Characteristic physical traits of first-grade children in the United States with fetal alcohol spectrum disorders (FASD) and associated alcohol and drug exposures

doi:10.1002/ajmg.a.62738

. 2022 Jul;188(7):2019-2035.

doi: 10.1002/ajmg.a.62738. Epub 2022 Mar 31.

Characteristic physical traits of first-grade children in the United States with fetal alcohol spectrum disorders (FASD) and associated alcohol and drug exposures

Philip A May^{1

2}, Julie M Hasken¹, Melanie A Manning³, Luther K Robinson⁴, Omar Abdul-Rahman⁵, Margaret P Adam⁶, Tamison Jewett⁷, Amy J Elliott^{8

9}, Wendy O Kalberg², David Buckley², H Eugene Hoyme^{9

10}

Affiliations

¹ Nutrition Research Institute, The University of North Carolina at Chapel Hill, Kannapolis, North Carolina, USA.
² Center on Alcohol, Substance Abuse and Addictions, The University of New Mexico, Albuquerque, New Mexico, USA.
³ Departments of Pathology and Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA.
⁴ Department of Pediatrics, State University of New York, Buffalo, New York, USA.
⁵ Department of Genetic Medicine, Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, Nebraska, USA.
⁶ Division of Genetic Medicine, Department of Pediatrics, University of Washington, Seattle, Washington, USA.
⁷ Department of Pediatrics, Wake Forest University, Winston-Salem, North Carolina, USA.
⁸ Avera Health, Sioux Falls, South Dakota, USA.
⁹ Department of Pediatrics, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota, USA.
¹⁰ Sanford Children's Genomic Medicine Consortium, Sanford Health, Sioux Falls, South Dakota, USA.

PMID: 35357075
PMCID: PMC9197851
DOI: 10.1002/ajmg.a.62738

Characteristic physical traits of first-grade children in the United States with fetal alcohol spectrum disorders (FASD) and associated alcohol and drug exposures

Philip A May et al. Am J Med Genet A. 2022 Jul.

. 2022 Jul;188(7):2019-2035.

doi: 10.1002/ajmg.a.62738. Epub 2022 Mar 31.

Authors

Affiliations

¹ Nutrition Research Institute, The University of North Carolina at Chapel Hill, Kannapolis, North Carolina, USA.
² Center on Alcohol, Substance Abuse and Addictions, The University of New Mexico, Albuquerque, New Mexico, USA.
³ Departments of Pathology and Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA.
⁴ Department of Pediatrics, State University of New York, Buffalo, New York, USA.
⁵ Department of Genetic Medicine, Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, Nebraska, USA.
⁶ Division of Genetic Medicine, Department of Pediatrics, University of Washington, Seattle, Washington, USA.
⁷ Department of Pediatrics, Wake Forest University, Winston-Salem, North Carolina, USA.
⁸ Avera Health, Sioux Falls, South Dakota, USA.
⁹ Department of Pediatrics, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota, USA.
¹⁰ Sanford Children's Genomic Medicine Consortium, Sanford Health, Sioux Falls, South Dakota, USA.

PMID: 35357075
PMCID: PMC9197851
DOI: 10.1002/ajmg.a.62738

Abstract

We compared growth, physical features, and minor anomalies in 131 first-grade children with fetal alcohol spectrum disorders (FASD) to those of a representative comparison group of typically developing children from the same populations (n = 1212). The data were collected from three regional sites in the NIAAA-funded Collaboration on FASD Prevalence (CoFASP). Dysmorphology examinations were performed by a team of expert clinical geneticists, and FASD diagnoses were assigned according to the Revised Institute of Medicine Guidelines, which include assessments of growth, dysmorphology, neurobehavior, and maternal risk interviews. We present detailed data on 32 physical traits, minor anomalies, and a summary dysmorphology score for children within each of the four diagnostic categories in the continuum of FASD. There were few differences in the frequency of FASD diagnoses by race or Hispanic ethnicity. Children with FASD were born to mothers who reported using alcohol, tobacco (28.3%), and other drugs (14.2%) during pregnancy. Controlling for tobacco and other drug use, risk analysis indicated that women with a drinking pattern of 3 drinks per drinking day prior to pregnancy were 10 times more likely (p < 0.001, OR = 9.92, 95% CI: 4.6-21.5) to bear a child with FASD than those who reported abstinence prior to pregnancy.

Keywords: FASD physical phenotypes; alcohol use in pregnancy; fetal alcohol spectrum disorders (FASD); maternal risk for FASD.

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Figures

**Figure 1.**
Institute of Medicine Diagnostic Guidelines for Specific Fetal Alcohol Spectrum Disorders (FASD) as clarified by Hoyme et al (2016). Reproduced with permission from Pediatrics, Vol. 138, Pages 3–4, Copyright © 2016 by the AAP

See this image and copyright information in PMC

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References

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1. Abel EL, & Sokol RJ (1987). Incidence of fetal alcohol syndrome and economic impact of FAS-related anomalies. Drug and Alcohol Dependence. 10.1016/0376-8716(87)90087-1 - DOI - PubMed
1. Abell K, May W, May PA, Kalberg W, Hoyme HE, Robinson LK, Manning M, Jones KL, & Abdul-Rahman O (2016). Fetal Alcohol Spectrum Disorders and Assessment of Maxillary and Mandibular Arc Measurements. American Journal of Medical Genetics. Part A, 170(7), 1763–1771. 10.1002/ajmg.a.37656 - DOI - PubMed
1. Achenbach T, & Rescorla L (2001). Manual For The ASEBA School-Age Forms And Profiles. University of Vermont, Research Center for Children, Youth, and Families.
1. Allanson JE, Cunniff C, Hoyme HE, McGaughran Julie, Muenke M, & Neri G (2009). Elements of morphology: Standard terminology for the head and face. American Journal of Medical Genetics Part A, 149A(1), 6–28. https://doi.org/doi: 10.1002/ajmg.a.32612 - DOI - PMC - PubMed

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[1] Aase JM (1994). Clinical Recognition of FAS. Alcohol Health and Research World, 18(1), 5–9. - PMC - PubMed

[2] Aase JM (1994). Clinical Recognition of FAS. Alcohol Health and Research World, 18(1), 5–9. - PMC - PubMed

[3] Abel EL, & Sokol RJ (1987). Incidence of fetal alcohol syndrome and economic impact of FAS-related anomalies. Drug and Alcohol Dependence. 10.1016/0376-8716(87)90087-1 - DOI - PubMed

[4] Abel EL, & Sokol RJ (1987). Incidence of fetal alcohol syndrome and economic impact of FAS-related anomalies. Drug and Alcohol Dependence. 10.1016/0376-8716(87)90087-1 - DOI - PubMed

[5] Abell K, May W, May PA, Kalberg W, Hoyme HE, Robinson LK, Manning M, Jones KL, & Abdul-Rahman O (2016). Fetal Alcohol Spectrum Disorders and Assessment of Maxillary and Mandibular Arc Measurements. American Journal of Medical Genetics. Part A, 170(7), 1763–1771. 10.1002/ajmg.a.37656 - DOI - PubMed

[6] Abell K, May W, May PA, Kalberg W, Hoyme HE, Robinson LK, Manning M, Jones KL, & Abdul-Rahman O (2016). Fetal Alcohol Spectrum Disorders and Assessment of Maxillary and Mandibular Arc Measurements. American Journal of Medical Genetics. Part A, 170(7), 1763–1771. 10.1002/ajmg.a.37656 - DOI - PubMed

[7] Achenbach T, & Rescorla L (2001). Manual For The ASEBA School-Age Forms And Profiles. University of Vermont, Research Center for Children, Youth, and Families.

[8] Achenbach T, & Rescorla L (2001). Manual For The ASEBA School-Age Forms And Profiles. University of Vermont, Research Center for Children, Youth, and Families.

[9] Allanson JE, Cunniff C, Hoyme HE, McGaughran Julie, Muenke M, & Neri G (2009). Elements of morphology: Standard terminology for the head and face. American Journal of Medical Genetics Part A, 149A(1), 6–28. https://doi.org/doi: 10.1002/ajmg.a.32612 - DOI - PMC - PubMed

[10] Allanson JE, Cunniff C, Hoyme HE, McGaughran Julie, Muenke M, & Neri G (2009). Elements of morphology: Standard terminology for the head and face. American Journal of Medical Genetics Part A, 149A(1), 6–28. https://doi.org/doi: 10.1002/ajmg.a.32612 - DOI - PMC - PubMed

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Characteristic physical traits of first-grade children in the United States with fetal alcohol spectrum disorders (FASD) and associated alcohol and drug exposures

Affiliations

Characteristic physical traits of first-grade children in the United States with fetal alcohol spectrum disorders (FASD) and associated alcohol and drug exposures

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