattle, WA, United States. 9. Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States. 10. Department of Pediatrics, Wake Forest University, Winston-Salem, NC, United States. 11. Department of Pediatrics, University of Arizona College of Medicine, Tucson, AZ, United States; Sanford Children's Genomic Medicine Consortium, Sanford Health, Sioux Falls, SD, United States.
Abstract
OBJECTIVE: Utilize a random sample to estimate the prevalence, child traits, and maternal risk for fetal alcohol spectrum disorders (FASD) in a Southeastern United States county. METHODS: From all first-grade students (n = 1073) a simple random sample was drawn, and 32 % (n = 231) were consented. All 231 children were examined for dysmorphology and growth, 84 were tested and rated on neurobehavior, and 72 mothers were interviewed for maternal risk. RESULTS: Significant differences (α = .05) between the physical traits of children diagnosed with FASD and the entire sample were height, weight, head circumference, body mass index, and total dysmorphology scores, and all three cardinal features of fetal alcohol syndrome: palpebral fissure length, smooth philtrum, and narrow vermilion. Intellectual function and inhibition were not significantly different between FASD and typically-functioning children, but two executive function measures and one visual/spatial measure approached significance (α = .10). Three behavioral measures were significantly worse for the FASD group: parent-rated problems of communication, daily living, and socialization. Significant maternal risk factors reported were postpartum depression, frequency of drinking, and recovery from problem drinking. The prevalence of FASD was 71.4 per 1,000 or 7.1 %. This rate falls clearly within the prevalence range identified in eight larger samples of other communities in the Collaboration on FASD Prevalence (CoFASP) study in four regions of the United States. CONCLUSION: Careful and detailed clinical evaluation of children from small random samples can be useful for estimating the prevalence and traits of FASD in a community.
OBJECTIVE: Utilize a random sample to estimate the prevalence, child traits, and maternal risk for fetal alcohol spectrum disorders (FASD) in a Southeastern United States county. METHODS: From all first-grade students (n = 1073) a simple random sample was drawn, and 32 % (n = 231) were consented. All 231 children were examined for dysmorphology and growth, 84 were tested and rated on neurobehavior, and 72 mothers were interviewed for maternal risk. RESULTS: Significant differences (α = .05) between the physical traits of children diagnosed with FASD and the entire sample were height, weight, head circumference, body mass index, and total dysmorphology scores, and all three cardinal features of fetal alcohol syndrome: palpebral fissure length, smooth philtrum, and narrow vermilion. Intellectual function and inhibition were not significantly different between FASD and typically-functioning children, but two executive function measures and one visual/spatial measure approached significance (α = .10). Three behavioral measures were significantly worse for the FASD group: parent-rated problems of communication, daily living, and socialization. Significant maternal risk factors reported were postpartum depression, frequency of drinking, and recovery from problem drinking. The prevalence of FASD was 71.4 per 1,000 or 7.1 %. This rate falls clearly within the prevalence range identified in eight larger samples of other communities in the Collaboration on FASD Prevalence (CoFASP) study in four regions of the United States. CONCLUSION: Careful and detailed clinical evaluation of children from small random samples can be useful for estimating the prevalence and traits of FASD in a community.
Authors: Philip A May; J Phillip Gossage; Anna-Susan Marais; Colleen M Adnams; H Eugene Hoyme; Kenneth L Jones; Luther K Robinson; Nathaniel C O Khaole; Cudore Snell; Wendy O Kalberg; Loretta Hendricks; Lesley Brooke; Chandra Stellavato; Denis L Viljoen Journal: Drug Alcohol Depend Date: 2006-11-28 Impact factor: 4.492
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