It is well known that children who develop fetal alcohol syndrome show growth retardation. Yet little has been done to determine whether disruption of growth related hormones is responsible for this problem. We measured levels of IGF1, IGF2, IGF binding protein 3, and leptin in our population of exposed and unexposed children to determine whether alcohol caused any changes in growth. IGF2 levels increased in both groups as they got older, but the levels were significantly higher in the alcohol exposed group at 3, 4, and 5 years of age. In exposed children IGF1 levels were also higher at 3 and 4 years of age while leptin levels were lower at 1 and 2 years. For as yet unknown reasons, exposed subjects showed a much lower correlation between IGF1 levels and growth parameters than unexposed subjects. These data suggest that IGF2 should be explored as a potential marker for prenatal alcohol exposure. Analysis is ongoing to determine how patterns of drinking, e.g. binge drinking, number of days per week alcohol is consumed, maximum intake per day, affect risk to the fetus. In addition alcohol consumption as a risk factor for stillbirth and preterm delivery is being studied. For this analysis patterns of drinking are also being considered.