Fetal Alcohol Syndrome Epidemiology Research in the U.S.: Methods and Initial Results

Introduction: The Fetal Alcohol Syndrome Epidemiology Research in the United States of America (FASER-USA) project of CoFASP is ongoing among diverse samples in three locales: Midwest, Rocky Mountain, and Southeast regions.

Methods: Active case ascertainment methods are used among first grade students in all elementary schools in representative communities. Various combinations of oversampling of small students and random-selection techniques are used to recruit children for a brief physical trait exam performed by a pediatric dysmorphologist/medical geneticist where key features of fetal alcohol spectrum disorders (FASD) and other known anomalies are assessed. Following this exam, all randomly-selected students and those children with significant indicators of FASD, or other known anomalies are then administered a battery of cognitive and behavioral tests and their mothers interviewed about maternal risk factors during the prenatal period and relevant to the prenatal and post-partum development of each child. Final diagnoses are made by the dysmorphologists in a formal case conference supported by evidence from each domain of data collection and interpretative input of the multidisciplinary team of testers and interviewers.

Results: The results from a first study in the USA yielded a prevalence of FAS of 6 to 9 per 1,000, and total FASD of 24 to 48 per 1,000. The results from four other samples from FASER-USA will also be presented.

Conclusions: Summaries of the population-based physical characteristics of children with FASD and normal controls and salient maternal risk factors for FASD in the USA studies will also be provided.