Fetal Alcohol Syndrome is Increasing in the U.S.

Fetal alcohol spectrum disorders are a group of conditions that occur in a person whose mother drank alcohol during pregnancy. These effects can include physical or dysmorphic problems and deficits in learning and behavioral control. More often than not, fetal alcohol syndrome manifests as a combination of the aforementioned problems. A child born with fetal alcohol syndrome will experience lifelong disability.

Characteristics of fetal alcohol syndrome include:
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  • Sleep and sucking problems as an infant
  • Abnormal facial features, such as the absence of the philtrum
  • Shorter-stature
  • Low body weight
  • Small head size
  • Hyperactive behavior
  • Difficulty with attention
  • Memory problems
  • Poor coordination
  • Learning disabilities, especially difficulty with math
  • Speech and language delays
  • Low IQ
  • Poor reasoning
  • Vision or hearing problems
  • Problems with the heart, kidneys, or bones

Fetal Alcohol Syndrome Data

Previous data regarding the prevalence of fetal alcohol syndrome in the United States was 10 per 1000 children. Studies using in-person assessment of school-aged children in several U.S. communities report higher estimates of fetal alcohol syndrome: 6 to 9 out of 1,000 children. Newer data that includes a broader, more diverse demographic based on larger U.S. population samples has yielded surprising increases in fetal alcohol syndrome. May, Chambers, Kalberg, et al (2018) designed a cross-sectional study to more accurately assess the prevalence of fetal alcohol syndrome.

A cross-sectional design was employed to assess children for fetal alcohol spectrum disorders between 2010 and 2016 from four diverse areas of the U.S. A total of 6639 children were selected for participation from a pool of 13,146 first-graders (boys, 51.9%; mean age, 6.7 years [SD, 0.41], white maternal race, 79.3%), plus interviews with the child’s parent or guardian.

The conservative prevalence estimates for fetal alcohol spectrum disorders ranged from 11.3 (95%CI, 7.8-15.8) to 50.0 (95%CI, 39.9-61.7) per 1000 children. The weighted prevalence estimates for fetal alcohol spectrum disorders ranged from 31.1 (95%CI, 16.1-54.0) to 98.5 (95%CI, 57.5-139.5) per 1000 children.

Why Does This Matter?

These increases in fetal alcohol syndrome may be representative of an emerging trend toward underestimating the harm of psychoactive substances. Certainly this has occurred in the shifting attitudes regarding cannabis and is reflected in the staggering increase in prevalence.

The truth is—no amount of drinking is safe for pregnant women. The risk of fetal alcohol syndrome was established 50 years ago, yet it is increasing in our society.  Although drinking is socially accepted, statistically, alcohol remains the most dangerous drug in terms of morbidity and mortality in the U.S. Doctors need to send clear unambiguous messages to their pregnant or potentially pregnant patients regarding the dangers of alcohol use during pregnancy.


May PA, Chambers CD, Kalberg WO, et al. Prevalence of fetal alcohol spectrum disorders in 4 US communities [published online February 6, 2018]. JAMA. doi:10.1001/jama.2017.21896