Risk Factors for Fetal Alcohol Syndrome

Identifying
maternal risk factors associated with fetal alcohol syndrome
(FAS) can help inform prevention efforts. Using a population-based
sample in the Western Cape Province of South Africa (an
area with extremely high FAS rates), researchers compared
mothers of first graders born with FAS (cases; n=53) with
mothers of first graders without FAS (controls; n=116).

• Cases
  were significantly more likely than controls to live
  in a rural area during their index pregnancy, work on
  a farm, have a greater number of children, and have
  a lower income and educational attainment. They were
  significantly less likely to be married while pregnant
  and to participate in religious activities.
• Cases
  drank for more years (13 versus 4) and had greater current
  use (13 versus 1 drink per week; binge drinking* among
  70% versus 6%).
• During
  pregnancy, over 85% of cases consumed the same or more
  than their current levels. Over 84% of controls drank
  less than their current levels.
• Immediate
  family members of cases drank significantly more than
  did the immediate family of controls (e.g., 63 drinks
  per month for fathers of cases versus 32 drinks for
  fathers of controls).
• Cases
  were also more likely to have smoked during pregnancy
  (e.g., 76% versus 27% during the third trimester).

Comments:

This
study confirms that the range of maternal risk factors
associated with FAS is broad. Clearly, maternal alcohol
consumption is the key risk factor for FAS; how other
factors increase risk is less clear. Nonetheless, clinicians
should consider and address all of these factors during
prenatal assessments.

Joseph Conigliaro, MD, MPH

Reference:

May PA, Gossage P, Brooke LE, et al. Maternal risk factors for fetal alcohol syndrome in the Western Cape Province of South Africa: a population-based study. Am J Public Health. 2005;95(7):1190-1199.