Published online March 2, 2009
PEDIATRICS Vol. 123 No. 3 March 2009, pp. e526-e533 (doi:10.1542/peds.2008-2423)
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SPECIAL ARTICLE

Characteristics of Children Whose Siblings Have Fetal Alcohol Syndrome or Incomplete Fetal Alcohol Syndrome

Valborg L. Kvigne, MBAa, Gary R. Leonardson, PhDb, Joseph Borzelleca, MD, MPHc, Martha Neff-Smith, PhD, MPH, RN, CS, FAANd and Thomas K. Welty, MD, MPHa

a Aberdeen Area Indian Health Service, Aberdeen, South Dakota
b Mountain Plains Research, Dillon, Montana
c Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, Virginia
d Global Consultants, Gordonsville, Virginia

OBJECTIVE. To describe the clinical features of American Indian children born just before and just after a sibling with fetal alcohol syndrome or incomplete fetal alcohol syndrome.

METHODS. Two retrospective case-control studies were conducted of Northern Plains American Indian children with fetal alcohol syndrome or incomplete fetal alcohol syndrome identified from 1981 to 1993 by using International Classification of Diseases, Ninth Revision, Clinical Modification code 760.71.

RESULTS. Compared with the controls, the 39 siblings born just before children with fetal alcohol syndrome (study 1) and 30 siblings born just before children with incomplete fetal alcohol syndrome (study 2) had more facial dysmorphology (23.1% and 16.7%, respectively), growth delay (38.5% and 10.0%), and central nervous system impairment (48.7% and 33.3%). The 20 siblings born just after children with fetal alcohol syndrome (study 1) and 22 siblings born just after children with incomplete fetal alcohol syndrome (study 2) had more facial dysmorphology (20.0% and 9.1%, respectively), growth delay (45.0% and 22.7%), and central nervous system impairment (50.0% and 31.8%) than the control siblings.

CONCLUSIONS. The "before" siblings had characteristics of fetal alcohol syndrome that could have predicted that the next child was at risk for fetal alcohol syndrome. The "after" siblings had better outcomes than the previous siblings with fetal alcohol syndrome, a finding that was associated with a decrease in maternal alcohol consumption during the after-sibling pregnancy.

Key Words: fetal alcohol syndrome • fetal alcohol spectrum disorders • American Indian • siblings • alcohol

Abbreviations: FAS—fetal alcohol syndrome • IHS—Indian Health Service • CNS—central nervous system • FASD—fetal alcohol spectrum disorders • OR—odds ratio • CI—confidence interval • SIDS—sudden infant death syndrome

Accepted Nov 25, 2008.


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