Fetal Alcohol Syndrome Reports Increase at Sixfold Rate, CDC Says

ALCOHOL September 1995

According to recent data released by the Centers for Disease Control (CDC), the rate of reported fetal alcohol syndrome (FAS) has increased sixfold between 1979 and 1993 ("Update: Trends in Fetal Alcohol Syndrome -- United States, 1979-1993," Morbidity and Mortality Weekly Report, April 7, 1995, p. 1; "FAS Births Six Times Higher in 1993 Than in 1979: CDCP," Drugs and Drug Abuse Education, March 1995, p. 26).

Data collected by the CDC in the Birth Defects Monitoring Program (BDMP) show that in 1993, the rate of newborn FAS was 6.7 per 10,000 infants, while in 1979 that rate was 1.0 per 10,000 births. Hospital data management services voluntarily submit data on births to the CDC for the BDMP.

To be diagnosed with FAS, children must exhibit abnormalities in three areas: growth (height, weight, or head circumference), central nervous system (behavioral or mental problems, for instance), and appearance (a specific pattern of recognizable deformities).

Editors of MMWR cautioned that the increasing rate may be a result of greater awareness of FAS, not necessarily greater incidence. Tom Donaldson of the National Organization on Fetal Alcohol Syndrome (NOFAS) told NewsBriefs that more doctors are aware of FAS and its symptoms now than in 1979. He said NOFAS has introduced an FAS curriculum at three medical schools, educating 75 to 100 new doctors every year.

Dr. Jon Aase, clinical professor of pediatrics at the University of New Mexico and an expert in FAS, told NewsBriefs that it is his "strong belief" that some of the children counted in the CDC data do not exhibit full characteristics of FAS. He said that educators may have done their job too well in teaching physicians about FAS. Some children with other developmental diseases may be misdiagnosed with FAS and thus may not get help or treatment for the cause of their real problem.

Aase said the development of a related diagnosis, "Fetal Alcohol Effects" (FAE), has impeded progress in understanding FAS. Doctors have been using the FAE diagnosis to describe children with some but not all of the FAS criteria whose mothers may have consumed some alcohol while carrying the child.

Aase said he knows some children that are receiving state benefits because of FAS, but does not know how many are receiving benefits nationwide. He is also aware of a few who have been able to qualify for SSI benefits under "expectation of lifelong handicap." The FAS diagnosis, he said he believes, is a "useful lever" to get state or federal benefits.

Two bills are pending in Congress concerning FAS. S. 170, the "Comprehensive Fetal Alcohol Syndrome Prevention Act," was introduced by Sen. Thomas A. Daschle (D-SD). It would direct the Department of Health and Human Services to establish prevention and awareness-raising programs and conduct research on FAS. A bill of the same name, H.R. 1649, was introduced by Rep. Bill Richardson (D-NM) to create an inter-agency coordinating committee to supervise FAS-related research, prevention, and public education programs.

[For more information, contact the CDC at 4770 Buford Highway, NE, MS F15, Atlanta, Georgia, 30341, 404-488-7370 or the National Organization on Fetal Alcohol Syndrome, 1815 H Street, NW, Suite 1000, Washington, DC 20006, 202-785-4585.]