Cardiovascular and Cardiometabolic Outcomes in Adults with Fetal Alcohol Spectrum Disorders: A Retrospective Cohort Study

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: = 824, mean age 41.6±14.5, 50% female). Cardiometabolic outcomes were overweight/obesity, dyslipidemia, and diabetes mellitus. Cardiovascular outcomes were congenital heart defects (CHDs), heart murmur, hypertension, conduction defects, arrhythmias, structural heart remodeling, systolic and diastolic dysfunction, heart failure, myocardial infarction (MI), stroke, and thromboembolic events. Associations were assessed using age-adjusted logistic and Poisson regression, with sex-by-diagnosis interaction testing. Multivariable logistic regression was then used to estimate the odds of cardiovascular outcomes with additional adjustment for cardiometabolic conditions. Associations between CHD and CVD outcomes were evaluated using Fisher's exact tests. Results: Adults with FASDs had a higher prevalence (p