Fetal Alcohol Spectrum Disorder Symptoms and Maternal Self-Reports of Prenatal Alcohol Exposure: Do They Converge?

• In Event: Poster Session 04
  In Poster Session: PS 04 Topic - Developmental Disabilities

Abstract

Prenatal alcohol exposure (PAE) can lead to the development of fetal alcohol spectrum disorder (FASD), which is marked by facial anomalies, stunted growth, and central nervous system (CNS) abnormalities (Astley, 2004). Evaluation of these symptoms and PAE are used to determine where an individual falls on the FASD spectrum. PAE is often assessed through maternal recall; however, maternal recall of PAE is known to be vulnerable to memory bias, have low consistency across time points (Ramos, 2020), and leads to inaccurate PAE prevalence rates (Lange, 2014). With maternal report of PAE playing a central role in the assessment and diagnosis of FASD, it is important to examine whether and how maternal recall of PAE and other indices of FASD converge, especially in adoptive families because of the higher risk of FASD for adopted children (Davies, 2005).

This study aims to examine the convergence between maternal self-report of PAE and child symptoms of FASD using a longitudinal adoption design with children adopted at birth, which allows for clear separation between prenatal and post-natal environmental influences. We hypothesized that there would be underreporting of PAE in maternal reports, with some children manifesting FASD features without confirmed PAE. We also hypothesized that the convergence between birth mother (BM) reports of PAE and indices of child FASD symptoms would deteriorate over time.

Method: Data is based on a sample of adopted children and their BMs who participated in the Early Growth and Development Study, a longitudinal adoption study. BM’s self-reports of PAE were collected at 5-months (n = 471) and 8-years (n = 146) postpartum. Facial features were analyzed using the Fetal Alcohol Syndrome (FAS) Photographic Analyses Software. Growth deficiencies were assessed through children’s percentiles of height and weight. Various domains of CNS abnormalities were assessed, including cognitive function (Woodcock Johnson Achievement Tests) executive function (Stroop Day-Night task), attention and hyperactivity (Conners’ Parent Rating Scale – Revised) and social skills (Social Skills Rating System).

Preliminary Findings and Discussion: A crosstabulation for facial anomaly scores and BM’s self-report of PAE at 5-months (Table 1) revealed that 76% of children with moderate to severe FAS facial features had BMs indicating they did not consume alcohol during pregnancy. For maternal reports of PAE at 8-years, the percentage increased to 92%. These preliminary results suggest that postpartum maternal reports of PAE may underreport the cases of PAE, and that the discrepancy between maternal recall of PAE and child FASD symptoms becomes more salient over time. This increasing discrepancy may leave adoptive parents facing unexpected challenges when symptoms arise and may delay the onset of treatment, as adoptive parents’ knowledge about prenatal care is dependent on BM’s reports or information from an adoption agency.

As the next step, we plan to conduct a series of confirmatory factor analysis to examine how BM’s self-reports of PAE converge with other FASD indicators at 5-months and 8-years postpartum. Given that all data is collected, and preliminary findings appear to support the hypotheses, completion by the time of the meeting is highly feasible.

Authors

• Erick Vladimir Perez, University of California - Riverside
  Presenting Author

• Misaki N. Natsuaki, University of California - Riverside
  Non-Presenting Author

• Leslie D. Leve, University of Oregon
  Non-Presenting Author

• Jody M. Ganiban, George Washington University
  Non-Presenting Author

• Daniel S. Shaw, University of Pittsburgh
  Non-Presenting Author

• David Reiss, Yale University
  Non-Presenting Author

• Jenae M Neiderhiser, Pennsylvania State University, University Park
  Non-Presenting Author