Fetal alcohol spectrum disorders were more prevalent among a cohort of first graders in the Midwest than indicated by previous estimates, according to study findings published in Pediatrics.
Philip A. May, PhD, of the University of North Carolina in Chapel Hill, and colleagues assessed the prevalence and characteristics of fetal alcohol spectrum disorders among children in first grade in a Midwestern US city. Of the 2,033 children enrolled in first grade in 32 public and private schools, 1,433 consented to participate in the study and 168 children served as controls. Maternal risk for fetal alcohol spectrum disorder was determined via interviews of 153 mothers.
Overall, 12 children were diagnosed with fetal alcohol syndrome, 23 had partial fetal alcohol syndrome, 13 had alcohol-related neurodevelopmental disorder and none had alcohol-related birth defects.
Analysis indicated a fetal alcohol syndrome prevalence of six to eight per 1,000; a prevalence rate of 17 to 24 per 1,000 for both fetal alcohol syndrome and partial fetal alcohol syndrome; and a prevalence rate of 24 to 34 per 1,000 for fetal alcohol spectrum disorder overall.
Children with fetal alcohol syndrome were shorter, weighed less and had smaller heads compared with all other study participants. They also had the lowest BMI, followed by children with partial fetal alcohol syndrome, those with alcohol-related neurodevelopmental disorder and children in the control group.
Children with fetal alcohol syndrome were more likely to have smooth philtrum than children with partial fetal alcohol syndrome, alcohol-related neurodevelopmental disorder or those in the control group.
A narrow vermilion border around the upper lip was more common among children with any fetal alcohol spectrum disorder compared with the control group.
Children with fetal alcohol syndrome had the highest average total dysmorphology score, followed by children with partial fetal alcohol syndrome, those with alcohol-related neurodevelopmental disorder and those in the control group.
Children with any fetal alcohol spectrum disorder were more likely to have a hypoplastic midface and lower maxillary and mandibular arc measurements. These children were also more likely to have clinodactyly and camptodactyly compared with controls. Epicanthal folds were more prevalent among children with a fetal alcohol spectrum disorder, but not significantly different compared with controls.
Children with a fetal alcohol spectrum disorder had lower scores on cognitive and behavioral tests compared with children in the control group. Compared with the control group, children with a fetal alcohol spectrum disorder performed most poorly on verbal IQ, working memory, general and conceptual ability, and parent and teacher rating of adaptive behavior.
Mothers of children with a fetal alcohol spectrum disorder reportedly recognized pregnancy later in gestation than controls and had fewer health care visits during pregnancy.
Compared with controls, mothers of children with a fetal alcohol spectrum disorder consumed significantly more drinks per drinking day 3 months prior to pregnancy. They reported greater alcohol consumption during the first trimester, were more likely to binge with five or more drinks and reported more drinking days in the past month than those in the control group.
Mothers of children with a fetal alcohol spectrum disorder reported their partner consumed significantly more drinks per drinking day during pregnancy. Parental binge drinking was greater among children with fetal alcohol spectrum disorders.
“The rate of fetal alcohol syndrome and overall fetal alcohol spectrum disorder appear to be substantially higher in this community than most estimates for the general population of the United States, Canada or Europe,” the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.