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Risk Factors for Adverse Life Outcomes in Fetal Alcohol Syndrome and Fetal Alcohol Effects

STREISSGUTH, ANN P. Ph.D.1; BOOKSTEIN, FRED L. Ph.D.2; BARR, HELEN M. M.A., M.S.3; SAMPSON, PAUL D. Ph.D.4; O'MALLEY, KIERAN M.B., D.A.B.P.N. (P)1; YOUNG, JULIA KOGAN M.Ed.1

Journal of Developmental & Behavioral Pediatrics: August 2004 - Volume 25 - Issue 4 - pp 228-238
Original Articles

ABSTRACT. Clinical descriptions of patients with Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE) suggest major problems with adaptive behavior. Five operationally defined adverse outcomes and 18 associated risk/protective factors were examined using a Life History Interview with knowledgeable informants of 415 patients with FAS or FAE (median age 14 years, range 6-51; median IQ 86, range 29-126). Eighty percent of these patients were not raised by their biological mothers. For adolescents and adults, the life span prevalence was 61% for Disrupted School Experiences, 60% for Trouble with the Law, 50% for Confinement (in detention, jail, prison, or a psychiatric or alcohol/drug inpatient setting), 49% for Inappropriate Sexual Behaviors on repeated occasions, and 35% for Alcohol/Drug Problems. The odds of escaping these adverse life outcomes are increased 2- to 4-fold by receiving the diagnosis of FAS or FAE at an earlier age and by being reared in good stable environments.

1Department of Psychiatry and Behavioral Sciences, Fetal Alcohol & Drug Unit, University of Washington School of Medicine, Seattle, Washington

2Institute of Gerontology, University of Michigan, Ann Arbor, Michigan

3Department of Psychiatry and Behavioral Sciences, Fetal Alcohol & Drug Unit, University of Washington School of Medicine, Seattle

4Department of Statistics, University of Washington, Seattle

Received July 2003; accepted April 2004.

Address for reprints: Ann P. Streissguth, Dept. of Psychiatry & Behavioral Sciences, Box 359112, University of Washington, Seattle, Washington, 98195; e-mail: astreiss@u.washington.edu.

© 2004 Lippincott Williams & Wilkins, Inc.