Fetal Alcohol Spectrum Disorders

The National Institute on Alcohol Abuse and Alcoholism (NIAAA)—part of the National Institutes of Health, the Nation’s medical research agency— funds research on fetal alcohol spectrum disorders (FASD) with projects on preventing prenatal alcohol exposure, treating women with alcohol use disorder, improving the diagnosis of FASD, establishing more precise prevalence estimates of FASD in the United States, increasing our understanding of the effects of alcohol on the unborn child, and developing effective interventions to mitigate the health effects on individuals prenatally exposed to alcohol.

Prenatal alcohol exposure is a leading preventable cause of birth defects and neurodevelopmental deficits in the United States. It can cause a range of intellectual and behavioral problems, which appear at any time during childhood and last a lifetime. FASD is an umbrella term for a range of physical, cognitive, and behavioral disorders caused by prenatal alcohol exposure. Depending on the features identified, the medical disorders labeled as FASD include: Fetal Alcohol Syndrome (FAS), partial FAS (pFAS), alcohol-related neurodevelopmental disorder (ARND), alcohol-related birth defects (ARBD), and neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE). Recent prevalence studies estimate that approximately 1 to 5 percent of U.S. first-grade children have FASD.

Historically, medical professionals did not recognize the risks posed by alcohol use during pregnancy. In 1973, responding to Jones and Smith’s publication on the original syndrome FAS, NIAAA initiated several epidemiological and animal studies on prenatal alcohol exposure. By 1977, this research facilitated NIAAA issuing the first government health advisory to limit alcohol use during pregnancy. Now, after 50 years, NIAAA continues to provide leadership and support as the largest funder of biomedical research on FASD in the United States.

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NIAAA’s FASD Grant Portfolio

In FY2023, NIAAA allocated approximately 7% of its extramural research and training budget, or roughly $30 million, for its portfolio of FASD-related grants. This portfolio currently comprises approximately 96 grants, including research project grants, cooperative agreements, training grants, center grants, fellowships, and career development awards, that collectively address FASD prevention, diagnosis, treatment, and etiology. In addition, NIAAA funds conference grants that support the annual meeting of the FASD Study Group (www.fasdsg.org) and the International Research Conference on FASD in Vancouver. A list of NIH funded FASD-related projects may be found at NIH RePORTER, selecting FASD under the NIH Spending Category of the Advanced Project Search.

Research Centers and Consortia working on FASD

• The Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CIFASD) is a multidisciplinary consortium of domestic and international projects established by NIAAA in 2003 to address prevention of FASD, diagnosis of the full range of birth defects associated with prenatal alcohol exposure, and ameliorative interventions for affected individuals. CIFASD aims to accelerate the translation of key research findings by fostering collaboration and by coordinating clinical, basic, and translational research. Learn more about the CIFASD at www.cifasd.org.


• New Mexico Alcohol Research Center (NMARC) is a NIAAA-designated specialized Alcohol Research Center located at the University of New Mexico Health Sciences Center. NMARC is one of just twenty Alcohol Research Centers in the United States, and the only such center focused solely on Fetal Alcohol Spectrum Disorders (FASD). NMARC’s central focus is on understanding the neurobiological mechanisms underlying the behavioral problems associated with FASD and how to use this knowledge to help develop better methods of early diagnoses and more effective interventions for patients with FASD. Learn more about the NMARC at https://hsc.unm.edu/nmarc/.


• Developmental Exposure Alcohol Research Center (DEARC) is a NIAAA-designated specialized Alcohol Research Center located at Binghamton University. The research of the DEARC focuses on the two primary developmental periods during which alcohol exposure occurs: prenatally/postnatally through maternal use and during adolescence. Learn more about the DEARC at https://www.binghamton.edu/centers/dearc/.


• Native Center for Alcohol Research and Education (NCARE) is a NIAAA-designated comprehensive Alcohol Research Center located at Washington State University. Among its research projects is Native CHOICES, a study implementing a culturally adapted intervention with American Indian women of reproductive age to reduce their risk for an alcohol-exposed pregnancy. Learn more about NCARE at https://ireach.wsu.edu/ncare/.

Program Directors to contact with FASD-related inquiries

• Tatiana Balachova, Ph.D.
  tatiana.balachova@nih.gov
  Program Director – Division of Epidemiology and Prevention Research (DEPR)
  Focus areas: Reproductive and perinatal epidemiology; Prevention among women of child-bearing age; Family-based prevention
• Bill Dunty, Ph.D.
  William.Dunty@nih.gov
  NIAAA FASD Research Coordinator
  Program Director – Division of Metabolism and Health Effects (DMHE)
  Focus areas: Basic and clinical research on the consequences of prenatal alcohol exposure; Animal models of FASD
• Elizabeth Powell, Ph.D.
  elizabeth.powell3@nih.gov
  Program Director – Division of Neuroscience and Behavior (DNB)
  Focus areas: Developmental neurobiology; FASD, Bioengineering
• Deidra Roach, M.D.
  droach@mail.nih.gov
  Program Director – Division of Treatment and Recovery Research (DTRR)
  Focus areas: AUD and co-occurring medical conditions; alcohol and women; Interventions for FASD

New FASD-related Initiatives

Notice of funding opportunities 

PAR-24-067:  Prevention and Intervention Approaches for Fetal Alcohol Spectrum Disorders (R34 Clinical Trial Optional)
Open Date: January 16, 2024
Expiration Date:  January 08, 2027

PAR-24-068:  Prevention and Intervention Approaches for Fetal Alcohol Spectrum Disorders (R61/R33 Clinical Trial Optional)
Open Date: January 16, 2024
Expiration Date:  November 17, 2026

PAR-23-270:  Screening, Brief Intervention and Referral to Treatment or Prevention (SBIRT/P) for alcohol, tobacco, and other drugs (ATOD) use and misuse in adult populations that experience health disparities (R01 Clinical Trial Required)
Open Date: January 05, 2024
Expiration Date:  May 08, 2027

NOT-OD-22-179:  Addressing Evidence Gaps in Screening
Open Date: October 04, 2022
Expiration Date:  May 08, 2025

NOT-OD-22-178:  Increasing Uptake of Evidence-Based Screening in Diverse Populations Across the Lifespan
Open Date: July 14, 2022
Expiration Date:  May 08, 2025

Consensus Conference on Research Classification of FASD

In October 2019, the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the US National Institutes of Health (NIH), convened a 1.5-day meeting to explore the possibility of developing an international consensus classification system for research on FASD. We believe that a single classification system will harmonize research efforts across the globe and accelerate progress in understanding the epidemiology, pathogenesis, diagnosis, and treatment of FASD. A major goal of the conference was to build consensus among participants who subsequently agreed to test a few draft classification systems in their own research databases to inform the process going forward. A summary of the meeting can be found here.

Latest News & Research

September 9 is International Fetal Alcohol Spectrum Disorders Awareness Day (September 2023)
NIAAA is bringing attention to the range of cognitive and behavioral problems associated with fetal alcohol spectrum disorders (FASDs) that may appear at various times during childhood or early adolescence and that last a lifetime by recognizing September 9^th as International FASD Awareness Day—part of FASD Awareness Month.

Drinking and smoking during pregnancy linked with stillbirth (August 2021)
The NIH-funded Safe Passage Study elucidates how stillbirth risk is influenced by the timing and amount of prenatal exposure to the combination of tobacco and alcohol. A report of the study appears in JAMA Network Open. 

Advances in Research on Fetal Alcohol Spectrum Disorders (September 2020)
This feature article from the Fall 2020 issue of the NIAAA Spectrum webzine highlights recent advances in research on Fetal alcohol spectrum disorders (FASD).

Choline supplements in young children with fetal alcohol spectrum disorder have lasting cognitive benefits (July 20, 2020)
NIAAA-funded scientists report that early life dietary choline supplements improve some of the cognitive and behavioral symptoms associated with fetal alcohol spectrum disorders (FASD) four years after treatment ended. The results of this study suggest that choline treatment during an important time window during early childhood can alter brain development in a way that produces lasting therapeutic behavioral effects for children with FASD. The findings were published in the Journal of Neurodevelopmental Disorders.

Fetal Alcohol Spectrum Disorders May Increase the Risk of Type 2 Diabetes and Other Metabolic Issues (June 9, 2020)
Adults with fetal alcohol spectrum disorders (FASD) may have an increased risk of type 2 diabetes, and other metabolic abnormalities such as low HDL cholesterol and elevated levels of triglycerides compared to people without FASD. The research team confirmed their findings in a zebrafish model of FASD and gained insight into the mechanisms that may play a role in these metabolic issues. The study was published in The Journal of Clinical Investigations

Combined prenatal smoking and drinking greatly increases SIDS risk (January 20, 2020)
SIDS is the sudden, unexplained, death of an infant under one year of age. Many studies have shown that the risk of SIDS is increased by maternal smoking during pregnancy. Some studies have also found that prenatal alcohol exposure, particularly from heavy drinking during pregnancy, can increase SIDS risk. The NIH-funded Safe Passage Study elucidates how SIDS risk is influenced by the timing and amount of prenatal exposure to tobacco and alcohol. A report of the study appears in EclinicalMedicine, an online journal published by The Lancet.

Using both marijuana and alcohol during early pregnancy may increase the likelihood of disrupting fetal development (November 8, 2019)
New preclinical research reported in animal models shows that exposure to compounds found in marijuana called cannabinoids (CBs), which include cannabidiol (CBD) and tetrahydrocannabinol (THC), during early pregnancy can cause malformations in the developing embryo. The research also demonstrated that co-exposure to CBs and alcohol increased the likelihood of birth defects involving the face and brain. The study was published in Scientific Reports.

Study of first-graders shows fetal alcohol spectrum disorders prevalent in US communities (February 6, 2019)
A study of more than 6,000 first graders across four U.S. communities has found that a significant number of the children have fetal alcohol spectrum disorders (FASD), with conservative rates ranging from 1 to 5 percent in community samples. The new findings represent more accurate prevalence estimates of FASD among general U.S. communities than prior research. Previous FASD estimates were based on smaller study populations and did not reflect the overall U.S. population. The study was published in JAMA.

Director's Blog: Why September is Especially Important to Alcohol Research (September 2019)
September is a significant month for the alcohol field for two reasons: it is the month dedicated to raising awareness about fetal alcohol spectrum disorders (FASD) and to celebrating recovery from alcohol and other substance use disorders.

Director's Blog: Raising Awareness about Fetal Alcohol Spectrum Disorders (September 2018)
Fetal alcohol spectrum disorders, also known as FASD, is a term that refers to the broad range of lifelong birth defects and neurodevelopmental abnormalities that occur as a result of prenatal alcohol exposure. In this edition of Dr. Koob’s blog, he wants to remind everyone that there is no known safe level of alcohol, or time to drink, during pregnancy.

FASD-related Brochures and Fact Sheets

• Fetal Alcohol Exposure [ PDF - 346.92 KB] 
   
• Alcohol and Your Pregnancy [ PDF - 184.65 KB l Español] 
   
• Women and Alcohol [ PDF - 1.41 MB | Español]

Federal and Professional Partners

• The Interagency Coordinating Committee on Fetal Alcohol Spectrum Disorders (ICCFASD) 
   
• Centers for Disease Control and Prevention (CDC) 
   
• American Academy of Pediatrics (AAP) 
   
• American College of Obstetricians and Gynecologists (ACOG) 
   
• FASD United (formerly NOFAS)
   
• PROOF Alliance