{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T06:32:53Z","timestamp":1777962773835,"version":"3.51.4"},"reference-count":63,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,1,8]],"date-time":"2024-01-08T00:00:00Z","timestamp":1704672000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["AA015134"],"award-info":[{"award-number":["AA015134"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alcohol, Clinical and Experimental Research"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A variety of maternal risk factors for fetal alcohol spectrum disorders (FASD) have been described in the literature. Here, we conducted a multivariate analysis of a large array of potential distal influences on FASD risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Interviews were conducted with 2515 mothers of first\u2010grade students whose children were evaluated to assess risk for FASD. Topics included: physical\/medical status, childbearing history, demographics, mental health, domestic violence, and trauma. Regression modeling utilized usual level of alcohol consumption by trimester and six selected distal variables (maternal head circumference, body mass index, age at pregnancy, gravidity, marital status, and formal years of education) to differentiate children with FASD from control children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Despite individual variation in distal maternal risk factors among and within the mothers of children with each of the common diagnoses of FASD, patterns emerged that differentiated risk among mothers of children with FASD from mothers whose children were developing typically. Case\u2010control comparisons indicate that mothers of children with FASD were significantly smaller physically, had higher gravidity and parity, and experienced more miscarriages and stillbirths, were less likely to be married, reported later pregnancy recognition, more depression, and lower formal educational achievement. They were also less engaged with a formal religion, were less happy, suffered more childhood trauma and interpersonal violence, were more likely to drink alone or with her partner, and drank to deal with anxiety, tension, and to be part of a group. Regression analysis showed that the predictor variables explain 57.5% of the variance in fetal alcohol syndrome (FAS) diagnoses, 30.1% of partial FAS (PFAS) diagnoses, and 46.4% of alcohol\u2010related neurodevelopmental disorder (ARND) diagnoses in children with FASD compared to controls. While the proximal variables explained most of the diagnostic variance, six distal variables explained 16.7% (<jats:sup>1<\/jats:sup>\/<jats:sub>6<\/jats:sub>) of the variance in FAS diagnoses, 13.9% (<jats:sup>1<\/jats:sup>\/<jats:sub>7<\/jats:sub>) of PFAS, and 12.1% (<jats:sup>1<\/jats:sup>\/<jats:sub>8<\/jats:sub>) of ARND.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Differences in distal FASD risks were identified. Complex models to quantify risk for FASD hold promise for guiding prevention\/intervention.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.15246","type":"journal-article","created":{"date-parts":[[2023,12,18]],"date-time":"2023-12-18T01:53:10Z","timestamp":1702864390000},"page":"319-344","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Maternal risk factors for fetal alcohol spectrum disorders: Distal variables"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1939-8701","authenticated-orcid":false,"given":"Philip A.","family":"May","sequence":"first","affiliation":[{"name":"Nutrition Research Institute The University of North Carolina at Chapel Hill  Kannapolis North Carolina USA"},{"name":"Department of Psychiatry, Faculty of Medicine and Health Sciences Stellenbosch Universitye  Cape Town South Africa"},{"name":"Center on Alcoholism, Substance Abuse and Addictions The University of New Mexico  Albuquerque New Mexico USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie M.","family":"Hasken","sequence":"additional","affiliation":[{"name":"Nutrition Research Institute The University of North Carolina at Chapel Hill  Kannapolis North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marlene M.","family":"de Vries","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine and Health Sciences Stellenbosch Universitye  Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna\u2010Susan","family":"Marais","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine and Health Sciences Stellenbosch Universitye  Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Abdul\u2010Rahman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, New York\u2010 Presbyterian Weill Cornell Medicine Columbia University  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luther K.","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics State University of New York  Buffalo New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret P.","family":"Adam","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melanie A.","family":"Manning","sequence":"additional","affiliation":[{"name":"Department of Pathology and Pediatrics Stanford University School of Medicine  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wendy O.","family":"Kalberg","sequence":"additional","affiliation":[{"name":"Center on Alcoholism, Substance Abuse and Addictions The University of New Mexico  Albuquerque New Mexico USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Buckley","sequence":"additional","affiliation":[{"name":"Center on Alcoholism, Substance Abuse and Addictions The University of New Mexico  Albuquerque New Mexico USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cudore L.","family":"Snell","sequence":"additional","affiliation":[{"name":"School of Social Work Howard University  Washington District of Columbia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soraya","family":"Seedat","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine and Health Sciences Stellenbosch Universitye  Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9787-2785","authenticated-orcid":false,"given":"Charles D. H.","family":"Parry","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine and Health Sciences Stellenbosch Universitye  Cape Town South Africa"},{"name":"Alcohol, Tobacco and Other Drug Research Unit South African Medical Research Council, Francie van Zijl Drive  Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. Eugene","family":"Hoyme","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine and Health Sciences Stellenbosch Universitye  Cape Town South Africa"},{"name":"Sanford Children's Genomic Medicine Consortium Sanford Health  Sioux Falls South Dakota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,1,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/13556210410001716980"},{"key":"e_1_2_9_3_1","volume-title":"Manual for the ASEBA school\u2010age forms and profiles","author":"Achenbach T.","year":"2001"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.15288\/jsad.2011.72.536"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0145-2134(02)00541-0"},{"key":"e_1_2_9_6_1","volume-title":"Test of reception of grammar (TROG)","author":"Bishop D.","year":"1989"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.13504"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2014.10.017"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.14213"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22168785"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291796004229"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00787-014-0603-2"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-52336-w"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2018.09.008"},{"key":"e_1_2_9_15_1","volume-title":"WHO Multi\u2010Country Study on Women\u2019s Health and Domestic Violence against Women: Initial Results on Prevalence, Health Outcomes and Women's Responses","author":"Garcia\u2010Moreno C.","year":"2005"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crtox.2023.100105"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-4256"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-0259"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.12876"},{"key":"e_1_2_9_20_1","volume-title":"IBM SPSS Statistics for Windows","author":"IBM","year":"2021"},{"key":"e_1_2_9_21_1","volume-title":"Kaufman assessment battery for children","author":"Kaufman A.","year":"2004"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2020.20091375"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.alcohol.2023.01.004"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.encep.2014.08.012"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2017.1919"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.12033"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2013.07.013"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph14050522"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2015.12.023"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.14922"},{"key":"e_1_2_9_31_1","first-page":"15","article-title":"Maternal risk factors for fetal alcohol Spectrum disorders: not as simple as it might seem","volume":"34","author":"May P.A.","year":"2011","journal-title":"Alcohol Research & Health"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/ddrr.68"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2006.11.007"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.2008.00634.x"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.reprotox.2014.02.002"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.14314"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.14315"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.15193"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.reprotox.2018.02.002"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.14313"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.108408"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2016.09.025"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00787-018-1264-3"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2018.10.013"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-017-2407-8"},{"key":"e_1_2_9_46_1","volume-title":"Clinical guide to alcohol treatment: the community reinforcement approach","author":"Meyers R.J.","year":"1995"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S85403"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.13425"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1139\/bcb-2017-0077"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17217986"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1093\/acref\/9780199976720.001.0001"},{"key":"e_1_2_9_52_1","unstructured":"Raven J.(1981)Manual for Raven's Progressive Matrices and Vocabulary Scales. Research Supplement No.1: The 1979 British Standardisation of the Standard Progressive Matrices and Mill Hill Vocabulary Scales together with Comparative Data from Earlier Studies in the UK. San Antonio TX Harcourt Assessment."},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-022578"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-38055-3"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1081\/JA-100102628"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4612-0357-5_3"},{"key":"e_1_2_9_57_1","volume-title":"Fetal alcohol syndrome: diagnosis, epidemiology, prevention, and treatment","author":"Stratton K.","year":"1996"},{"key":"e_1_2_9_58_1","first-page":"463","volume-title":"Handbook of clinical neurology","author":"Sulik K.K.","year":"2014"},{"key":"e_1_2_9_59_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI167624"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1983.01790100013001"},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.15288\/jsad.2017.78.795"},{"key":"e_1_2_9_62_1","volume-title":"Wechsler intelligence scale for children","author":"Wechsler D.","year":"2003"},{"key":"e_1_2_9_63_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.114.099168"},{"key":"e_1_2_9_64_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.2008.26811F"}],"container-title":["Alcohol, Clinical and Experimental Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acer.15246","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T10:55:41Z","timestamp":1707303341000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acer.15246"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,8]]},"references-count":63,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1111\/acer.15246"],"URL":"https:\/\/doi.org\/10.1111\/acer.15246","archive":["Portico"],"relation":{},"ISSN":["2993-7175","2993-7175"],"issn-type":[{"value":"2993-7175","type":"print"},{"value":"2993-7175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,8]]},"assertion":[{"value":"2023-08-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}