title: Prevalence and characteristics of fetal alcohol spectrum disorders.
abstract: OBJECTIVE
  To determine the prevalence and characteristics of fetal alcohol spectrum disorders (FASD) among first grade students (6- to 7-year-olds) in a representative Midwestern US community.
  
  
  METHODS
  From a consented sample of 70.5% of all first graders enrolled in public and private schools, an oversample of small children (≤ 25th percentile on height, weight, and head circumference) and randomly selected control candidates were examined for physical growth, development, dysmorphology, cognition, and behavior. The children's mothers were interviewed for maternal risk.
  
  
  RESULTS
  Total dysmorphology scores differentiate significantly fetal alcohol syndrome (FAS) and partial FAS (PFAS) from one another and from unexposed controls. Alcohol-related neurodevelopmental disorder (ARND) is not as clearly differentiated from controls. Children who had FASD performed, on average, significantly worse on 7 cognitive and behavioral tests and measures. The most predictive maternal risk variables in this community are late recognition of pregnancy, quantity of alcoholic drinks consumed 3 months before pregnancy, and quantity of drinking reported for the index child's father. From the final multidisciplinary case findings, 3 techniques were used to estimate prevalence. FAS in this community likely ranges from 6 to 9 per 1000 children (midpoint, 7.5), PFAS from 11 to 17 per 1000 children (midpoint, 14), and the total rate of FASD is estimated at 24 to 48 per 1000 children, or 2.4% to 4.8% (midpoint, 3.6%).
  
  
  CONCLUSIONS
  Children who have FASD are more prevalent among first graders in this Midwestern city than predicted by previous, popular estimates.
authors.affiliation: Department of Nutrition, Gillings School of Global Public Health, Nutrition Research Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Center on Alcoholism, Substance Abuse and Addictions (CASAA), The University of New Mexico, Albuquerque, New Mexico; Department of Pediatrics, Sanford School of Medicine, The University of South Dakota, Sioux Falls, South Dakota philip_may@unc.edu.
authors.forename: Philip A
authors.initials: PA
authors.lastname: May
authors.affiliation: Sanford Research, Sioux Falls, South Dakota;
authors.forename: Amy
authors.initials: A
authors.lastname: Baete
authors.affiliation: Sanford Research, Sioux Falls, South Dakota;
authors.forename: Jaymi
authors.initials: J
authors.lastname: Russo
authors.affiliation: Sanford Research, Sioux Falls, South Dakota; Department of Pediatrics, Sanford School of Medicine, The University of South Dakota, Sioux Falls, South Dakota.
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Elliott
authors.affiliation: Center on Alcoholism, Substance Abuse and Addictions (CASAA), The University of New Mexico, Albuquerque, New Mexico;
authors.forename: Jason
authors.initials: J
authors.lastname: Blankenship
authors.affiliation: Center on Alcoholism, Substance Abuse and Addictions (CASAA), The University of New Mexico, Albuquerque, New Mexico;
authors.forename: Wendy O
authors.initials: WO
authors.lastname: Kalberg
authors.affiliation: Center on Alcoholism, Substance Abuse and Addictions (CASAA), The University of New Mexico, Albuquerque, New Mexico;
authors.forename: David
authors.initials: D
authors.lastname: Buckley
authors.affiliation: Center on Alcoholism, Substance Abuse and Addictions (CASAA), The University of New Mexico, Albuquerque, New Mexico;
authors.forename: Marita
authors.initials: M
authors.lastname: Brooks
authors.affiliation: Department of Nutrition, Gillings School of Global Public Health, Nutrition Research Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;
authors.forename: Julie
authors.initials: J
authors.lastname: Hasken
authors.affiliation: Department of Pediatrics, University of Mississippi, Jackson, Mississippi;
authors.forename: Omar
authors.initials: O
authors.lastname: Abdul-Rahman
authors.affiliation: Department of Pediatrics, University of Washington, Seattle, Washington;
authors.forename: Margaret P
authors.initials: MP
authors.lastname: Adam
authors.affiliation: Dysmorphology and Clinical Genetics, State University of New York at Buffalo, Buffalo, New York;
authors.forename: Luther K
authors.initials: LK
authors.lastname: Robinson
authors.affiliation: Departments of Pathology and Pediatrics, Stanford University, Stanford, California; and.
authors.forename: Melanie
authors.initials: M
authors.lastname: Manning
authors.affiliation: Sanford Research, Sioux Falls, South Dakota; Department of Pediatrics, Sanford School of Medicine, The University of South Dakota, Sioux Falls, South Dakota.
authors.forename: H Eugene
authors.initials: HE
authors.lastname: Hoyme
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008425:Maternal Behavior / Q000523:psychology; D011247:Pregnancy; D015995:Prevalence; D055815:Young Adult
keywords: alcohol use and abuse; children with FASD; fetal alcohol spectrum disorders; prenatal alcohol use; prevalence; women