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In Cohort Sample 1, all consented small children (\u226425th centile on height, weight, and\/or head circumference) entered the study along with a random sample from all enrolled students. Cohort Sample 2 was drawn totally at random. Child growth, dysmorphology, and neurobehavior were assessed using the Collaboration on FASD Prevalence (CoFASP) criteria, and mothers were interviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For the samples combined, 891 children received dysmorphology examinations, and 692 were case\u2010conferenced for final diagnosis. Forty\u2010four children met criteria for FASD. Total dysmorphology scores differentiated diagnostic groups: fetal alcohol syndrome (FAS), 16.7; partial FAS, 11.8; alcohol\u2010related neurodevelopmental disorder (ARND), 6.1; and typically developing controls, 4.2. Neurobehavioral tests distinguished children with FASD from controls, more for behavioral problems than cognitive delay. Children with ARND demonstrated the poorest neurobehavioral indicators. An adjusted regression model of usual prepregnancy drinking indicated that maternal reports of 3 drinks per drinking day (DDD) were\u00a0significantly associated with a FASD diagnosis (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.020, OR\u00a0=\u00a010.1, 95% CI\u00a0=\u00a01.44 to 70.54), as were 5 or more DDD (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001, OR\u00a0=\u00a026.47, 95% CI\u00a0=\u00a04.65 to 150.62). Other significant maternal risk factors included the following: self\u2010reported drinking in any trimester; smoking and cocaine use during pregnancy; later pregnancy recognition and later and less prenatal care; lower maternal weight, body mass index (BMI), and head circumference; and unmarried status. There was no significant difference in FASD prevalence by race, Hispanic ethnicity, or socioeconomic status at this site, where the prevalence of FASD was 14.4 to 41.2 per 1,000 (1.4 to 4.1%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This city displayed the lowest prevalence of FASD of the 4 CoFASP sites. Nevertheless, FASD were common, and affected children demonstrated a common, recognizable, and measurable array of traits.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.14314","type":"journal-article","created":{"date-parts":[[2020,4,15]],"date-time":"2020-04-15T15:00:59Z","timestamp":1586962859000},"page":"919-938","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Fetal Alcohol Spectrum Disorders in a Midwestern City: Child Characteristics, Maternal Risk Traits, and Prevalence"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1939-8701","authenticated-orcid":false,"given":"Philip A.","family":"May","sequence":"first","affiliation":[{"name":"Department of Nutrition Nutrition Research Institute University of North Carolina Chapel Hill North Carolina"},{"name":"Center on Alcoholism, Substance Abuse and Addictions (CASAA) University of New Mexico Albuquerque New Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie M.","family":"Hasken","sequence":"additional","affiliation":[{"name":"Department of Nutrition Nutrition Research Institute University of North Carolina Chapel Hill North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Baete","sequence":"additional","affiliation":[{"name":"Sanford Research Sioux Falls South Dakota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaymi","family":"Russo","sequence":"additional","affiliation":[{"name":"Sanford Research Sioux Falls South Dakota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy J.","family":"Elliott","sequence":"additional","affiliation":[{"name":"Avera Research Sioux Falls South Dakota"},{"name":"Department of Pediatrics Sanford School of Medicine University of South Dakota Sioux Falls South Dakota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy O.","family":"Kalberg","sequence":"additional","affiliation":[{"name":"Center on Alcoholism, Substance Abuse and Addictions (CASAA) University of New Mexico Albuquerque New Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Buckley","sequence":"additional","affiliation":[{"name":"Center on Alcoholism, Substance Abuse and Addictions (CASAA) University of New Mexico Albuquerque New Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marita","family":"Brooks","sequence":"additional","affiliation":[{"name":"Center on Alcoholism, Substance Abuse and Addictions (CASAA) University of New Mexico Albuquerque New Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marian A.","family":"Ortega","sequence":"additional","affiliation":[{"name":"Center on Alcoholism, Substance Abuse and Addictions (CASAA) University of New Mexico Albuquerque New Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dixie M.","family":"Hedrick","sequence":"additional","affiliation":[{"name":"Department of Nutrition Nutrition Research Institute University of North Carolina Chapel Hill North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara G.","family":"Tabachnick","sequence":"additional","affiliation":[{"name":"California State University, Northridge Northridge California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Abdul\u2010Rahman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Nebraska College of Medicine Omaha Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret P.","family":"Adam","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Washington School of Medicine Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamison","family":"Jewett","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Wake Forest University School of Medicine Winston\u2010Salem North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luther K.","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics State University of New York at Buffalo School of Medicine and Biomedical Sciences Buffalo New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie A.","family":"Manning","sequence":"additional","affiliation":[{"name":"Departments of Pathology and Pediatrics Stanford University School of Medicine Stanford California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. 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