Comorbidities associated with fetal alcohol spectrum disorders in the United States

Abstract The detrimental effects of prenatal alcohol exposure on the development of humans are well understood and include fetal alcohol spectrum disorders (FASD), a broad set of conditions referring to the adverse physical and behavioral health impairments associated with exposure to alcohol in ute...

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Main Authors: Brandon K. Attell, Angela B. Snyder, Claire Coles, Julie Kable
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-13366-9
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author Brandon K. Attell
Angela B. Snyder
Claire Coles
Julie Kable
author_facet Brandon K. Attell
Angela B. Snyder
Claire Coles
Julie Kable
author_sort Brandon K. Attell
collection DOAJ
description Abstract The detrimental effects of prenatal alcohol exposure on the development of humans are well understood and include fetal alcohol spectrum disorders (FASD), a broad set of conditions referring to the adverse physical and behavioral health impairments associated with exposure to alcohol in utero. Using a case-control study design, the purpose of this study was to better understand the complex comorbidity patterns associated with FASD (N = 3,248) and to examine how they differ with the general patient population (N = 16,240) and a cohort of behavioral health controls (N = 16,240). Employing a novel unsupervised machine learning algorithm applied to a nationally representative hospital discharge database, we found 57 distinct comorbidities that frequently occurred among FASD cases, in addition to a set of 144 complex overlapping comorbidity patterns. The identified comorbidities were generally more likely to occur in the FASD cases compared to the general patient population control group, while differences with behavioral health controls were less readily apparent. This study adds to a small but growing body of research on comorbidities experienced by individuals with FASD. We discuss the implications of the identified comorbidity patterns on the ongoing identification, treatment, and surveillance of FASD in the US.
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spelling doaj-art-5464060c91264ad78e9f7cf4f3a34d032025-08-20T03:43:11ZengNature PortfolioScientific Reports2045-23222025-08-0115111410.1038/s41598-025-13366-9Comorbidities associated with fetal alcohol spectrum disorders in the United StatesBrandon K. Attell0Angela B. Snyder1Claire Coles2Julie Kable3Georgia Health Policy Center, Georgia State UniversityGeorgia Health Policy Center, Georgia State UniversityEmory University School of MedicineEmory University School of MedicineAbstract The detrimental effects of prenatal alcohol exposure on the development of humans are well understood and include fetal alcohol spectrum disorders (FASD), a broad set of conditions referring to the adverse physical and behavioral health impairments associated with exposure to alcohol in utero. Using a case-control study design, the purpose of this study was to better understand the complex comorbidity patterns associated with FASD (N = 3,248) and to examine how they differ with the general patient population (N = 16,240) and a cohort of behavioral health controls (N = 16,240). Employing a novel unsupervised machine learning algorithm applied to a nationally representative hospital discharge database, we found 57 distinct comorbidities that frequently occurred among FASD cases, in addition to a set of 144 complex overlapping comorbidity patterns. The identified comorbidities were generally more likely to occur in the FASD cases compared to the general patient population control group, while differences with behavioral health controls were less readily apparent. This study adds to a small but growing body of research on comorbidities experienced by individuals with FASD. We discuss the implications of the identified comorbidity patterns on the ongoing identification, treatment, and surveillance of FASD in the US.https://doi.org/10.1038/s41598-025-13366-9Fetal alcohol spectrum disordersFetal alcohol syndromeComorbiditiesDiagnosesMachine learningNational inpatient sample
spellingShingle Brandon K. Attell
Angela B. Snyder
Claire Coles
Julie Kable
Comorbidities associated with fetal alcohol spectrum disorders in the United States
Scientific Reports
Fetal alcohol spectrum disorders
Fetal alcohol syndrome
Comorbidities
Diagnoses
Machine learning
National inpatient sample
title Comorbidities associated with fetal alcohol spectrum disorders in the United States
title_full Comorbidities associated with fetal alcohol spectrum disorders in the United States
title_fullStr Comorbidities associated with fetal alcohol spectrum disorders in the United States
title_full_unstemmed Comorbidities associated with fetal alcohol spectrum disorders in the United States
title_short Comorbidities associated with fetal alcohol spectrum disorders in the United States
title_sort comorbidities associated with fetal alcohol spectrum disorders in the united states
topic Fetal alcohol spectrum disorders
Fetal alcohol syndrome
Comorbidities
Diagnoses
Machine learning
National inpatient sample
url https://doi.org/10.1038/s41598-025-13366-9
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AT angelabsnyder comorbiditiesassociatedwithfetalalcoholspectrumdisordersintheunitedstates
AT clairecoles comorbiditiesassociatedwithfetalalcoholspectrumdisordersintheunitedstates
AT juliekable comorbiditiesassociatedwithfetalalcoholspectrumdisordersintheunitedstates