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- Title
Prevalence of Fetal Alcohol Spectrum Disorders in 4 US Communities.
- Authors
May, Philip A.; Chambers, Christina D.; Kalberg, Wendy O.; Zellner, Jennifer; Feldman, Haruna; Buckley, David; Kopald, David; Hasken, Julie M.; Xu, Ronghui; Honerkamp-Smith, Gordon; Taras, Howard; Manning, Melanie A.; Robinson, Luther K.; Adam, Margaret P.; Abdul-Rahman, Omar; Vaux, Keith; Jewett, Tamison; Elliott, Amy J.; Kable, Julie A.; Akshoomoff, Natacha
- Abstract
<bold>Importance: </bold>Fetal alcohol spectrum disorders are costly, life-long disabilities. Older data suggested the prevalence of the disorder in the United States was 10 per 1000 children; however, there are few current estimates based on larger, diverse US population samples.<bold>Objective: </bold>To estimate the prevalence of fetal alcohol spectrum disorders, including fetal alcohol syndrome, partial fetal alcohol syndrome, and alcohol-related neurodevelopmental disorder, in 4 regions of the United States.<bold>Design, Setting, and Participants: </bold>Active case ascertainment methods using a cross-sectional design were used to assess children for fetal alcohol spectrum disorders between 2010 and 2016. Children were systematically assessed in the 4 domains that contribute to the fetal alcohol spectrum disorder continuum: dysmorphic features, physical growth, neurobehavioral development, and prenatal alcohol exposure. The settings were 4 communities in the Rocky Mountain, Midwestern, Southeastern, and Pacific Southwestern regions of the United States. First-grade children and their parents or guardians were enrolled.<bold>Exposures: </bold>Alcohol consumption during pregnancy.<bold>Main Outcomes and Measures: </bold>Prevalence of fetal alcohol spectrum disorders in the 4 communities was the main outcome. Conservative estimates for the prevalence of the disorder and 95% CIs were calculated using the eligible first-grade population as the denominator. Weighted prevalences and 95% CIs were also estimated, accounting for the sampling schemes and using data restricted to children who received a full evaluation.<bold>Results: </bold>A total of 6639 children were selected for participation from a population of 13 146 first-graders (boys, 51.9%; mean age, 6.7 years [SD, 0.41] and white maternal race, 79.3%). A total of 222 cases of fetal alcohol spectrum disorders were identified. The conservative prevalence estimates for fetal alcohol spectrum disorders ranged from 11.3 (95% CI, 7.8-15.8) to 50.0 (95% CI, 39.9-61.7) per 1000 children. The weighted prevalence estimates for fetal alcohol spectrum disorders ranged from 31.1 (95% CI, 16.1-54.0) to 98.5 (95% CI, 57.5-139.5) per 1000 children.<bold>Conclusions and Relevance: </bold>Estimated prevalence of fetal alcohol spectrum disorders among first-graders in 4 US communities ranged from 1.1% to 5.0% using a conservative approach. These findings may represent more accurate US prevalence estimates than previous studies but may not be generalizable to all communities.
- Subjects
UNITED States; FETAL alcohol syndrome; MOTHERS; RESEARCH funding; STATISTICAL sampling; SOCIOECONOMIC factors; DISEASE prevalence; CROSS-sectional method
- Publication
JAMA: Journal of the American Medical Association, 2018, Vol 319, Issue 5, p474
- ISSN
0098-7484
- Publication type
journal article
- DOI
10.1001/jama.2017.21896