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Alcohol Exposure of Parents

1996). The last two categories are used for offspring who have morphologic and neurologic alcohol-related effects, respectively, without the full features of FAS, and they may co-occur in the same individual.

Alcoholism and Alcohol Use Among Women

In a nationwide household survey conducted in 1992, 4.08 percent of the women who were interviewed met the criteria(1) for alcohol abuse and/or dependence within the 12 months preceding the survey (Grant et al. 1994). The highest prevalence rates for alcohol abuse and/or dependence were found among women of childbearing age (9.84 percent for women ages 18 to 29 and 3.98 percent for women ages 30 to 44).

Women who are alcoholic typically experience several other problems, including comorbid medical or psychiatric disorders (e.g., depression) and social problems (e.g., unstable marriages; spouses with drinking problems; and child-care responsibilities, often as single mothers). This multiplicity of problems complicates the pregnancy of an alcoholic woman, because her fetus is exposed not only to the teratogenic effects of alcohol, but also to the negative effects of the other factors that coexist in her life. By comparing birth outcomes in upper middle class and lower class alcoholic mothers, Bingol and colleagues (1987) showed that economic or lifestyle factors play a role in the rate of FAS. They found that, although the intake of absolute alcohol was equivalent in the two groups, 2.7 percent of the upper middle class mothers had a child with FAS, compared with 40.5 percent of the lower class mothers.

The problem of alcohol exposure during pregnancy is not limited to alcoholic women, however. A majority of women drink, as evidenced by a national household survey (Hilton 1991) in which 64 percent of the women surveyed were drinkers (i.e., drank at least once a year), 4 percent reported daily drinking, 6 percent drank five or more drinks on occasion at least weekly, and 1 percent report...

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