European Child & Adolescent Psychiatry

, Volume 23, Issue 10, pp 877–889 | Cite as

Identifying maternal risk factors associated with Fetal Alcohol Spectrum Disorders: a systematic review

  • Larissa Horta Esper
  • Erikson Felipe FurtadoEmail author


To identify the demographic, psychological, and social maternal risk factors associated with the development of Fetal Alcohol Spectrum Disorders (FASD). A bibliographic search was conducted in PubMed, SciELO, Lilacs, Web of Knowledge, and PsycINFO. The Newcastle–Ottawa Quality Assessment Scale (NOS) was used to evaluate the quality of the studies with case–control design. Articles were selected based on their relevance and presentation of data related to statistical comparisons of at least one or more demographic, psychological, or social maternal risk factors for FASD. 738 references were identified, of which 15 met the criteria to be included in the present review. Mothers of FASD children tend to: be older at the time of birth of the affected child, present lower educational level, have other family relatives with alcohol abuse, have other children with FASD, present a pattern of little prenatal care and a distinguishing pattern of alcohol consumption (alcohol use before and during pregnancy, failure to reduce alcohol use during pregnancy, and frequent episodes of binge drinking). Application of the NOS scale of methodological quality indicated that 8 studies (53 %) met the criterion for selection, 4 (27 %) were suitable for the criterion for comparability and only 4 studies were suitable for the exposition criterion. Mothers of FASD children have a distinctive pattern of drinking and accumulate several social risk factors. Maternal age at birth of the child seems to accentuate the risk. There are, however, few controlled studies that are adequate according to the NOS requirements for methodological quality. Fewer are based on the verification of a theoretical model. Clinicians should be aware of the relevance of preventive assessment of FASD risk mothers.


Fetal alcohol spectrum disorders Fetal alcohol syndrome Alcohol drinking Maternal risk factors Systematic review Research quality assessment 



CAPES Foundation (Brazilian Coordination for the Improvement of Higher Education Personnel, Ministry of Education) provided a PhD grant for Larissa Horta Esper. The authors greatly acknowledge Prof. Hendree E. Jones, University of North Carolina at Chapel Hill, for her contribution with many suggestions for the improvement of the manuscript.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Larissa Horta Esper
    • 1
  • Erikson Felipe Furtado
    • 1
    • 2
    Email author
  1. 1.PAI-PAD Program for Assessment, Intervention and Prevention of Alcohol and Drugs in the Community, Faculty of Medicine of Ribeirao PretoUniversity of Sao PauloSao PauloBrazil
  2. 2.Section of Child and Adolescent Psychiatry, Department of Neurosciences and Behavior, Faculty of Medicine of Ribeirao PretoUniversity of Sao PauloSao PauloBrazil

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