Epidemiology of fetal alcohol syndrome among American Indians of the southwest

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Abstract
The epidemiological features of Fetal Alcohol Syndrome (FAS) were examined among American Indians in the southwestern USA. All FAS suspects were screened in specific populations of Navajo, Pueblo anmd Plains culture tribes. A total of 115 alcohol-affected children was identified. The incidence of FAS was found to be highly variable from 1 cultural group to the next, ranging from 1.3/1000 births (1/749) for the Navago to 10.3 (1/97) for the Plains. The pattern of age-specific prevalence indicates an increase over the past 15 yr. The overall rate of mothers who have produced fetal alcohol children was 6.1/1000 women of childbearing age with a range of 4-33/1000. These maternal prevalence rates were important for the accurate prediction of public health risk because 25% of all mothers who had produced 1 affected child had also produced others. The average per mother was 1.3 alcohol-affected children. Other findings indicate that the mothers of these children led highly disruptive and chaotic lives and were frequently isolated from mainstream social activities. In general, the gross social and cultural patterns of the tribes studied can readily explain the variation in incidence of FAS.