Accurate identification of teens with “at-risk” prenatal alcohol exposure is vital for diagnosis and treatment of teens with behavioral problems, and for determining the true level of risk for FASDs in a population. The present results help fill gaps in the evidence that may lead to a preference for using “prospective” (antenatal or concurrent) reports in diagnosis, and in studies assessing relations of maternal drinking to child neurobehavioral outcomes. Present and prior evidence demonstrates that retrospective report is at least as valid as antenatal report. Based on this greater predictive validity, and utility, it may be inferred that retrospective report may be a more accurate measure of in-pregnancy drinking than antenatal report. Antenatal reports have been viewed as being more susceptible to denial and/or distortion motivated by guilt and fear of discovery (cf., ACOG, 2006; Ernhart, et al., 1988; Morrow-Tlucak, et al., 1989), although the opposite interpretation has also been made (Rosett & Weiner, 1984).
