Maternal alcohol consumption producing fetal alcohol spectrum disorders (FASD): quantity, frequency, and timing of drinking

Drug Alcohol Depend. 2013 Dec 1;133(2):502-12. doi: 10.1016/j.drugalcdep.2013.07.013. Epub 2013 Aug 8.


Background: Concise, accurate measures of maternal prenatal alcohol use are needed to better understand fetal alcohol spectrum disorders (FASD).

Methods: Measures of drinking by mothers of children with specific FASD diagnoses and mothers of randomly-selected controls are compared and also correlated with physical and cognitive/behavioral outcomes.

Results: Measures of maternal alcohol use can differentiate maternal drinking associated with FASD from that of controls and some from mothers of alcohol-exposed normals. Six variables that combine quantity and frequency concepts distinguish mothers of FASD children from normal controls. Alcohol use variables, when applied to each trimester and three months prior to pregnancy, provide insight on critical timing of exposure as well. Measures of drinking, especially bingeing, correlate significantly with increased child dysmorphology and negative cognitive/behavioral outcomes in children, especially low non-verbal IQ, poor attention, and behavioral problems. Logistic regression links (p<.001) first trimester drinking (vs. no drinking) with FASD, elevating FASD likelihood 12 times; first and second trimester drinking increases FASD outcomes 61 times; and drinking in all trimesters 65 times. Conversely, a similar regression (p=.008) indicates that drinking only in the first trimester makes the birth of a child with an FASD 5 times less likely than drinking in all trimesters.

Conclusions: There is significant variation in alcohol consumption both within and between diagnostic groupings of mothers bearing children diagnosed within the FASD continuum. Drinking measures are empirically identified and correlated with specific child outcomes. Alcohol use, especially heavy use, should be avoided throughout pregnancy.

Keywords: Alcohol use and abuse; Cognition; Dysmorphology; Fetal alcohol spectrum disorders; Prenatal alcohol use; South Africa; Women.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Alcohol Drinking / adverse effects*
  • Anthropometry
  • Binge Drinking / complications
  • Central Nervous System Depressants / adverse effects*
  • Central Nervous System Depressants / blood
  • Data Interpretation, Statistical
  • Ethanol / adverse effects*
  • Ethanol / blood
  • Executive Function
  • Female
  • Fetal Alcohol Spectrum Disorders / etiology*
  • Fetal Alcohol Spectrum Disorders / pathology
  • Fetal Alcohol Spectrum Disorders / psychology
  • Humans
  • Infant, Newborn
  • Intelligence Tests
  • Mothers
  • Neuropsychological Tests
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy Trimester, First
  • Pregnancy Trimester, Second
  • Pregnancy Trimester, Third
  • Regression Analysis
  • Surveys and Questionnaires
  • Wechsler Scales


  • Central Nervous System Depressants
  • Ethanol