Background Prenatal alcohol exposure (PAE) is a community health problem with up to 50% of pregnant women drinking alcohol. The relationship between low or sporadic binge PAE and adverse child outcomes is not clear. This study examines the association between PAE in the general antenatal population and child neurodevelopment at 2 years, accounting for relevant contributing factors.
Methods This prospective population-based cohort recruited 1570 pregnant women, providing sociodemographic, psychological and lifestyle information and alcohol use for five time periods. PAE categories were ‘low’, ‘moderate/high’, ‘binge’, in trimester 1 or throughout pregnancy. Measures of cognitive, language and motor development (Bayley Scales of Infant and Toddler Development) were available for 554 children, while measures of sensory processing (Infant/Toddler Sensory Profile) and social–emotional development (Brief Infant Toddler Social Emotional Assessment) were available for 948.
Results A positive association in univariate analysis with low-level PAE throughout pregnancy and cognition (β=4.1, 95% CI −0.02 to 8.22, p=0.05) was attenuated by adjusting for environmental/social deprivation risk factors (β=3.06 (−1.19 to 7.30), p=0.16). Early binge drinking, plus continued PAE at lower levels, was associated with the child being more likely to score low in sensation avoidance (adjusted OR 1.88 (1.03 to 3.41), p=0.04).
Conclusion Early binge exposure, followed by lower-level PAE, demonstrated an increase in sensation-avoiding behaviour. There were, however, no significant associations between PAE and neurodevelopment following adjustment for important confounders and modifiers. Follow-up is paramount to investigate subtle or later onset problems.
- cohort studies
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Contributors JH, EM, SL, EE, DA, CO’L, SD, DF, CN, JC and PA all contributed to the planning, conduct and reporting of this study. Analysis of data was conducted by JH who also drafted the manuscript. Further interpretation of data and intellectual input were provided by EM, PA and SL in particular. JH is the guarantor. JH, EM, SL, EE, DA, CO’L, SD, DF, CN, JC and PA all contributed to writing and reviewing the manuscript and approved the final version.
Funding This work was supported by the Australian National Health and Medical Research Council (grant no. 1011070; senior research fellowships nos. 1081288 (PA) and 1021252 (JH); practitioner fellowship no. 1021480 (EE)) and the Victorian state government’s operational Infrastructure support program.
Competing interests None declared.
Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.
Ethics approval Multiple human research ethics committees at participating sites in Victoria Australia.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional dare are available.