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Module 3: Risk Factors for FASD

Maternal Drinking Patterns

Determining how much alcohol  is dangerous to a developing fetus  is a complex issue. Many factors influence peak BACs. These include the amount and pattern of alcohol use. It can take several hours for the alcohol from one drink to pass through the fetus back to the mother.

Differences in drinking patterns can be crucial in determining the effects of alcohol use during pregnancy. For example, drinking four or more drinks in about 2 hours ("binge drinking") can be more harmful than drinking one drink per day for 4 days. Binge drinking exposes the fetus to considerably higher peak BACs than drinking one drink at a time. This binge drinking increases the risk of alcohol-related damage.

Although binge drinking can be more harmful, continuous alcohol use during pregnancy can also be damaging. Certain factors have been associated with different consumption patterns. The table summarizes risk factors associated with heavy maternal drinking and FASD.

Risk Factors Associated With Heavy Maternal Drinking and FASD

Influential Element

Maternal Risk Factor


Older than 30 when child is born
Has three or more children when child is born
Uses other drugs, including tobacco and illicit substances
Has experienced alcohol-related physical problems

Socioeconomic status (SES)

Social transience
Unemployed or marginally employed
Work in male-dominated occupation

Drinking pattern

Long history of drinking
Frequent binge drinking
Frequent drinking, such as every day or every weekend
High BAC
No reduction in drinking during pregnancy

Psychological profile

Low self-esteem
Sexual dysfunction

Family social traits

Heavy drinking by a family member
Heavy drinking by the woman's male partner
Tenuous marital status (cohabitation, never married, separated, or divorced)
Loss of children to foster or adoptive placement

Local culture and community

Relatively tolerant of heavy drinking

Sources: Adapted from National Institute on Alcohol Abuse and Alcoholism. 2000. Issues in Fetal Alcohol Syndrome Prevention. Tenth Special Report to the U.S. Congress on Alcohol and Health.Bethesda, MD: National Institutes of Health; Stratton, K.; Howe, C.; and Battaglia, F., eds. 1996. Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment. Washington, DC: National Academy Press; Abel, E.L. 1998. Fetal Alcohol Abuse Syndrome.New York: Plenum Press.
Jacobson, J.L.; Jacobson, S.W.; and Sokol, R.J. 1996. Increased vulnerability to alcohol-related birth defects in the offspring of mothers over 30. Alcoholism: Clinical and Experimental Research 20(2): 359-363.

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