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,
Estimating the community prevalence, child traits, and maternal risk factors of fetal alcohol spectrum disorders (FASD) from a random sample of school children, Drug and Alcohol Dependence, Volume 227, 2021,108918,
ISSN 0376-8716,
https://doi.org/10.1016/j.drugalcdep.2021.108918.
(https://www.sciencedirect.com/science/article/pii/S0376871621004130)
Highlights
- The prevalence of FASD in this random sample was 7.1 %.
- The prevalence estimates are consistent with current US estimates.
- Microcephaly and total dysmorphology score were typical of FASD.
- Impulse control and adaptive function were significant FASD traits.
- Random samples can be useful for estimating the prevalence of FASD.
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). Six behavioral measures were significantly worse for the FASD group: teacher-rated aggressive behavior, oppositional defiant problems, and conduct problems, and 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.