The current small study utilized prospective data collection of patterns of prenatal alcohol and tobacco exposure (PAE and PTE) to examine associations with structural brain outcomes in 6-year-olds, and served as a pilot to determine the value of prospective data describing community-level patterns of PAE and PTE in a non-clinical sample of children. Participants from the Safe Passage Study in pregnancy were approached when their child was ∼6 years old and completed structural brain magnetic resonance imaging (MRI) to examine with archived PAE and PTE data (n=51 children-mother dyads). Linear regression was used to conduct whole brain structural analyses, with FDR correction, to examine: a) main effects of PAE, PTE and their interaction; and b) predictive potential of data that reflects patterns of PAE and PTE (e.g., quantity, frequency, and timing (QFT)). Associations between PAE, PTE and their interaction with brain structural measures demonstrated unique profiles of cortical and subcortical alterations that were distinct between PAE only, PTE only and their interactive effects. Analyses examining associations between patterns of PAE and PTE (e.g., QFT) were able to significantly detect brain alterations (that survived FDR correction) in this small non-clinical sample of children. These findings support the hypothesis that considering QFT and co-exposures is important for identifying brain alterations following PAE and/or PTE in a small group of young children. Current results demonstrate that teratogenic outcomes on brain structure differ as a function PAE, PTE or their co-exposures, as well as the pattern (QFT) or exposure.

Background Neuroimaging studies have emphasized the impact of prenatal alcohol exposure (PAE) on brain development, traditionally in heavily exposed participants. However, less is known about how naturally occurring community patterns of PAE (including light to moderate exposure) affect brain development, particularly in consideration of commonly occurring concurrent impacts of prenatal tobacco exposure (PTE). Methods Three hundred thirty‐two children (ages 8 to 12) living in South Africa's Cape Flats townships underwent structural magnetic resonance imaging. During pregnancy, their mothers reported alcohol and tobacco use, which was used to evaluate PAE and PTE effects on their children's brain structure. Analyses involved the main effects of PAE and PTE (and their interaction) and the effects of PAE and PTE quantity on cortical thickness, surface area, and volume. Results After false‐discovery rate (FDR) correction, PAE was associated with thinner left parahippocampal cortices, while PTE was associated with smaller cortical surface area in the bilateral pericalcarine, left lateral orbitofrontal, right posterior cingulate, right rostral anterior cingulate, left caudal middle frontal, and right caudal anterior cingulate gyri. There were no PAE × PTE interactions nor any associations of PAE and PTE exposure on volumetrics that survived FDR correction. Conclusion PAE was associated with reduction in the structure of the medial temporal lobe, a brain region critical for learning and memory. PTE had stronger and broader associations, including with regions associated with executive function, reward processing, and emotional regulation, potentially reflecting continued postnatal exposure to tobacco (i.e., second‐hand smoke exposure). These differential effects are discussed with respect to reduced PAE quantity in our exposed group versus prior studies within this geographical location, the deep poverty in which participants live, and the consequences of apartheid and racially and economically driven payment practices that contributed to heavy drinking in the region. Longer‐term follow‐up is needed to determine potential environmental and other moderators of the brain findings here and assess the extent to which they endure over time.

The onset of the COVID-19 pandemic created various challenges for individuals and families across the globe. Many countries went into a state of disaster and applied strict lockdown regulations to limit the spread of the novel coronavirus. Although the sudden changes in livelihoods impacted families globally, this research is limited to understanding how families connected and resolved conflict during the pandemic. The current study therefore aimed at exploring how family dynamics and resilience in South African families were affected by the COVID-19 pandemic. This study was conducted qualitatively in the Western Cape, South Africa, with 31 participants. The results indicated that families in the Western Cape had trouble adjusting to the imposed restrictions; however, some of these families used the time they had together to adapt and find new ways of building their relationships and strengthening their bonds. The main themes indicated that the most difficult challenges were the children’s schooling, financial impact from job losses, and separation from extended family members due to restrictions on movement. Furthermore, familial support and connecting as a family through open and honest communication helped the families remain resilient and fostered positive relationships.

ObjectiveThe aim of this pilot study was to assess associations of prenatal alcohol exposure (PAE), prenatal tobacco exposure (PTE), and their interaction and quantity on subsequent cortical and subcortical measures at age 6 years.MethodsMothers with varying levels and timing of alcohol and tobacco exposures in pregnancy were approached when their children (born participating in the Safe Passage Study) were approximately 6 years old. 72 mothers agreed to participate, and 51 children completed brain magnetic resonance imaging (MRI). Linear regression was used to identify associations between PAE, PTE, and their interaction with cortical (n = 68 ROIs) and subcortical (n = 40 ROIs) measures. Brain regions of interest, that were significantly associated prior to multiple comparison testing, were examined for associations related to exposure quantity, frequency, and timing (QFT), to explore how patterns of PAE and PTE influence brain outcomes in children.ResultsPrior to correction for multiple comparison testing, both PAE and PTE, as well as their interaction, were associated with a range of cortical and subcortical measures. However, none of these findings survived correction for multiple comparisons. Nevertheless, when exploring quantity of PAE, the total amount of standard drinks consumed during pregnancy and the average number of drinks per drinking day were individually and positively associated with cortical volume in the right fusiform gyrus.ConclusionThese trend results in this pilot study provide preliminary evidence that PAE impacts brain development in unique ways from PTE, and their interactive co-exposure is not a straight forward synergistic or additive effect on the brain.

There is strong evidence that dropping out of school has short-term and long-term effects for the individual, the family, the community, and other strata in society. In South Africa, learners dropping out of school has increased. The link between intention, motivation, and self-efficacy to drop out of school is an understudied area of research. The study aimed to determine the relationship between learners’ intention, motivation, and self-efficacy to drop out of low and high socio-economic schools. A quantitative methodological approach with a cross-sectional design was utilised. Participant’s selection included high school learners in Grades 9 and 11, at both high and low socio-economic public schools in the Western Cape, in South Africa. Most participants were female (51.2%), with a mean age of 16 years, attending schools in resource-constrained communities (50.1). Data was analysed using an independent t-test to assess a significant difference between learners in low and high socio-economic communities. Findings showed that many learners in high socio-economic schools hardly considered dropping out of school, whereas the opposite was true for learners in resource-constrained schools. Family challenges were often cited as a major reason for dropping out of school. The differences between the two groups of learners were significant.