al., 2004) and epigenetic variables also influence outcome. They are also beyond the scope of these epidemiologic sample data and of this paper. In light of these findings, it seems impossible to easily determine that there is a specific threshold level of drinking that might be safe for any individual mother. Even by drinking exclusively in the first trimester a woman in this sample increases the likelihood of a child with an FASD twelve fold. Therefore, these data clearly reinforce that there is no safe level of alcohol consumption that can be recommended for any woman at any time of pregnancy, especially in the first trimester when many do not yet know that they are pregnant.
