title: Prevalence and characteristics of fetal alcohol syndrome and partial fetal alcohol syndrome in a Rocky Mountain Region City.
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.
authors: 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.
authors: Philip A
authors: PA
authors: May
authors: City\County Health Department, USA.
authors: Carol
authors: C
authors: Keaster
authors: City\County Health Department, USA.
authors: Rosemary
authors: R
authors: Bozeman
authors: Rocky Mountain City Public Schools, USA.
authors: Joelene
authors: J
authors: Goodover
authors: Center on Alcoholism, Substance Abuse, and Addictions (CASAA), The University of New Mexico, 2650 Yale SE, Albuquerque, NM 87106, USA.
authors: Jason
authors: J
authors: Blankenship
authors: 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.
authors: Wendy O
authors: WO
authors: Kalberg
authors: 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.
authors: David
authors: D
authors: Buckley
authors: 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.
authors: Marita
authors: M
authors: Brooks
authors: 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.
authors: Julie
authors: J
authors: Hasken
authors: 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.
authors: J Phillip
authors: JP
authors: Gossage
authors: Dysmorphology and Clinical Genetics, School of Medicine, State University of New York at Buffalo, Buffalo, NY 10138, USA. Electronic address: lrobinson@upa.chob.edu.
authors: Luther K
authors: LK
authors: Robinson
authors: 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.
authors: Melanie
authors: M
authors: Manning
authors: 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.
authors: H Eugene
authors: HE
authors: Hoyme
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D002657:Child Development / Q000187:drug effects*; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D009035:Mothers / Q000706:statistics & numerical data; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
keywords: Alcohol use and abuse; Children with FAS and PFAS; Fetal alcohol spectrum disorders; Maternal risk factors; Prenatal alcohol use; Prevalence; United States