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A new study published on Tuesday has found that fetal alcohol syndrome and other alcohol-related disorders are as common in American children as autism.

The study, published in JAMA: The Journal of the American Medical Association, looked at 3,000 children in schools in four different communities in America, the New York Times reports. Researchers estimated that fetal alcohol disorders affect 1.1 to 5% of children in the U.S, and compares that number to the 1.5% of children currently diagnosed with autism. The first graders who participated in the study were given neurodevelopmental evaluations, physically evaluated, and 62% of their mothers were interviewed.

The group of disorders being studied, known as FASDs (fetal spectrum alcohol disorders), cause cognitive and behavioral problems. The NYT reports that it’s typically unclear how common FASDs are because of how some symptoms are subtle, such as problems paying attention, or facial features. There’s also the stigma of being a mother who drinks during her pregnancy, which leads many women to decline to be interviewed for studies or to let their children be evaluated.

In recent years the CDC has warned women about the damage drinking alcohol during a pregnancy does to children, but some of these warnings, like a 2016 recommendation that all women of child-bearing age who aren’t on birth control should not drink, come off as deeply unrealistic and even patronizing. Still, these researchers are doubling down on the serious consequences for even a teeny tiny bit of alcohol.

“People say, ‘Don’t be ridiculous, I went to a wine tasting and my kid came out fine,’” Dr. Howard Taras, a participant in the study, told the NYT. “But the C.D.C. is saying, ‘We don’t know. Maybe you just won the lottery.’”