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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
.