Research
In 1973, fifty years ago, two physicians from the University of Washington, Dr. Kenneth Jones and Dr. David Smith, published their research on the effects of maternal alcohol use on the developing fetus. This was the start of awareness of FAS (FASD) in the U.S.* Since then, there have been hundreds of research articles on FASD published in mainstream journals. A sample of this research, by topic, is listed below.
*Paul Lemoine MD, a French pediatrician, published the first research on FAS in 1968.
Recent Research/Reports
Flannigan, Katherine, et al. Suicidality and Associated Factors Among Individuals Assessed for Fetal Alcohol Spectrum Disorder Across the Lifespan in Canada. The Canadian Journal of Psychiatry / La Revue Canadienne de Psychiatrie 2022, Vol. 67(5) 361‐370
January 2022 The CDC Alcohol Consumption and Binge Drinking During Pregnancy Among Adults Aged 18–49 Years United States, 2018–2020
In the U.S. 1 in 7 pregnant adults reported drinking at least one alcoholic drink in the last 30 days, 5.2% reported binge drinking - four or more drinks on at least one occasion in the last 30 days. This is an increase of 2 percentage points from 2019 data, in which 11.5% of pregnancies were alcohol exposed. In New England (Region 1) the rate of reported alcohol use among pregnant adults was 1 in 6, 16.4%. This was the second highest rate in the country - Region 9 was 16.7%.
Flannigan, Katherine, et al. Responding to the Unique Complexities of Fetal Alcohol Spectrum Disorder. Frontiers in Psychology. January 2022. Volume 12. doi: 10.3389/fpsyg.2021.778471
Ernst, Abigial M., et al. Prenatal and Postnatal Choline Supplementation in Fetal Alcohol Spectrum Disorder. Nutrients 2022, 14, 688. https://doi.org/10.3390/nu14030688
Flannigan, K and Temple, V. Difficulties in Daily Living Experienced by Adolescents, Transition-Aged Youth, and Adults With Fetal Alcohol Spectrum Disorder. May 2020. Alcoholism Clinical and Experimental Research 44(1) DOI: 10.1111/acer.14385
Jacobson, Sandra W., et al. Efficacy of maternal choline supplementation during pregnancy in mitigating adverse effects of prenatal alcohol exposure on growth and cognitive function: A randomized, double-blind, placebo-controlled clinical trial. Alcohol Clin Exp Res. 2018 July ;42(7): 1327–1341. doi:10.1111/acer.13769
Prenatal Alcohol Exposure
CDC Maine Rate of Alcohol Use Among Women Aged 18-44
CDC Maine Rate of Binge Drinking Among Women Aged 18-44
DHHS OCFS State Custody Summary SFY 2019
Maine PRAMS Data Alcohol Use During Last Trimester
Concurrent Drug Use and Alcohol Use
Bakhireva, Ludmila, et al. Prevalence of Alcohol Use in Pregnant Women with Substance Use Disorder. Drug Alcohol Depend.2018 June 01;187:305-310
doi:10.1016/j.drugalcdep.2018.02.025
Jarlenski, Marian, et al. Polysubstance use among US women of reproductive age who use opioids for nonmedical reasons. Am J Public Health. 2017 August; 107(8): 1308–1310
Prevalence of FASD
May PA, et al. Prevalence of Fetal Alcohol Spectrum Disorders in 4 US Communities. JAMA. 2018 Feb 6;319(5):474-482
Bell, Carl C, et al. Prevalence of Neurodevelopmental Disorders Among Low-income African Americans at a Clinic on Chicago's South Side. Psychiatr Serv. 2015 May 1;66(5):539-42
A comprehensive review combining the molecular as well as the gross physiological and anatomical effects of prenatal alcohol exposure.
Chasnoff, Ira, et al. Misdiagnosis and missed diagnoses in foster and adopted children with prenatal alcohol exposure. Pediatrics. 2015 Feb;135(2):264-70
Smith, Vincent, et al. Caring for Patients with Prenatal Alcohol Exposure: A Needs Assessment. J Popul Ther Clin Pharmacol Vol 24(1):e25-e39; January 27, 2017
"Prenatal alcohol exposure (PAE) is the United States’ most common preventable cause of birth defects and intellectual and developmental disabilities collectively referred to as Fetal Alcohol Spectrum Disorders (FASD). This study was designed to identify gaps in pediatric providers’ knowledge and practices regarding FASD patient identification, diagnosis, management and referral, and to inform needs-based FASD resource development."
Stigma and FASD
Corrigan, Patrick, W. et al. The Public Stigma of Birth Mothers of Children with Fetal Alcohol Spectrum Disorders. Alcohol Clin Exp Res 2017 Jun;41(6):1166-1173. doi: 10.1111/acer.13381
Flannigan, Katherine, et al. Responding to the Unique Complexities of Fetal Alcohol Spectrum Disorder. Front Psychol 2022 Jan 25;12:778471. doi: 10.3389/fpsyg.2021.778471
American Academy of Pediatrics
Screening for Prenatal Alcohol Exposure: An Implementation Guide for Pediatric Primary Care Providers
Genetic Vulnerability of Fetus
Hemingway Astley, Susan J., et al. Twin study confirms virtually identical prenatal alcohol exposures can lead to markedly different fetal alcohol spectrum disorder outcomes - fetal genetics influences fetal vulnerability. Advances in Pediatric Research. 2019;5:23
FASD
Hagan, Joseph Jr., et al. Neurobehavioral disorder associated with prenatal alcohol exposure. Pediatrics 2016 Oct;138(4):e20151553
Glass, Leila, et al. Academic Difficulties in Children with Prenatal Alcohol Exposure: Presence, Profile, and Neural Correlates. Alcohol Clin Exp Res. 2017 May ; 41(5): 1024-1034 doi:10.1111/acer.13366
Glass, Leila, M.S. and Mattson, Sarah N. PhD. Fetal Alcohol Spectrum Disorders: A Case Study. J Pediatr Neuropsychol. 2017 June ; 3(2): 114–135. doi:10.1007/s40817-016-0027-7
Jirikowic,Tracy, et al. Prevalence and patterns of sensory processing behaviors in a large clinical sample of children with prenatal alcohol exposure. Research in Developmental Disabilities. 2020 May;100:103617.doi:10.1016/j.ridd.2020.103617
Astley, Susan, J., et al. The essential role of growth deficiency in the diagnosis of fetal alcohol spectrum disorder.Advances in Pediatric Research. 2016;3:9
McLachlanan, K., et al. Dysregulation of the cortisol diurnal rhythm following prenatal alcohol exposure and early life adversity.Alcohol.2016 June ; 53: 9–18. doi:10.1016/j.alcohol.2016.03.003
Jirikowic, Tracy, et al. Regulatory Behaviors and Stress Reactivity Among Infants at High Risk for Fetal Alcohol Spectrum Disorders: An Exploratory Study. Journal of Mental Health Research in Intellectual Disabilities. 9:3; 171-188. DOI: 10.1080/19315864.2016.1183246
James, Jan E., et al. Sleep health issues for children with FASD: Clinical considerations. Int J Pediatr. 2010; 2010:1–7
McLaughlin, Susan A., et al. Listening Difficulties in Children With Fetal Alcohol Spectrum Disorders: More Than a Problem of Audibility. J Speech Lang Hear Res. 2019 May 21;62(5):1532-1548. doi: 10.1044/2018_JSLHR-H-18-0359
Stephen, Julia M., et al. Delays in auditory processing identified in preschool children with FASD. Alcohol Clin Exp Res. 2012;36(10):1720-1727
Kalberg, Wendy O., et al. Early-life predictors of fetal alcohol spectrum disorders. Pediatrics.2019;144(6)e20182141
Rachappa, Mallikarjuna and Nalawade, Triveni. Alcohol, It’s Effect on Dental Structures and the Role of a Dentist. J Alcohol Drug Depend. 2014 Jan;2(4):166. DOI: 10.4172/2329-6488.1000166
Chen, Maida Lynn, et al. Sleep problems in children with fetal alcohol spectrum disorders. J Clin Sleep Med. 2012 Aug 15;8(4):421-9
Bell, Stephanie H., et al.The remarkably high prevalence of epilepsy and seizure history in fetal alcohol spectrum disorders. Alcohol Clin Exp Res. 2010 Jun;34(6):1084-9
Chasnoff, Ira, et al. Misdiagnosis and missed diagnoses in foster and adopted children with prenatal alcohol exposure. Pediatrics. 2015 Feb;135(2):264-70
Khazan, Olga.When ADHD Isn't What It Seems. The Atlantic. January 15, 2015
(Ira Chasnoff interview)
Jarlenski, Marian, et al. Polysubstance use among US women of reproductive age who use opioids for nonmedical reasons. Am J Public Health. 2017 August; 107(8): 1308–1310
Nutritional Supplementation and FASD (Choline)
Wozniak, Jeffrey R., et al. Four-year follow-up of a randomized controlled trial of choline for
neurodevelopment in fetal alcohol spectrum disorder.J Neurodev Disord..2020 Mar 12;12(1):9
"Children who received choline had higher non-verbal intelligence, higher visual-spatial skill, higher working memory ability, better verbal memory, and fewer behavioral symptoms of attention deficit hyperactivity disorder than the placebo group. No differences were seen for verbal intelligence, visual memory, or other executive functions.
These data support choline as a potential neurodevelopmental intervention for FASD and highlight the need for long-term follow-up to capture treatment effects on neurodevelopmental trajectories."
Jeffrey Wozniak PhD 2015 FASD Choline Supplementation Webinar Video
Active Study on Choline Supplementation as a Neurodevelopmental Intervention in Fetal Alcohol Spectrum Disorders Study (CHOLINE4) 2022
This is a randomized, double-blind controlled trial of choline supplementation in children with Fetal Alcohol Spectrum Disorders (FASD). The study is comparing two administration durations (3 months vs. 6 months) of choline. The primary outcome measures are cognitive measures.
Eligible: Children ages 30 to 72 months
For more information about participating in this study
Jeff Wozniak, University of Minnesota
For more information about previous choline studies
Collaborator:National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Northeast Conference on Fetal Alcohol Spectrum Disorders 2017
Colby College, Maine
Dr. Bell presented on the use of choline supplementation in the treatment of FASD, prenatally and in early childhood.
Jacobson, Sandra, et al. Efficacy of Maternal Choline Supplementation During Pregnancy in Mitigating Adverse Effects of Prenatal Alcohol Exposure on Growth and Cognitive Function: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. Alcohol Clin Exp Res. 2018 Jul;42(7):1327-1341
Kable, J.A., et al.The Impact of Micronutrient Supplementation in Alcohol Exposed Pregnancies on Information Processing Skills in Ukranian Infants. Alcohol 2015 Nov;49(7):647-656
Coles, Claire D., et al. Dose and Timing of Prenatal Alcohol Exposure and Maternal Nutritional Supplements: Developmental Effects on 6-Month-Old Infants. Matern Child Health J. 2015 Dec;19(12):2605-14
Adults with FASD
NIH/NIAAA Current Study
Fetal Alcohol Spectrum Disorders (FASD) in Adults: Health and Behavior
Principal Investigators: Claire Coles, Ph.D. (Emory University, Atlanta, Georgia), Therese Grant Ph.D. (University of Washington, Seattle, Washington)This current NIH/NIAAA-funded research addresses the deficit of research on adults with FASD with the following Specific Aims: 1) Establish a registry of 500 individuals, older than 30 years of age, with known alcohol exposure/FASD diagnosis or who are matched controls who will respond to a health survey, and who will be available for future studies; 2) Evaluate in depth current physical health, mental health, and functional status among affected individuals (FAS or FASD) and controls (120 from Seattle and 120 from Atlanta); with the goal of refining diagnostic criteria for FASD in this age group and determining the persistence and severity of disability associated with PAE. and 3) Assess immune status in collaboration with Dr. Weinberg (University of British Columbia) and identify outcomes associated with health indicators. 07/01/17 through 06/30/22
Advances in Research on Fetal Alcohol Spectrum Disorders.NIAAA Spectrum Fall 2020 12(3)
FASD Interventions
Carmichael Olson, Heather and Montague, Rachel A. An Innovative Look at Early Intervention
for Children Affected by Prenatal Alcohol Exposure. Prenatal Alcohol Use
and FASD: Diagnosis, Assessment and New Directions in Research and Multimodal Treatment,
2011, 64-107
Paley, Blair, Ph.D, O'Connor, Mary J. Ph.D. Behavioral Interventions for Children and Adolescents With Fetal Alcohol Spectrum Disorders. Alcohol Res Health. 2011; 34(1): 64–75
Petrenko, Christie L. M. PhD. Positive Behavioral Interventions and Family Support for Fetal Alcohol Spectrum Disorders. Curr Dev Disord Rep. 2015 Sep; 2(3): 199–209
Jirikowic,Tracy, et al.Children and Youth with Fetal Alcohol Spectrum Disorders: Summary of Intervention Recommendations after Diagnosis. Intellect Dev Disabil. 2010 Oct;48(5):330-44
Petrenko, Christie L. M., et al.The Association Between Parental Attributions of Misbehavior and Parenting Practices in Caregivers Raising Children with Prenatal Alcohol Exposure: A Mixed-Methods Study. Res Dev Disabil. 2016 Dec;59:255-267
“Caregivers who attributed their child's misbehavior to underlying neurodevelopmental disabilities were more likely to use antecedent strategies and feel more confident in managing their child's behavior. Parents who attributed their child's misbehavior to willful disobedience were more likely to rely on consequence strategies and feel more ineffective.”
FASD Sensory Processing Disorder Occupational Therapy
Jirikowic, Tracy L. et al. Prevalence and Patterns of Sensory Processing Behaviors in A Large Clinical Sample of Children with Prenatal Alcohol Exposure. Research in Developmental Disabilities 2020;(100) 105617
Fjeldsted, Brenda and Xue, Lin. Sensory Processing in Young Children with Fetal Alcohol Spectrum Disorder. Phys Occup Ther Pediatr2019;39(5):553-565
Franklin, Laureen, et al. Children with Fetal Alcohol Spectrum Disorders: Problem Behaviors and Sensory Processing. Am J Occup Ther. May-Jun 2008;62(3):265-73