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Maternal and paternal data were reported by mothers of children with an FASD diagnosis and controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Interviews were conducted with mothers of children with an FASD (<jats:italic>n<\/jats:italic>\u2009=\u2009114) and controls (<jats:italic>n<\/jats:italic>\u2009=\u2009753). Fifty\u2010seven percent of control mothers usually drank 2.7 drinks per drinking day (DDD) once per month prior to pregnancy, and 79% of mothers of children with FASD reported drinking 4.2 drinks 1\u20132 times per week. Mothers of children with alcohol\u2010related neurodevelopmental disorder reported the most alcohol consumption overall: bingeing, drinking frequency, drinking in each trimester, and other drug use. Mothers of children with fetal alcohol syndrome (FAS) and partial FAS (PFAS) underreported consumption. Distal maternal risk factors were liver problems, depression, later pregnancy recognition and first prenatal visit, lower frequency of marriage, and lower spirituality. Postnatal risk indicators were low birthweight and gestational age. Regression analysis indicated that maternal reports of three DDD before pregnancy were associated with a diagnosis within the FASD continuum (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, OR\u2009=\u20099.92). First\u2010trimester exposure (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, OR\u2009=\u20097.64) and all three trimesters (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, OR\u2009=\u20097.77) were associated with a child's FASD diagnosis. An independent association was found between paternal DDD during pregnancy and FASD diagnoses (<jats:italic>p<\/jats:italic>\u2009=\u20090.002, OR\u2009=\u20091.08); but, once maternal drinking was a covariate, paternal influence was not significant. Stepwise models indicated that combined maternal alcohol use measures (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, <jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200961.09), later pregnancy recognition (<jats:italic>p<\/jats:italic>\u2009=\u20090.032, <jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20094.58), later prenatal visits (<jats:italic>p<\/jats:italic>\u2009=\u20090.036, <jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20094.38), and depression in lifetime (<jats:italic>p<\/jats:italic>\u2009=\u20090.002, <jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20099.47) were significant FASD predictors. The final 10\u2010step model explained 27.4% of the variance in FASD risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>While multiple, significant maternal risk factors for FASD were identified, paternal drinking was not a statistically significant, independent risk factor.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.15501","type":"journal-article","created":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T01:58:26Z","timestamp":1734055106000},"page":"185-204","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Maternal and paternal risk factors associated with diagnoses within the continuum of fetal alcohol spectrum disorders in the <scp>USA<\/scp>: Proximal and distal influences"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1939-8701","authenticated-orcid":false,"given":"Philip A.","family":"May","sequence":"first","affiliation":[{"name":"Nutrition Research Institute University of North Carolina at Chapel Hill  Kannapolis NC USA"},{"name":"Center on Alcohol, Substance Use, and Addictions University of New Mexico  Albuquerque NM USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie M.","family":"Hasken","sequence":"additional","affiliation":[{"name":"Nutrition Research Institute University of North Carolina at Chapel Hill  Kannapolis NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie M.","family":"Stegall","sequence":"additional","affiliation":[{"name":"Nutrition Research Institute University of North Carolina at Chapel Hill  Kannapolis NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather A.","family":"Mastro","sequence":"additional","affiliation":[{"name":"Nutrition Research Institute University of North Carolina at Chapel Hill  Kannapolis NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Baete","sequence":"additional","affiliation":[{"name":"Sanford Health  Sioux Falls SD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaymi","family":"Russo","sequence":"additional","affiliation":[{"name":"Sanford Health  Sioux Falls SD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosemary","family":"Bozeman","sequence":"additional","affiliation":[{"name":"City\/County Health Department  USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Kay","family":"Burns","sequence":"additional","affiliation":[{"name":"City\/County Health Department  USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo\u2010Viviane","family":"Jones","sequence":"additional","affiliation":[{"name":"City\/County Health Department  USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wendy O.","family":"Kalberg","sequence":"additional","affiliation":[{"name":"Center on Alcohol, Substance Use, and Addictions University of New Mexico  Albuquerque NM USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Buckley","sequence":"additional","affiliation":[{"name":"Center on Alcohol, Substance Use, and Addictions University of New Mexico  Albuquerque NM USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Abdul\u2010Rahman","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Pediatrics Cornell University  New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret P.","family":"Adam","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Pediatrics University of Washington  Seattle WA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamison","family":"Jewett","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Pediatrics Wake Forest University  Winston\u2010Salem NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luther K.","family":"Robinson","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Pediatrics State University of New York at Buffalo  Buffalo NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melanie A.","family":"Manning","sequence":"additional","affiliation":[{"name":"Department of Pathology, School of Medicine Stanford University  Palo Alto CA USA"},{"name":"Department of Pediatrics, School of Medicine Stanford University  Palo Alto CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. 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