ArticlemedRxiv : the preprint server for health sciences2026
Cardiovascular and Cardiometabolic Outcomes in Adults with Fetal Alcohol Spectrum Disorders: A Retrospective Cohort Study.
Article in medRxiv : the preprint server for health sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
7 authors.
Funding
Abstract
Background: Fetal alcohol spectrum disorders (FASDs) impact up to 5% of U.S. school age children; however, the burden of cardiovascular disease (CVD) in adults with FASDs remains poorly defined. We investigated associations between FASDs, cardiometabolic abnormalities, and CVD using electronic health record (EHR) data. Methods: We performed a retrospective cohort study of adults (≥18 years) receiving ambulatory care with a FASD diagnosis ( Results: Adults with FASDs had a higher prevalence (p<0.05) of cardiometabolic abnormalities, including dyslipidemia, type 2 diabetes mellitus (T2DM), and the co-occurrence of multiple of these conditions (overweight/obese, HDL cholesterol < 40 mg/dL, and T2DM). CHDs were significantly more common in individuals with FASDs than controls (6% vs 1%, p < 0.001). Similarly, the FASD cohort had a higher incidence of systolic and diastolic dysfunction (6% vs. 2%), structural heart remodeling (11% vs 5%), MI (6% vs. 2%), stroke (4% vs 1%), and thromboembolic events (4% vs 1%; all p < 0.05). Significant sex-by-diagnosis interactions were observed for hypertension, arrhythmia, and heart failure, with elevated rates specific to FASD females. In individuals with FASDs, CHD diagnosis was associated with an increased incidence of conduction defects, arrhythmias, heart remodeling, heart failure, and systolic and diastolic dysfunction. Increased CVD burden in FASD adults remained significant after adjustment for BMI, composite cardiometabolic abnormalities, and hyperlipidemia. Conclusions: Adults with FASDs exhibit an increased burden of CVD not fully explained by conventional cardiometabolic risk factors. These findings support enhanced cardiovascular screening in individuals with FASDs.
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Registered trials
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