{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T09:43:53Z","timestamp":1785836633461,"version":"3.56.0"},"reference-count":33,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["U01AA026108"],"award-info":[{"award-number":["U01AA026108"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["U01AA026101"],"award-info":[{"award-number":["U01AA026101"]}],"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":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Dysmorphology examinations have established that fetal alcohol spectrum disorders (\n                      <jats:styled-content style=\"fixed-case\">FASD<\/jats:styled-content>\n                      ) are associated with characteristic physical features from infancy through adolescence. As individuals mature into young adulthood and beyond, the aging process may attenuate characteristic features over time. The purpose of this study was to evaluate\n                      <jats:styled-content style=\"fixed-case\">FASD<\/jats:styled-content>\n                      \u2010related dysmorphology at midlife.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Subjects (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009192) were recruited from two longitudinal cohorts and from the general community (\n                      <jats:italic>M<\/jats:italic>\n                      <jats:sub>age<\/jats:sub>\n                      \u2009=\u200939.5\u2009years,\n                      <jats:styled-content style=\"fixed-case\">\n                        SD\n                        <jats:sub>age<\/jats:sub>\n                      <\/jats:styled-content>\n                      \u2009=\u20098.1\u2009years). A majority (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009132, 68.8%) had an\n                      <jats:styled-content style=\"fixed-case\">FASD<\/jats:styled-content>\n                      or well\u2010documented prenatal alcohol exposure (\n                      <jats:styled-content style=\"fixed-case\">PAE<\/jats:styled-content>\n                      ). Standard dysmorphology examinations of 23 physical features were conducted, blind to\n                      <jats:styled-content style=\"fixed-case\">FASD<\/jats:styled-content>\n                      \/\n                      <jats:styled-content style=\"fixed-case\">PAE<\/jats:styled-content>\n                      status. Participants were stratified into experimental groups according to actual or inferred degree of dysmorphology at the time of their initial examination in childhood or adolescence: high dysmorphology or low dysmorphology. Age\u2010matched controls with no diagnosed or suspected\n                      <jats:styled-content style=\"fixed-case\">FASD<\/jats:styled-content>\n                      formed the third experimental group. Hierarchical multiple and logistic regression analyses were conducted, regressing the 23 physical characteristics on age, race\/ethnicity, and sex (Block 1), experimental group (Block 2), and the two\u2010way interactions between experimental group and the demographic variables (Block 3).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Numerous main effects were found for the demographic variables. Controlling for these, main effects for experimental group were found for orbitofrontal circumference, palpebral fissure lengths, philtrum score, vermilion border score, hypoplastic midface, and camptodactyly. Demographics moderated effects of experimental group for philtrum length, philtrum score, and vermilion border score, cardinal features of\n                      <jats:styled-content style=\"fixed-case\">FASD<\/jats:styled-content>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Findings indicate that\n                      <jats:styled-content style=\"fixed-case\">PAE<\/jats:styled-content>\n                      \u2010related dysmorphological features persist into adulthood and further into midlife and may remain useful in diagnosis of\n                      <jats:styled-content style=\"fixed-case\">FASD<\/jats:styled-content>\n                      beyond young adulthood. However, as demographic factors appear to impact some of the cardinal features of\n                      <jats:styled-content style=\"fixed-case\">FASD<\/jats:styled-content>\n                      , age\u2010, gender\u2010, and race\u2010related norms and reference image sets for the sentinel features of\n                      <jats:styled-content style=\"fixed-case\">FASD<\/jats:styled-content>\n                      in adults of different ages may be helpful in diagnosing individuals in adulthood and beyond.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acer.70359","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T08:21:54Z","timestamp":1782807714000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prenatal Alcohol Exposure and Dysmorphic Features in Adults at Midlife"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8548-219X","authenticated-orcid":false,"given":"Susan A.","family":"Stoner","sequence":"first","affiliation":[{"name":"Fetal Alcohol and Drug Unit, Department of Psychiatry and Behavioral Sciences, Addictions, Drug &amp; Alcohol Institute University of Washington School of Medicine  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret L. P.","family":"Adam","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Washington School of Medicine  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7301-5700","authenticated-orcid":false,"given":"Tamara S.","family":"Bodnar","sequence":"additional","affiliation":[{"name":"Department of Biological Sciences University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3399-6644","authenticated-orcid":false,"given":"Claire D.","family":"Coles","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Del Campo Casanelles","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of California  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Therese M.","family":"Grant","sequence":"additional","affiliation":[{"name":"Fetal Alcohol and Drug Unit, Department of Psychiatry and Behavioral Sciences, Addictions, Drug &amp; Alcohol Institute University of Washington School of Medicine  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1655-5935","authenticated-orcid":false,"given":"Charlis","family":"Raineki","sequence":"additional","affiliation":[{"name":"Department of Psychology Brock University  St. Catherines Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7937-3904","authenticated-orcid":false,"given":"Joanne","family":"Weinberg","sequence":"additional","affiliation":[{"name":"Department of Cellular &amp; Physiological Sciences University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Collaborative Initiative on Fetal Alcohol Spectrum Disorders","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916\u2010024\u201003656\u2010w"},{"key":"e_1_2_9_3_1","first-page":"e416","article-title":"Validation of the Fetal Alcohol Spectrum Disorder (FASD) 4\u2010Digit Diagnostic Code","volume":"20","author":"Astley S. 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