{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T06:32:23Z","timestamp":1777962743811,"version":"3.51.4"},"reference-count":44,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T00:00:00Z","timestamp":1604016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011094","name":"Public Health Agency of Canada","doi-asserted-by":"publisher","award":["# 1415-HQ-000805"],"award-info":[{"award-number":["# 1415-HQ-000805"]}],"id":[{"id":"10.13039\/100011094","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Objective: To compare the characteristics of mothers of children with Fetal Alcohol Spectrum Disorder (FASD) with mothers of typically developing control children. Methods: The study utilized a cross-sectional, observational design, using active case ascertainment. Biological mothers were interviewed using a standardized retrospective questionnaire to collect data on demographics, living environment, pregnancy history, nutrition, alcohol and other drug use prior to and following pregnancy recognition. Results: A total of 173 mothers were interviewed. Of these, 19 had a child who was diagnosed with FASD, five had a child who had received a deferred FASD diagnosis, and 37 had children who were selected into the control group as typically developing children. The remaining 112 mothers had children who did not meet diagnostic criteria for FASD. The mothers of children with FASD did not differ significantly from mothers of the control group children with respect to age, ethnicity, marital status, and employment status at the time of pregnancy. However, mothers of children with FASD had lower levels of education (p &lt; 0.01) and were more likely to have received financial support (p &lt; 0.05) at the time of pregnancy, to have smoked tobacco (p &lt; 0.001), and to have used marijuana or hashish (p &lt; 0.01) prior to pregnancy recognition, compared with mothers of control children. All mothers of children with FASD reported alcohol consumption prior to pregnancy recognition; however, only 10.5% reported alcohol consumption following pregnancy recognition. None of the mothers interviewed reported any drug use following pregnancy recognition. Conclusions: Population-based preventive interventions, including repeated screening, monitoring, and education regarding the effects of alcohol use, as well as other substances, before and during pregnancy, are needed to eliminate risk for FASD and other negative consequences on child and maternal health.<\/jats:p>","DOI":"10.3390\/ijerph17217986","type":"journal-article","created":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T09:29:32Z","timestamp":1604050172000},"page":"7986","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Profile of Mothers of Children with Fetal Alcohol Spectrum Disorder: A Population-Based Study in Canada"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6308-1157","authenticated-orcid":false,"given":"Svetlana","family":"Popova","sequence":"first","affiliation":[{"name":"Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada"},{"name":"Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, ON M5S 1V4, Canada"},{"name":"Institute of Medical Science, University of Toronto, Faculty of Medicine, Medical Sciences, Building, 1 King\u2019s College Circle, Toronto, ON M5S 1A8, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shannon","family":"Lange","sequence":"additional","affiliation":[{"name":"Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerie","family":"Temple","sequence":"additional","affiliation":[{"name":"Surrey Place, 2 Surrey Place, Toronto, ON M5S 2C2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vladimir","family":"Poznyak","sequence":"additional","affiliation":[{"name":"Department of Mental Health and Substance Abuse, World Health Organization, 20 Avenue Appia, CH-1211 Geneva, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert E.","family":"Chudley","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health, University of Manitoba, 840 Sherbrook Street, Winnipeg, MB R3A 1S1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larry","family":"Burd","sequence":"additional","affiliation":[{"name":"North Dakota Fetal Alcohol Syndrome Center, Pediatrics Department, 1301 N Columbia Rd, Stop 9037 Grand Forks, ND 58202-9037, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Murray","sequence":"additional","affiliation":[{"name":"National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5665-0385","authenticated-orcid":false,"given":"J\u00fcrgen","family":"Rehm","sequence":"additional","affiliation":[{"name":"Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada"},{"name":"Institute of Medical Science, University of Toronto, Faculty of Medicine, Medical Sciences, Building, 1 King\u2019s College Circle, Toronto, ON M5S 1A8, Canada"},{"name":"Institute of Clinical Psychology and Psychotherapy &amp; Center of Clinical Epidemiology and Longitudinal Studies, Technische Universit\u00e4t Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany"},{"name":"Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON M5T 1R8, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Burd, L., and Popova, S. (2019). Fetal Alcohol Spectrum Disorders: Fixing Our Aim to Aim for the Fix. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16203978"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"887","DOI":"10.12688\/f1000research.7645.1","article-title":"Substance use during pregnancy","volume":"5","author":"Forray","year":"2016","journal-title":"F1000Research"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e290","DOI":"10.1016\/S2214-109X(17)30021-9","article-title":"Estimation of national, regional, and global prevalence of alcohol use during pregnancy and fetal alcohol syndrome: A systematic review and meta-analysis","volume":"5","author":"Popova","year":"2017","journal-title":"Lancet Glob. Health"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1016\/S0140-6736(73)91092-1","article-title":"Recognition of the Fetal Alcohol Syndrome in Early Infancy","volume":"302","author":"Jones","year":"1973","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Burd, L. (2020). Drinking at the end of pregnancy: Why don\u2019t we see it?. Pediatr. Res., 1\u20132.","DOI":"10.1038\/s41390-020-0846-1"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2578","DOI":"10.1111\/acer.14213","article-title":"Fetal Alcohol Spectrum Disorders in a Pacific Southwest City: Maternal and Child Characteristics","volume":"43","author":"Chambers","year":"2019","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_7","first-page":"1332","article-title":"Fetal alcohol spectrum disorders in a midwestern city: Child characteristics, maternal risk traits, and prevalence","volume":"16","author":"May","year":"2020","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1111\/acer.14315","article-title":"Fetal Alcohol Spectrum Disorders in a Rocky Mountain Region City: Child Characteristics, Maternal Risk Traits, and Prevalence","volume":"44","author":"May","year":"2020","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1111\/acer.13375","article-title":"Prevalence of Prenatal Alcohol Exposure in the State of Texas as Assessed by Phosphatidylethanol in Newborn Dried Blood Spot Specimens","volume":"41","author":"Bakhireva","year":"2017","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1001\/jamapediatrics.2017.1919","article-title":"Global Prevalence of Fetal Alcohol Spectrum Disorder Among Children and Youth: A systematic review and meta-analysis","volume":"171","author":"Lange","year":"2017","journal-title":"JAMA Pediatr."},{"key":"ref_11","unstructured":"Popova, S., Lange, S., Chudley, A.E., Reynolds, J.N., Rehm, J., May, P.A., and Riley, E.P. (2018). World Health Organization International Study on the Prevalence of Fetal Alcohol Spectrum Disorder (FASD): Canadian Component, Centre for Addiction and Mental Health. Available online: https:\/\/www.camh.ca\/-\/media\/files\/pdfs%2D%2D-reports-and-books%2D%2D-research\/who-fasd-report-english-april2018-pdf.pdf?la=en&hash=347373E4C8C362E1F746C28BB063C7DA9E2987AE."},{"key":"ref_12","unstructured":"National Autism Spectrum Disorder Surveillance (NASS) (2019, September 08). Autism Spectrum Disorder among Children and Youth in Canada 2018. A Report of the National Autism Spectrum Disorder Surveillance System. Available online: https:\/\/www.canada.ca\/en\/public-health\/services\/publications\/diseases-conditions\/autism-spectrum-disorder-children-youth-canada-2018.html."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1111\/add.14598","article-title":"Prevalence of fetal alcohol spectrum disorder among special subpopulations: A systematic review and meta-analysis","volume":"114","author":"Popova","year":"2019","journal-title":"Addiction"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1007\/s10995-011-0844-3","article-title":"Fetal alcohol spectrum disorders: A population based study of premature mortality rates in the mothers","volume":"16","author":"Li","year":"2012","journal-title":"Matern. Child Health J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"96","DOI":"10.2174\/1573404813666170418114243","article-title":"The Hidden Face of Fetal Alcohol Spectrum Disorder","volume":"13","author":"Schwartz","year":"2017","journal-title":"Curr. Womens Health Rev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1002\/bdra.20445","article-title":"Mortality rates in subjects with fetal alcohol spectrum disorders and their siblings","volume":"82","author":"Burd","year":"2008","journal-title":"Birth Defects Res. Part A Clin. Mol. Teratol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1136\/eb-2013-101346","article-title":"Maternal alcohol use increases risk of infant mortality","volume":"19","author":"Burd","year":"2013","journal-title":"Evid. Based Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1097\/ADM.0000000000000438","article-title":"A Multicountry Updated Assessment of the Economic Impact of Fetal Alcohol Spectrum Disorder: Costs for children and adults","volume":"12","author":"Greenmyer","year":"2018","journal-title":"J. Addict. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1111\/add.14841","article-title":"Fetal alcohol spectrum disorder: A systematic review of the cost of and savings from prevention in the United States and Canada","volume":"115","author":"Greenmyer","year":"2019","journal-title":"Addiction"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1111\/acer.14317","article-title":"Fetal Alcohol Spectrum Disorder: Can We Change the Future?","volume":"44","author":"Popova","year":"2020","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1016\/0892-0362(95)00005-C","article-title":"An update on the incidence of FAS: FAS is not an equal opportunity birth defect","volume":"17","author":"Abel","year":"1995","journal-title":"Neurotoxicol. Teratol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/0892-0362(91)90084-A","article-title":"Effects of prenatal alcohol exposure at school age: I. Physical and cognitive development","volume":"13","author":"Coles","year":"1991","journal-title":"Neurotoxicol. Teratol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1190","DOI":"10.2105\/AJPH.2003.037093","article-title":"Maternal risk factors for FAS in the Western Cape Province of South Africa: A population based study","volume":"95","author":"May","year":"2005","journal-title":"Am. J. Public Health"},{"key":"ref_24","unstructured":"Statistics Canada (2019, May 17). Population and Dwelling Counts, for Canada, Provinces and Territories, and Census Divisions, 2016 and 2011 Censuses\u2014100% Data, Available online: https:\/\/www12.statcan.gc.ca\/census-recensement\/2016\/dp-pd\/hlt-fst\/pd-pl\/Table.cfm?Lang=Eng&T=101&S=50&O=A."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1503\/cmaj.1040302","article-title":"Fetal alcohol spectrum disorder: Canadian guidelines for diagnosis","volume":"172","author":"Chudley","year":"2005","journal-title":"Can. Med Assoc. J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1503\/cmaj.141593","article-title":"Fetal alcohol spectrum disorder: A guideline for diagnosis across the lifespan","volume":"188","author":"Cook","year":"2016","journal-title":"Can. Med Assoc. J."},{"key":"ref_27","unstructured":"Stata Corporation (2017). Statistical Software: Release 15, Stata Corporation."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000150597","article-title":"Combined Effects of Cigarette Smoking and Alcohol Consumption on Perinatal Outcome","volume":"67","author":"Odendaal","year":"2009","journal-title":"Gynecol. Obstet. Investig."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.ejmg.2016.09.010","article-title":"Prevalence of alcohol consumption during pregnancy and Fetal Alcohol Spectrum Disorders among the general and Aboriginal populations in Canada and the United States","volume":"60","author":"Popova","year":"2017","journal-title":"Eur. J. Med. Genet."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/S0301-2115(98)00246-2","article-title":"Ten years of experience in periconceptual care","volume":"84","author":"Czeizel","year":"1999","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1111\/j.1530-0277.1988.tb01354.x","article-title":"Early Measures of Maternal Alcohol Misuse as Predictors of Adverse Pregnancy Outcomes","volume":"12","author":"Russell","year":"1988","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_32","unstructured":"Health Canada (2019, May 17). Canadian Cannabis Survey 2017\u2014Summary. Ottawa, ON, Canada. Available online: https:\/\/www.canada.ca\/en\/health-canada\/services\/publications\/drugs-health-products\/canadian-cannabis-survey-2017-summary.html."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.mehy.2019.02.017","article-title":"Cannabis use during pregnancy: Are we at the verge of defining a \u201cfetal cannabis spectrum disorder\u201d?","volume":"124","author":"Schreiber","year":"2019","journal-title":"Med. Hypotheses"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e196471","DOI":"10.1001\/jamanetworkopen.2019.6471","article-title":"Self-reported Daily, Weekly, and Monthly Cannabis Use Among Women Before and During Pregnancy","volume":"2","author":"Sarovar","year":"2019","journal-title":"JAMA Netw. Open"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1111\/acer.14313","article-title":"Fetal Alcohol Spectrum Disorders in a Southeastern County of the United States: Child Characteristics and Maternal Risk Traits","volume":"44","author":"May","year":"2020","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.drugalcdep.2018.11.028","article-title":"Beliefs and attitudes regarding prenatal marijuana use: Perspectives of pregnant women who report use","volume":"196","author":"Chang","year":"2019","journal-title":"Drug Alcohol Depend."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/j.whi.2016.03.010","article-title":"Pregnant Women\u2019s Access to Information About Perinatal Marijuana Use: A Qualitative Study","volume":"26","author":"Jarlenski","year":"2016","journal-title":"Women\u2019s Health Issues"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1093\/ntr\/ntn014","article-title":"Prenatal alcohol consumption and fetal growth restriction: Potentiation effect by concomitant smoking","volume":"11","author":"Aliyu","year":"2009","journal-title":"Nicotine Tob. Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1093\/alcalc\/35.5.509","article-title":"Fetal Alcohol Syndrome (FAS) Primary Prevention through Fas Diagnosis: II. A comprehensive profile of 80 birth mothers of children with FAS","volume":"35","author":"Astley","year":"2000","journal-title":"Alcohol. Alcohol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1177\/0706743717703646","article-title":"The Psychiatric Morbidity of Women Who Give Birth to Children with Fetal Alcohol Spectrum Disorder (FASD): Results of the Manitoba Mothers and FASD Study","volume":"62","author":"Singal","year":"2017","journal-title":"Can. J. Psychiatry"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"E646","DOI":"10.9778\/cmajo.20160127","article-title":"Suicide and suicide attempts among women in the Manitoba Mothers and Fetal Alcohol Spectrum Disorder cohort: A retrospective matched analysis using linked administrative data","volume":"5","author":"Singal","year":"2017","journal-title":"CMAJ Open"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Lange, S., Shield, K., Koren, G., Rehm, J., and Popova, S. (2014). A comparison of the prevalence of prenatal alcohol exposure obtained via maternal self-reports versus meconium testing: A systematic literature review and meta-analysis. BMC Pregnancy Childbirth, 14.","DOI":"10.1186\/1471-2393-14-127"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1542\/peds.2013-3319","article-title":"Prevalence and Characteristics of Fetal Alcohol Spectrum Disorders","volume":"134","author":"May","year":"2014","journal-title":"Pediatrics"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1007\/s00381-011-1607-6","article-title":"Head circumference at birth and exposure to tobacco, alcohol and illegal drugs during early pregnancy","volume":"28","author":"Claudio","year":"2012","journal-title":"Childs Nerv Syst."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/21\/7986\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:26:58Z","timestamp":1760178418000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/21\/7986"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,30]]},"references-count":44,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2020,11]]}},"alternative-id":["ijerph17217986"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17217986","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,30]]}}}