National trend of fetal alcohol syndrome incidence in the United States

Objectives: Alcohol use during pregnancy is linked to adverse infant health outcomes including Fetal Alcohol Syndrome (FAS). FAS rates have been estimated for a number of years but not readily available to establish a trend. This study estimates the trend and number of FAS cases across socio-demographic groups in U.S since 1985. Methods: Prevalence of maternal binge drinking during 1985-2005 was estimated from the Behavioral Risk Factor Surveillance System. FAS rates from available years and prevalence of binge drinking were used to compute the risk of FAS for each year from 1985-1991. A simulation model was developed to estimate the number of FAS cases born by women ages 15-44 during 1985-2005. Additional data came from national vital statistics. Results: The trend of FAS incidence is flat over 1988-2005. The number of cases in the three-year interval was 1,977 during 1988-1990, 1,964 during 1996-1998, and 1,948 during 2003-2005. FAS rate is significantly higher among non-Hispanic Blacks (8.27 cases per 10,000 births) compared to non-Hispanic Whites (1.10 cases per 10,000 births) in 2005. Conclusions: FAS is still a significant challenge to child health. The absolute number of cases has not changed much over time. Positive factors (interventions, polices aiming to reduce maternal drinking) could have been offset by “negative” factors (such as population growth, increase in number of “hard” drinkers). Although African-American women tend to drink less in general and during pregnancy, a group of “hard drinkers” can be largely responsible for FAS. Interventions specifically targeting heavy drinkers during pregnancy are necessary.