Risk Marker Score

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    Risk Marker
    Binges - 5 or more drinks per drinking day per month 0 1 2 3 4 5 6 7 8 9 10
    Projected cumulative alcohol exposure during pregnancy 0 1 - 50 51 - 100 101 - 500
    501 - 1000 1001 - 2000 2001 - 4000+
    Previous child with FAS 0 1 2+
    Previous child with FAE/ARND/ARBD 0 1 2+
    Previous child with birth defect 0 1 2+
    Child with PAE placed out of home 0 1 2+
    Previous death of live born child with PAE 0 1 2+
    Maternal smoking cigarettes/day 0 1-5 6-10 11-20 20+
    Previous alcohol-substance abuse treatment 0 1 2 3 4+
    Poor social support or most friends/family are alcohol users 0 1-5 6-10 11-20 20+
    Months Pregnant today 0 1 2 3 4 5 6 7 8 9
    Number of prenatal visits 0 1 2 3 4 5 6 7 8 9
    Prenatal visits-1st trimester 0 1 2+
    Maternal Age <17 17-20 21-25 26-29 30+
    Annual Income <10,000 10,001 - 15,000 15,001 - 22,000
    22,001 - 30,000 30000+
    Diet Poor Average Good
    Education (last grade completed) <9 9-12 HS Graduate Additional Education
    Physical Abuse
    Alcoholic partner
    Having FAS
    Having sibling with FAS or FAE
    Maternal grandmother has FAS or FAE



    Total Risk Marker Score:
    Questions? Send them to larry.burd@med.und.edu.