{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T06:38:31Z","timestamp":1770014311714,"version":"3.49.0"},"reference-count":75,"publisher":"American Public Health Association","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[2005,7]]},"abstract":"<jats:p> Objectives. We defined risk factors for fetal alcohol syndrome (FAS) in a region with the highest documented prevalence of FAS in the world. <\/jats:p><jats:p> Methods. We compared mothers of 53 first-grade students with FAS (cases) with 116 randomly selected mothers of first-grade students without FAS (controls). <\/jats:p><jats:p> Results. Differences between case and control mothers in our study population existed regarding socioeconomic status, religiosity, education, gravidity, parity, and marital status. Mothers of children with FAS came from alcohol-abusing families in which heavy drinking was almost universal; control mothers drank little to no alcohol. Current and past alcohol use by case mothers was characterized by heavy binge drinking on weekends, with no reduction of use during pregnancy in 87% of the mothers. Twenty percent of control mothers drank during pregnancy, a rate that declined to 12.7% by the third trimester. The percentage who smoked during pregnancy was higher for case mothers than for control mothers (75.5% vs 30.3%), but the number of cigarettes smoked was low among case mothers. The incidence of FAS in offspring of relatively young women (28 years) was not explained by early drinking onset or years of drinking (mean, 7.6 years among case mothers). In addition to traditional FAS risk factors, case mothers were smaller in height, weight, head circumference, and body mass index, all anthropomorphic measures that indicate poor nutrition and second-generation fetal alcohol exposure. <\/jats:p><jats:p> Conclusions. Preventive interventions are needed to address maternal risk factors for FAS. <\/jats:p>","DOI":"10.2105\/ajph.2003.037093","type":"journal-article","created":{"date-parts":[[2005,6,3]],"date-time":"2005-06-03T00:50:15Z","timestamp":1117759815000},"page":"1190-1199","source":"Crossref","is-referenced-by-count":145,"title":["Maternal Risk Factors for Fetal Alcohol Syndrome in the Western Cape Province of South Africa: A Population-Based Study"],"prefix":"10.2105","volume":"95","author":[{"given":"Philip A.","family":"May","sequence":"first","affiliation":[{"name":"Philip A. May and J. Phillip Gossage are with The University of New Mexico Center on Alcoholism, Substance Abuse and Addictions, Albuquerque. Lesley E. Brooke, Anna-Susan Marais, and Loretta S. Hendricks are with the University of Cape Town and the Foundation for Alcohol Related Research, Cape Town, Republic of South Africa. Cudore L. Snell is with the Department of Social Work, Howard University, Washington, DC. Julie A. Croxford is with the Department of Psychiatry and Behavioral Neurosciences, Wayne..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Phillip","family":"Gossage","sequence":"additional","affiliation":[{"name":"Philip A. May and J. Phillip Gossage are with The University of New Mexico Center on Alcoholism, Substance Abuse and Addictions, Albuquerque. Lesley E. Brooke, Anna-Susan Marais, and Loretta S. Hendricks are with the University of Cape Town and the Foundation for Alcohol Related Research, Cape Town, Republic of South Africa. Cudore L. Snell is with the Department of Social Work, Howard University, Washington, DC. Julie A. Croxford is with the Department of Psychiatry and Behavioral Neurosciences, Wayne..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lesley E.","family":"Brooke","sequence":"additional","affiliation":[{"name":"Philip A. May and J. Phillip Gossage are with The University of New Mexico Center on Alcoholism, Substance Abuse and Addictions, Albuquerque. Lesley E. Brooke, Anna-Susan Marais, and Loretta S. Hendricks are with the University of Cape Town and the Foundation for Alcohol Related Research, Cape Town, Republic of South Africa. Cudore L. Snell is with the Department of Social Work, Howard University, Washington, DC. Julie A. Croxford is with the Department of Psychiatry and Behavioral Neurosciences, Wayne..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cudore L.","family":"Snell","sequence":"additional","affiliation":[{"name":"Philip A. May and J. Phillip Gossage are with The University of New Mexico Center on Alcoholism, Substance Abuse and Addictions, Albuquerque. Lesley E. Brooke, Anna-Susan Marais, and Loretta S. Hendricks are with the University of Cape Town and the Foundation for Alcohol Related Research, Cape Town, Republic of South Africa. Cudore L. Snell is with the Department of Social Work, Howard University, Washington, DC. Julie A. Croxford is with the Department of Psychiatry and Behavioral Neurosciences, Wayne..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna-Susan","family":"Marais","sequence":"additional","affiliation":[{"name":"Philip A. May and J. Phillip Gossage are with The University of New Mexico Center on Alcoholism, Substance Abuse and Addictions, Albuquerque. Lesley E. Brooke, Anna-Susan Marais, and Loretta S. Hendricks are with the University of Cape Town and the Foundation for Alcohol Related Research, Cape Town, Republic of South Africa. Cudore L. Snell is with the Department of Social Work, Howard University, Washington, DC. Julie A. Croxford is with the Department of Psychiatry and Behavioral Neurosciences, Wayne..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loretta S.","family":"Hendricks","sequence":"additional","affiliation":[{"name":"Philip A. May and J. Phillip Gossage are with The University of New Mexico Center on Alcoholism, Substance Abuse and Addictions, Albuquerque. Lesley E. Brooke, Anna-Susan Marais, and Loretta S. Hendricks are with the University of Cape Town and the Foundation for Alcohol Related Research, Cape Town, Republic of South Africa. Cudore L. Snell is with the Department of Social Work, Howard University, Washington, DC. Julie A. Croxford is with the Department of Psychiatry and Behavioral Neurosciences, Wayne..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie A.","family":"Croxford","sequence":"additional","affiliation":[{"name":"Philip A. May and J. Phillip Gossage are with The University of New Mexico Center on Alcoholism, Substance Abuse and Addictions, Albuquerque. Lesley E. Brooke, Anna-Susan Marais, and Loretta S. Hendricks are with the University of Cape Town and the Foundation for Alcohol Related Research, Cape Town, Republic of South Africa. Cudore L. Snell is with the Department of Social Work, Howard University, Washington, DC. Julie A. Croxford is with the Department of Psychiatry and Behavioral Neurosciences, Wayne..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denis L.","family":"Viljoen","sequence":"additional","affiliation":[{"name":"Philip A. May and J. Phillip Gossage are with The University of New Mexico Center on Alcoholism, Substance Abuse and Addictions, Albuquerque. Lesley E. Brooke, Anna-Susan Marais, and Loretta S. Hendricks are with the University of Cape Town and the Foundation for Alcohol Related Research, Cape Town, Republic of South Africa. Cudore L. Snell is with the Department of Social Work, Howard University, Washington, DC. Julie A. Croxford is with the Department of Psychiatry and Behavioral Neurosciences, Wayne..."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"844","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1300\/J251v06n04_08"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1097\/00003081-199306000-00005"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.1991.tb00519.x"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.1999.tb04195.x"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(87)90199-2"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1986.tb40323.x"},{"key":"R7","doi-asserted-by":"crossref","unstructured":"May A, Hymbaugh KJ, Aase JM, Samet JM. Epidemiology of fetal alcohol syndrome among American Indians of the Southwest. Soc Biol. 1983;30:374\u2013387.","DOI":"10.1080\/19485565.1983.9988551"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.90.12.1905"},{"key":"R9","doi-asserted-by":"crossref","unstructured":"Viljoen D, Croxford J, Gossage JP, Kodituwakku PW, May PA. Characteristics of mothers of children with fetal alcohol syndrome in the Western Cape Province of South Africa: a case\u2013control study. J Stud Alcohol. 2002;63:6\u201317.","DOI":"10.15288\/jsa.2002.63.6"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.16.4.296"},{"key":"R11","unstructured":"May PA, Hymbaugh KJ. A pilot project on fetal alcohol syndrome among American Indians. Alcohol Health Res World. 1982;7:3\u20139."},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.15288\/jsa.1989.50.508"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.3109\/10826089509104417"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.1980.tb05628.x"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.1001\/jama.265.7.876"},{"key":"R17","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.alcalc.a044880"},{"key":"R18","unstructured":"Godel JC, Pabst HF, Hodges PE, et al. Smoking and caffeine and alcohol intake during pregnancy in a northern population: effect on fetal growth. Can Med Assoc J. 1992;147:181\u2013187."},{"key":"R20","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1986.tb40323.x"},{"key":"R21","unstructured":"Abel EL, Sokol RJ. Maternal and fetal characteristics affecting alcohol\u2019s teratogenicity. Neurobehav Toxicol Teratol. 1986;8:329\u2013334."},{"key":"R22","doi-asserted-by":"publisher","DOI":"10.1300\/J013v18n04_03"},{"key":"R23","doi-asserted-by":"publisher","DOI":"10.1016\/0892-0362(95)00005-C"},{"key":"R24","doi-asserted-by":"publisher","DOI":"10.1016\/0892-0362(95)98055-6"},{"key":"R25","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.1996.tb01653.x"},{"key":"R26","unstructured":"Kodituwakku PW, Kalberg W, May PA. The effects of prenatal alcohol exposure on executive functioning. Alcohol Res Health. 2001;25:192\u2013198."},{"key":"R27","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.1999.tb04077.x"},{"key":"R28","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617799555082"},{"key":"R29","unstructured":"May PA, Gossage JP. Estimating the prevalence of fetal alcohol syndrome: a summary. Alcohol Res Health. 2001;25:159\u2013167."},{"key":"R30","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9926(199711)56:5<317::AID-TERA5>3.0.CO;2-U"},{"key":"R31","unstructured":"May P, Gossage J, Brooke L, Croxford J, Viljoen D. An epidemiological analysis of a second wave of data from children with fetal alcohol syndrome and controls in the Western Cape, South Africa [abstract 208]. Alcohol Clin Exp Res. 2000;24:41A."},{"key":"R32","unstructured":"Viljoen DL, Craig P, Hymbaugh K, Boyle C, Blount S. FAS in South Africa, 2001. MMWR Morb Mortal Wkly Rep. 2003;52:660\u2013662."},{"key":"R34","doi-asserted-by":"publisher","DOI":"10.1300\/J251v06n04_08"},{"key":"R36","doi-asserted-by":"publisher","DOI":"10.1097\/00003081-199306000-00005"},{"key":"R37","unstructured":"Centers for Disease Control and Prevention. Alcohol consumption among pregnant and child-bearing aged women: United States, 1991 and 1995. MMWR Morb Mortal Wkly Rep. 1997;46:346\u2013350."},{"key":"R38","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/20.4.927"},{"key":"R39","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.pubmed.a042822"},{"key":"R41","unstructured":"Croxford J, Viljoen D. Alcohol consumption by pregnant women in the Western Cape. S Afr Med J. 1999;89:962\u2013965."},{"key":"R42","doi-asserted-by":"publisher","DOI":"10.1001\/jama.268.14.1877"},{"key":"R43","doi-asserted-by":"publisher","DOI":"10.1016\/0741-8329(91)90870-3"},{"key":"R44","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1996.01830030020005"},{"key":"R45","doi-asserted-by":"publisher","DOI":"10.1002\/j.1879-3479.1979.tb00476.x"},{"key":"R46","doi-asserted-by":"publisher","DOI":"10.1177\/000992288402300515"},{"key":"R47","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-199304000-00001"},{"key":"R48","unstructured":"Wilsnack SC. Women at high risk for alcohol abuse. The Counselor. 1989;7(1):16\u201317, 29."},{"key":"R49","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.81.3.305"},{"key":"R50","unstructured":"Wilsnack SC. Sexuality and women\u2019s drinking. Alcohol Health Res World. 1991;15:147\u2013150."},{"key":"R52","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.1991.tb01767.x"},{"key":"R53","doi-asserted-by":"publisher","DOI":"10.1300\/J013v19n04_04"},{"key":"R54","unstructured":"Schlesinger S, Susman M, Koenigsberg J. Self-esteem and purpose of life: a comparative study of women alcoholics. J Alcohol Drug Educ. 1990;36:127\u2013141."},{"key":"R55","doi-asserted-by":"publisher","DOI":"10.1080\/09595239000185181"},{"key":"R56","doi-asserted-by":"publisher","DOI":"10.3109\/00952999009001591"},{"key":"R57","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.2001.tb02180.x"},{"key":"R58","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.c.30011"},{"key":"R59","doi-asserted-by":"publisher","DOI":"10.1016\/0899-3289(93)90119-V"},{"key":"R60","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.1990.tb03069.x"},{"key":"R62","doi-asserted-by":"publisher","DOI":"10.1016\/S0376-8716(99)00120-9"},{"key":"R63","doi-asserted-by":"publisher","DOI":"10.1016\/S0376-8716(99)00121-0"},{"key":"R65","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1995.02170250031004"},{"key":"R66","unstructured":"Maier SE, West JR. Drinking patterns and alcohol-related birth defects. Alcohol Res Health. 2001;25: 168\u2013174."},{"key":"R67","doi-asserted-by":"publisher","DOI":"10.1016\/0741-8329(86)90036-4"},{"key":"R68","unstructured":"Goodlett CR, Horn K. Mechanisms of alcohol-induced damage to the developing nervous system. Alcohol Res Health. 2001;25:175\u2013184."},{"key":"R69","unstructured":"Mattson SN, Schoenfeld AM, Riley EP. Teratogenic effects of alcohol on brain and behavior. Alcohol Res Health. 2001;25:185\u2013191."},{"key":"R70","unstructured":"Parry CDH. Alcohol problems in developing countries: challenges for the new millennium. Suchtmedizin in Forschung und Praxis. 2000;2:216\u2013220."},{"key":"R72","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.2001.tb02250.x"},{"key":"R73","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.84.2.294"},{"key":"R74","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.1988.tb00485.x"},{"key":"R75","doi-asserted-by":"publisher","DOI":"10.1081\/JA-100102628"},{"key":"R76","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.90.8.1260"},{"key":"R77","doi-asserted-by":"publisher","DOI":"10.15288\/jsa.1990.51.403"},{"key":"R78","doi-asserted-by":"publisher","DOI":"10.15288\/jsa.1990.51.68"},{"key":"R79","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.1996.tb01653.x"},{"key":"R80","doi-asserted-by":"publisher","DOI":"10.15288\/jsa.2002.63.352"},{"key":"R81","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.2002.tb02622.x"},{"key":"R82","doi-asserted-by":"publisher","DOI":"10.15288\/jsa.2002.63.762"},{"key":"R85","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-3797(98)00158-5"},{"key":"R86","unstructured":"Li C, Olsen Y, Kvigne V, Welty T. Implementation of substance use screening in prenatal clinics. S D J Med. 1999;52:59\u201364."}],"container-title":["American Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ajph.aphapublications.org\/doi\/pdf\/10.2105\/AJPH.2003.037093","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T22:29:33Z","timestamp":1652135373000},"score":1,"resource":{"primary":{"URL":"https:\/\/ajph.aphapublications.org\/doi\/full\/10.2105\/AJPH.2003.037093"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,7]]},"references-count":75,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2005,7]]}},"alternative-id":["10.2105\/AJPH.2003.037093"],"URL":"https:\/\/doi.org\/10.2105\/ajph.2003.037093","relation":{},"ISSN":["0090-0036","1541-0048"],"issn-type":[{"value":"0090-0036","type":"print"},{"value":"1541-0048","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,7]]}}}